Management Questions Research Articles

Performance of plantain pastures on Tararua dairy farms

Based on the published benefits of narrow-leaved plantain for reducing nitrogen leaching losses in grazed pasture systems, dairy farmers in the Tararua District implemented a development programme to increase plantain in the diet of cows. To address key establishment and management questions posed by dairy farmers, an associated pasture monitoring programme commenced in autumn 2019. The inclusionof plantain at levels of >30% of harvested dry matter (autumn-measured) in perennial ryegrass/white clover pastures significantly improved annual herbage accumulation (+12%). Herbage accumulation of pure plantain and plantain-white clover pastures was not significantly different from established perennial ryegrass/white clover pastures. Forage quality was high in all pasture that included plantain and decreased only slightly in swards with high plantain content. In grass-based pastures, the greatest plantain content after a year was achieved when sown in a new pasture mix in autumn. However, the plantain content of all pastures declined with time regardless of establishment method and was typically <10% after two years. Dairy farmers can have confidence that the use of plantain in pastures will be unlikely to result in a reduction inforage quantity or quality, but the need to find ways to maintain plantain content over time remains, in order to realise the benefits for forage supply and N leaching.

Perspectives of Health Care Personnel on the Benefits of Bronchiolitis Interventions.

Many interventions in bronchiolitis are low-value or poorly studied. Inpatient bronchiolitis management is multidisciplinary, with varying degrees of registered nurse (RN) and respiratory therapist (RT) autonomy. Understanding the perceived benefit of interventions for frontline health care personnel may facilitate deimplementation efforts. Our objective was to examine perceptions surrounding the benefit of common inpatient bronchiolitis interventions. We conducted a cross-sectional survey of inpatient pediatric RNs, RTs, and physicians/licensed practitioners (P/LPs) (eg, advanced-practice practitioners) from May to December of 2021 at 9 university-affiliated and 2 community hospitals. A clinical vignette preceded a series of inpatient bronchiolitis management questions. A total of 331 surveys were analyzed with a completion rate of 71.9%: 76.5% for RNs, 57.4% for RTs, and 71.2% for P/LPs. Approximately 54% of RNs and 45% of RTs compared with 2% of P/LPs believe albuterol would be "extremely or somewhat likely" to improve work of breathing (P < .001). Similarly, 52% of RNs, 32% of RTs, and 23% of P/LPs thought initiating or escalating oxygen in the absence of hypoxemia was likely to improve work of breathing (P < .001). Similar differences in perceived benefit were observed for steroids, nebulized hypertonic saline, and deep suctioning, but not superficial nasal suctioning. Hospital type (community versus university-affiliated) did not impact the magnitude of these differences. Variation exists in the perceived benefit of several low-value or poorly studied bronchiolitis interventions among health care personnel, with RNs/RTs generally perceiving higher benefit. Deimplementation, educational, and quality improvement efforts should be designed with an interprofessional framework.

Can antidepressant use be associated with emotional blunting in a subset of patients with depression? A scoping review of available literature.

Despite frequent recognition of emotional blunting in the published literature, either as a primary symptom of depression or as an adverse effect of antidepressants, there is no systematic synthesis on this topic to our knowledge. We undertook this scoping review to assess the prevalence, clinical features, implicated causes and management of emotional blunting, outlining the phenomenological and clinical gaps in research. A systematic search was done until March 15, 2022, to include all original studies (i.e., interventional trials, cohort & cross-sectional studies, case reports, and case series). All reviewed data were delineated to answer pertinent clinical, phenomenological, and management questions related to the phenomenon of emotional blunting. A total of 25 original studies were included in our scoping review. Emotional blunting was described as a persistent diminution in both positive and negative feelings in depressed patients, who could subjectively differentiate it from their acute symptoms. However, the literature lacked the distinction between emotional blunting as a primary symptom of depression or an adverse effect of antidepressants. Common clinical strategies to manage antidepressant-induced emotional blunting included dose reduction or switching to a different antidepressant. Emotional blunting was a significant patient-reported concern with antidepressants. Future research should clarify phenomenological and neurobiological constructs underlying emotional blunting to improve diagnostic and management skills.

Transport chains in the time of the Egyptian Pharaohs: a still unknown organizational efficiency

The Egypt of the Pharaohs has been the subject of a huge deal of research by historians, archaeologists, and engineering specialists over the past decades. The construction of immense pyramids is largely the focus of attention insofar as it bears witness to the human genius capable of erecting monuments that have survived the millennia. The question of the logistics management involved in these majestic constructions is still little known, or at least rarely addressed. It is however undeniable that without a perfect organization of transport chains, the construction of the pyramids could not have been achieved. This article uses the example of the Great Pyramid of Giza to illustrate this point, the importance of which must be recognized by researchers specializing in management science.

Development of a Project Management System, Case Study: FUTA Step-B Center of Excellence on Food Security

In this research, we model a project management system for FUTA Step-B and other management programme by using non-learning data structure which makes the data encryption easy, fully secure and time efficient. We devise a method that relies on Earned Value Management (EVM) to solve management questions for efficient forecasting that can be used to control the problem of under budget or over budget and predictive accuracy of each model was calculated. Evaluating this method on Science and Technology Education at the Post-Basic Level (STEP-B) project of the Federal University of Technology Akure (FUTA), we demonstrated its effectiveness with different interfaces which cover all sections and activities with functions to perform. The result obtained shows that the predictive accuracy is good with low error rate in under budget within the data present in our database. Also, with the result generated there is a need to keep control on the project schedule in order to control under budget or over budget rate. The system was implemented using C++ and visual studio 2008.

Egyptian evidence-based consensus on clinical practice recommendations for the management of Kawasaki disease

BackgroundKawasaki disease (KD) is an acute, self-limited febrile disease of unidentified cause that mostly affects children less than 5 years of age. This work aimed to provide an appropriate Egyptian evidence-based consensus on clinical practice recommendations for the management of Kawasaki disease. The main objective of this study, which employed the Delphi method, was to reach a consensus among experts on a treat-to-target management approach for KD.ResultsThe expert panel was confined to an online survey (n=26), and all the expert completed the three rounds. At the conclusion of round 3, a total of 17 recommendation items were gathered, which were divided into two sections. The range of respondents (ranks 7–9) who agreed with the recommendations was 92.3 to 100%. All 17 clinical standards identified by the scientific committee were written in the same way. There have been algorithms proposed for managing various KD conditions.ConclusionThe developed evidence-based consensus recommendations for the diagnosis and management of KD represent an up-to-date document that focuses on clinical management questions which are generally posed to health care professionals involved in the management of KD. This guideline was developed considering experience with and availability of treatment and diagnostic options in Egypt.

Re-Reading Deming’s 14 Points in the Era of Data Science: 14 Questions for Vibrant Management of Statistical Information Systems

This article is based on the Deming Lecture presented at the 2018 Joint Statistical Meetings and reconsiders the "14 Points" on management that were developed by W. Edwards Deming and suggests that these points reflect fundamental concepts and principles that can offer important insights for the statistical community as it responds to these opportunities and challenges related to improvement of the quality, integrity, and societal value of statistical information. The concepts un-derlying Deming's 14 Points can provide a useful lens for considering a wide range of management opportunities and challenges that arise in many complex organizations, especially those that produce or use statistical information.

Reeling in complement in transplant-associated thrombotic microangiopathy: You're going to need a bigger boat.

Over the last decade there have been numerous advances in both the diagnosis and treatment of transplant-associated thrombotic microangiopathy (TA-TMA). These are largely the result of an improved understanding of complement activation in TA-TMA and the ability to prevent end organ injury and death with timely initiation of complement-blocking therapies. In this article, we review our current understanding of the pathophysiology of TA-TMA, particularly as it pertains to complement activation, endothelial injury, and clinical management. We then review novel complement-blocking therapies that are currently under investigation for use in TA-TMA, as well as discuss special considerations for complement-blocking therapy in hematopoietic stem cell transplant recipients. Through these reviews we aim to answer or at least provide an educated discussion on the most commonly posed TA-TMA management questions and dilemmas.

The effect of co-patenting as a form of knowledge meta-integration on technological differentiation at Siemens

PurposeThe paper proposes an answer to one of the most important questions in corporate innovation management: what mechanisms of technological diversification exist within multinational companies? It is ascertained that research and development (R&amp;D) intra-firm co-invention or co-patenting is one of those mechanisms. Co-invention implies knowledge-sharing, which should lead to unique combinations of knowledge and expertise and hence technological diversification of patent applications.Design/methodology/approachThis paper offers a novel conceptual framework exploring the relationship between patents’ technological diversification and a detailed classification of different forms of international co-invention. Based on the case of Siemens’ Patent Cooperation Treaty (PCT) applications, the revealed technological advantage (RTA) index is utilized to measure the extent of the technological diversification of patent output.FindingsThe results show that patent applications generated by subsidiaries in advanced economies in cooperation with other subsidiaries feature unique technological areas that deviate from the company's overall technological specializations. These results provide a strong argument in favor of inter-subsidiary or horizontal co-patenting as a mechanism of new knowledge creation.Research limitations/implicationsOn the conceptual level, the results accentuate inter-subsidiary patenting being an important mechanism of knowledge meta-integration boosting technological diversification. The obvious limitation of this paper lies in exploring a single company case, which restricts the generalizability of our findings. Due to the dynamic nature of technological change, the author’s dataset also suffers from a lack of temporal external validity. Future research can expand the scope in both regards in applying our co-invention mode typology.Practical implicationsBased on the results, to diversify knowledge portfolio, companies should strengthen the co-patenting effort and reinforce horizontal (inter-subsidiary) R&amp;D collaborations.Originality/valueTo the author’s knowledge, this is the first time when such a nuanced typology of co-invention modes is being utilized to understand the effect of different co-invention categories on knowledge diversification.

Study of Modifications Induced by Continued Direct Oral Anticoagulant Therapy during Atrial Fibrillation Ablation Procedures on Standard Hemostasis Parameters

Unfractionated heparin (UFH) is used as an anticoagulant during the atrial fibrillation (AF) ablation procedure to prevent the occurrence of thromboembolic events. Guidelines recommend an activated clotting time (ACT) greater than 300 s (s) based on studies of patients treated with vitamin K antagonist (VKA) for their AF. However, direct oral anticoagulants (DOACs) have supplanted VKAs in AF and are now used as first-line therapy. It is recommended not to interrupt them during the procedure, which could interfere with the ACT measures. To assess the real-life relationship between ACT, DOAC concentrations, and UFH anti-Xa activity in patients treated by uninterrupted DOAC therapy. We conducted a single-center retrospective study. We analyzed consecutive patients with AF who underwent catheter ablation under DOAC therapy. In total, 40 patients were included, including 15 (37.5%), 20 (50.0%), and 5 (12.5%) on rivaroxaban, apixaban, and dabigatran, respectively. Baseline ACT was significantly lower in the apixaban group. ACT was linearly correlated with the residual concentration of apixaban and dabigatran but not with rivaroxaban. After UFH injection, ACT was linearly correlated with the anti-Xa activity, regardless of DOAC. Patients in the apixaban group received a higher total dose of UFH during the procedure to achieve a target ACT > 300 s, which resulted in significantly higher anti-Xa activity during the procedure. Our results raise the question of optimal management of intra-procedural heparin therapy and highlight the limitations of the ACT test, particularly in patients on apixaban.

Combining Statewide Surveys and Classification to Support Management of Streams

Data from agency‐based inventory programs could be very useful for local fishery management if appropriately summarized and served, but data are often accessible to few. Fundamental management questions at regional and local scales center around resource status and trends, highlighting the need for decision support tools operating at multiple scales. As stream classifications are developed for regions, survey programs become standardized, and innovations for serving spatially and temporally extensive data publicly become common, opportunities arise for developing locally relevant management decision support tools. We describe simple public‐facing tools that use information from a statewide stream inventory program to increase understanding of local and regional trends in important fish populations, describe benchmark conditions for all stream types at various spatial scales, and provide empirical support for local and broader scale management of stream fishes and habitat. We provide examples demonstrating their utility to encourage development of similar tools elsewhere.

Investigating the disruptiveness of the sharing economy at the individual consumer level: How consumer reflexivity drives re-engagement in sharing.

The sharing economy represents an emerging technology-enabled socioeconomic system. Given its disruptive nature, the sharing economy not only challenges traditional marketing theories but also alters consumer norms and beliefs related to consumption concepts. Whether, when, and how the sharing economy transforms consumption remain important questions for managers to investigate. This study examines how sharing experiences influence consumers' critical self-reflection and shape their intentions to re-engage in sharing practices. With data collected fromtwo surveys and four experiments (including three pretests and one main study), we show that consumers' perceived economic utility, social value, and sustainability potential in the sharing economy influence their intentions to re-engage in sharing practices, thus forming a loyal customer base. In addition, consumer reflexivity mediates this effect. We also show that past experience with business-to-consumer sharing practices moderates the proposed mediating effect. Overall, we demonstrate the disruptive impact of the sharing economy on individual consumers with meaningful managerial implications and contributions to marketing theories.

New public management in U.S. higher education: is privatization associated with lower costs?

ABSTRACT This study investigates the application of the three-dimensional New Public Management (NPM) framework to the public higher education setting to examine the relationship between one of the NPM dimensions, privatization, and cost management at 159 public research institutions in the United States between 2005 and 2015. We develop four statistical measures to quantify privatization and find privatization is linked to lower costs as institutions increase the share of revenue from auxiliary enterprises and tuition and fees, but higher costs when increasing out-of-state first-year enrolment. This raises management questions about public higher education cost efficiency, access and DEI for in-state students.

Hunting or gathering? A comparison of reptile survey techniques suggests the survey aims should direct the monitoring method

ABSTRACT The choice of methods used for biodiversity assessments and monitoring are an important consideration for an effective inventory of species. There is little published data comparing trapping and active searching for reptile surveys. In this study we used data collected from 509 sites between 2000 and 2012 in Queensland's tropical savannas to examine the relative success of trapping versus searching for surveying reptiles. Sampling comprised pitfall and funnel trapping, and diurnal and nocturnal active searching within a 1-ha quadrat over a five-day period. We used summary data, mixed model regression and Chi-squared tests to examine variation in abundance, richness, and frequency in captures. A total of 167 species representing nine families were recorded from 9986 captures or observations (3127 records from pitfall traps, 1813 from funnel traps and 5046 from active searching). Our results indicated that different methods were more appropriate depending on taxa (i.e., pitfall trapping for terrestrial skinks, funnel traps for Elapids), its habit (i.e., pitfalls or active searching for fossorial species, active searching for arboreal species) or rarity (i.e., Typhlopidae). We conclude that multiple survey methods are required for a full inventory of species; however, using the most appropriate method that address specific management questions in relation to target species or taxa, the reptile's habit and different habitats being surveyed, should be a component in planning and approach to any research or monitoring.

Impact of COVID-19 on KPIs Development Focused on Inventory Turnover Ratio in Automotive Sector

Key Performance Indicators (KPIs) are the vital navigation instruments used by managers to understand whether their business is on a successful voyage or whether it is veering off the prosperous path. The right set of indicators will show the company performance and point out the areas which need attention. The impact of COVID-19 on today’s globally integrated automotive sector is significant. The management has focused on main questions like how to accelerate cost-out measures and optimize the working capital across the entity. One of the items that have started to be in the center of attention nowadays is a company’s inventory and its level and turnover time. Therefore concerning about this, the inventory management should be sensitive in terms of continuous production and cash flow. Important question for management is how to identify, prioritize and accelerate cost-out measures across the entity. Finding the way how to optimize of volume of inventory, working capital and identify the proper measures to deliver rapid, tangible cash-flow benefits should be consulted in each company on daily basis.

Quantifying spatial characteristics of the Bowhead Whale Aerial Survey Project (BWASP) survey design

The Bowhead Whale Aerial Survey Project (BWASP) has been conducted annually since 1979 in the Alaskan Beaufort Sea to monitor the distribution and relative abundance of the Bering-Chukchi-Beaufort (BCB) stock of bowhead whales (Balaena mysticetus) during their autumn migration. BWASP was created to specifically address broad-scale research and management questions related to bowhead whale ecology, with particular interest in the potential effects of oil and natural gas exploration, development and production activities on the BCB bowhead whales. With elevated concerns about climate change, increasing oil and gas activities and the forecasted increase in vessel traffic, it is expected that interest in the BWASP dataset will also increase in order to evaluate effects of these anthropogenic activities on BCB bowhead whales and indigenous whaling. The following analysis quantified the spatial characteristics of the BWASP survey design and provided guidelines for the types of investigations that the BWASP data can potentially address. Sampling lags (transect spacing) in the BWASP survey design of approximately 20km along the east/west axis of the study area limit the spatial scale of phenomena that can be detected using data from a single BWASP survey. Therefore, BWASP data are relatively uninformative for studying variability in distribution or relative abundance along the east/west axis over short time scales (one survey) and within small areas measuring less than approximately 20km. In addition, computer simulations showed spatial heterogeneity in the long-term survey coverage probability (the probability that a given location will be included in a survey having an assumed effective search width under the BWASP survey design). Pooled transects created from simulated surveys resulted in a repeating diamond pattern in which coverage probability was low. Analyses incorporating data from many BWASP surveys should account for this spatial heterogeneity, via either the survey coverage probabilities or quantification of survey effort; otherwise estimates of variables such as relative density, density, or habitat use may be biased. The BWASP surveys have increased understanding of the broad-scale patterns of bowhead distribution, relative abundance and behaviour. The utility of this dataset in informing other questions will depend upon the scale of the ecological phenomena under investigation and the analytical scales used to address the questions.

Structured Decision Making to Prioritize Regional Bird Monitoring Needs

Conservation planning for large ecosystems has multiple benefits but is often challenging to implement because of the multiple jurisdictions, species, and habitats involved. In addition, decision making at large spatial scales can be hampered because many approaches do not explicitly incorporate potentially competing values and concerns of stakeholders. After the Deepwater Horizon oil spill, establishing baselines was challenging because of (1) variation in study designs, (2) inconsistent use of explicit objectives and hypotheses, (3) inconsistent use of standardized monitoring protocols, and (4) variation in spatial and temporal scope associated with avian monitoring projects before the spill. Herein, we show how the Gulf of Mexico Avian Monitoring Network members used structured decision making to identify bird monitoring priorities. We used multiple tools and techniques to clearly define the problem and stakeholder objectives and to identify bird monitoring priorities at the scale of the entire northern Gulf of Mexico region. Although our example is specific to the northern Gulf of Mexico, this approach provides an example of how stakeholder values can be incorporated into the coordination process of broad-scale monitoring programs to address management, restoration, and scientific questions in other ecosystems and for other taxa. History: This paper was refereed. This paper was accepted for the Special Issue of INFORMS Journal on Applied Analytics—Decision Analysis. Funding: Thanks to the National Fish and Wildlife Foundation [Grant 324423], which supported A. Fournier as a postdoctoral research associate at Mississippi State University. M. Woodrey was supported by the U.S. Department of Agriculture, National Institute of Food and Agriculture, Hatch Project funds, the Mississippi Agricultural and Forestry Experiment Station, National Oceanographic and Atmospheric Administration [Grant NA16NOS4200088 to the Mississippi Department of Marine Resources’ Grand Bay National Estuarine Research Reserve], and the Mississippi Department of Marine Resources [Grant 8200025414]. This publication is a contribution of the Mississippi Agricultural and Forestry Experiment Station. T. Zenzal was supported by the National Oceanic and Atmospheric Administration RESTORE Act Science Program [Grant NA17NOS4510092].

Improving the methodology for assessing models of public debt management in Kazakhstan

One of the macroeconomic instruments of state activity is the public debt. For the stable functioning of the state, the fulfillment of all strategic goals and the fulfillment of obligations assumed, the state attracts borrowed funds, distributing them to finance the relevant budget expenditure items. The state of public finances is influenced by numerous parameters of the country's macroeconomic policy, including, of course, the level of public debt, the policy of the state in terms of its management. In world practice, the use of government borrowing is widespread to ensure a balance of budget revenues and expenditures. State borrowing is inherent in all countries of the world, and this is the norm in current realities, and the Republic of Kazakhstan is no exception. The amount of public debt varies significantly from country to country. In some states, this is a significant ratio of public debt to GDP, while in others it is low. In this regard, the question of effective management of public debt and the impact of public debt on the economic security of the country logically arises. Effective public debt management assumes that the state has the ability to control the volume of its debt obligations, the main parameters of financial stability, such as the stability of the stock and financial markets, regulate economic processes, as well as establish the necessary norms and rules for the functioning of public debt.

Urethral management after artificial urinary sphincter explantation due to cuff erosion.

The artificial urethral sphincter (AUS) is the gold standard treatment in cases of moderate-to-severe stress urinary incontinence in males. Cuff erosions are one of the most important distant complications of AUS implantation. The optimal urethral management has still not been established. Search terms related to 'urethral stricture', 'artificial urinary sphincter', and 'cuff erosion' were used in the PubMed database to identify relevant articles. In this mini review we identified 6 original articles that assessed the urethral management after AUS explantation due to cuff erosion and included urinary diversion by transurethral and/or suprapubic catheterization, urethrorrhaphy, and in situ urethroplasty. We summarized the results of different management methods and their efficacy in terms of preventing urethral stricture formation. We highlight the need for better-quality evidence on this topic. The available data do not provide a clear answer to the question of optimal urethral management during AUS explantation. There is a great need to provide higher-quality evidence on this topic.

Treatment of patients with periprosthetic infection

The review article presents the main questions of pathogenesis, early diagnosis, and surgical management of patients with paraprosthetic infection that developed after surgery for fractured limb bones and deforming arthrosis. The main factors that influenced the occurrence of purulent complications and the ways of their prevention, treatment, taking into account the current ideas about wound infection, are indicated. Pathogenetic mechanisms of paraprosthetic infection development are directly related to the presence of hematoma in the operated joint. Risk factors for large joint arthroplasty can be divided into three conditional types: general and local patient status; conditions for the operation; features of surgery. To detail the risk factors associated with the general or local status of the patient, two subtypes are highlighted — primary and secondary. The main subtype includes: 1) focus infection, located in the operated joint; 2) focus infection, located in the paraarticular tissues of the operated joint; 3) generalization of the infectious process — sepsis. The additional subtype includes: 1) history of previous joint surgery; 2) critical changes in body mass index; 3) uncontrolled diabetes mellitus; 4) presence of systemic diseases associated with prolonged administration of glucocorticosteroids and cytostatics and others. Two-stage revision endoprosthesis in patients with chronic periprosthetic infection is the gold standard to date. In many ways, the success of treatment depends on the correctness of all stages, on the adequacy of diagnostic measures, the scrupulousness of compliance with surgical technique and is determined by the surgeon’s experience, as well as the equipment of the hospital.