[Factors conditioning primary care services utilization. Empirical evidence and methodological inconsistencies].

PubMed

Sáez, M

2003-01-01

In Spain, the degree and characteristics of primary care services utilization have been the subject of analysis since at least the 1980s. One of the main reasons for this interest is to assess the extent to which utilization matches primary care needs. In fact, the provision of an adequate health service for those who most need it is a generally accepted priority. The evidence shows that individual characteristics, mainly health status, are the factors most closely related to primary care utilization. Other personal characteristics, such as gender and age, could act as modulators of health care need. Some family and/or cultural variables, as well as factors related to the health care professional and institutions, could explain some of the observed variability in primary care services utilization. Socioeconomic variables, such as income, reveal a paradox. From an aggregate perspective, income is the main determinant of utilization as well as of health care expenditure. When data are analyzed for individuals, however, income is not related to primary health utilization. The situation is controversial, with methodological implications and, above all, consequences for the assessment of the efficiency in primary care utilization. Review of the literature reveals certain methodological inconsistencies that could at least partly explain the disparity of the empirical results. Among others, the following flaws can be highlighted: design problems, measurement errors, misspecification, and misleading statistical methods.Some solutions, among others, are quasi-experiments, the use of large administrative databases and of primary data sources (design problems); differentiation between types of utilization and between units of analysis other than consultations, and correction of measurement errors in the explanatory variables (measurement errors); consideration of relevant explanatory variables (misspecification); and the use of multilevel models (statistical methods).

Diabetes Care Management Teams Did Not Reduce Utilization When Compared With Traditional Care: A Randomized Cluster Trial.

PubMed

Kearns, Patrick

2017-10-01

PURPOSE: Health services research evaluates redesign models for primary care. Care management is one alternative. Evaluation includes resource utilization as a criterion. Compare the impact of care-manager teams on resource utilization. The comparison includes entire panes of patients and the subset of patients with diabetes. DESIGN: Randomized, prospective, cohort study comparing change in utilization rates between groups, pre- and post-intervention. METHODOLOGY: Ten primary care physician panels in a safety-net setting. Ten physicians were randomized to either a care-management approach (Group 1) or a traditional approach (Group 2). Care managers focused on diabetes and the cardiovascular cluster of diseases. Analysis compared rates of hospitalization, 30-day readmission, emergency room visits, and urgent care visits. Analysis compared baseline rates to annual rates after a yearlong run-in for entire panels and the subset of patients with diabetes. RESULTS: Resource utilization showed no statistically significant change between baseline and Year 3 (P=.79). Emergency room visits and hospital readmission increased for both groups (P=.90), while hospital admissions and urgent care visits decreased (P=.73). Similarly, utilization was not significantly different for patients with diabetes (P=.69). CONCLUSIONS: A care-management team approach failed to improve resource utilization rates by entire panels and the subset of diabetic patients compared to traditional care. This reinforces the need for further evidentiary support for the care-management model's hypothesis in the safety net.

Methodological and Epistemological Considerations in Utilizing Qualitative Inquiry to Develop Interventions.

PubMed

Duggleby, Wendy; Williams, Allison

2016-01-01

The purpose of this article is to discuss methodological and epistemological considerations involved in using qualitative inquiry to develop interventions. These considerations included (a) using diverse methodological approaches and (b) epistemological considerations such as generalization, de-contextualization, and subjective reality. Diverse methodological approaches have the potential to inform different stages of intervention development. Using the development of a psychosocial hope intervention for advanced cancer patients as an example, the authors utilized a thematic study to assess current theories/frameworks and interventions. However, to understand the processes that the intervention needed to target to affect change, grounded theory was used. Epistemological considerations provided a framework to understand and, further, critique the intervention. Using diverse qualitative methodological approaches and examining epistemological considerations were useful in developing an intervention that appears to foster hope in patients with advanced cancer. © The Author(s) 2015.

Time management problems and discounted utility.

PubMed

König, Cornelius J; Kleinmann, Martin

2007-05-01

The lens of behavioral decision theory offers a new perspective for research on time management. The basic idea of this approach is that people discount future consequences of their time management decisions, meaning that they work on tasks with smaller but sooner outcomes rather than on tasks with larger but later outcomes. The authors performed 2 experimental studies to test whether people are sensitive to differences in the discounted utility of time management decisions. In Experiment 1, they used vignettes of typical time management situations; Experiment 2 was a laboratory simulation (an in-basket task that was part of a training assessment). Participants in both studies were German students. As expected, manipulating the discounted utility of options resulted in different time management decisions. In Experiment 1, reactions to time management situations were judged as less likely if the reactions had lower discounted utilities. In Experiment 2, people spent less time on an interruption.

Tribal water utility management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-03-01

Contents: primacy program (what is primacy, advantages and disadvantages, treatment as a state, grant applications and funding); safe drinking water act (sampling requirements, coliform standard, public notification, surface water treatment rule impacts, uic and wellhead protection programs, lead/copper rule); water utility management (how is the utility program evaluated, who's responsible, what is the board and tribal council role).

Risk Assessment Methodology for Hazardous Waste Management (1998)

EPA Pesticide Factsheets

A methodology is described for systematically assessing and comparing the risks to human health and the environment of hazardous waste management alternatives. The methodology selects and links appropriate models and techniques for performing the process.

Variables contributing to an excellent customer service management profile within the regulated electric utility industry: A comparison of self-concept with customer satisfaction for customer service management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, L.E.

1991-01-01

This research sought to address the relationship between self-concept and customer satisfaction: can customer satisfaction with a major electric utility be explained in terms of the self-reported, self-concept of the utility's managers The population to which the results of this study were generalized consisted of customer service managers in public electric utilities across the United States. In order to represent this population, a sample was selected consisting of customer service managers at a midwestern electric utility based in a large metropolitan area. Participants in this study were managers of four direct customer contact service organizations within six geographic division organizations.more » The methodology included comparisons of these four customer contact service organizations on twelve independent, self-concept variables and six customer satisfaction dependent variables using Analysis of Variance (ANOVA), Scheffe' tests, Chi-Square, and Stepwise multiple regression. The groups were found not to be significantly different and knowledge of the self-concept scores for managers will not increase the ability to predict customer satisfaction over no knowledge of self-concept scores.« less

Technology Transfer and Utilization Methodology; Further Analysis of the Linker Concept.

ERIC Educational Resources Information Center

Jolly, James A.; Creighton, J. W.

This study is based on a comparison of data from two independent studies of technology utilization and dissemination methodology that sought to identify the behavior characteristics of "linkers" and "stabilizers" and their relative existence within different groups of technical personnel. Hypothesis for this study is that the…

A hybrid design methodology for structuring an Integrated Environmental Management System (IEMS) for shipping business.

PubMed

Celik, Metin

2009-03-01

The International Safety Management (ISM) Code defines a broad framework for the safe management and operation of merchant ships, maintaining high standards of safety and environmental protection. On the other hand, ISO 14001:2004 provides a generic, worldwide environmental management standard that has been utilized by several industries. Both the ISM Code and ISO 14001:2004 have the practical goal of establishing a sustainable Integrated Environmental Management System (IEMS) for shipping businesses. This paper presents a hybrid design methodology that shows how requirements from both standards can be combined into a single execution scheme. Specifically, the Analytic Hierarchy Process (AHP) and Fuzzy Axiomatic Design (FAD) are used to structure an IEMS for ship management companies. This research provides decision aid to maritime executives in order to enhance the environmental performance in the shipping industry.

Controlling inpatient psychiatric utilization through managed care.

PubMed

Wickizer, T M; Lessler, D; Travis, K M

1996-03-01

There is little current understanding of how managed care strategies affect hospital inpatient psychiatric care for mentally ill patients. This study examined one prominent form of managed care, utilization management, which reviews requests for psychiatric care and authorizes provision of care deemed appropriate and clinically necessary. The authors analyzed data on 2,265 utilization management reviews conducted during 1989-1992 for patients insured by a single large commercial insurance company. Three utilization management procedures were examined: preadmission review, continued-stay review, and case management. The performance indicators analyzed included percent of admission requests granted, number of days requested and approved, and number of treatment extensions granted. Utilization management initially approved inpatient psychiatric treatment for nearly all (98.8%) of the patients but authorized, on average, only one-third of the days requested (6.9 versus 19.0). On average, 23.5 (total) days of care were requested and 16.8 days were approved. Care for patients with alcohol or drug dependence diagnoses was more restricted than was care for other patients. These data suggest that managed care does restrict inpatient psychiatric care, primarily by managing length of stay. The fact that almost all patients were approved for the same initial length of stay implies adherence to strict treatment protocols that do not distinguish among different clinical or patient factors. There is a need for careful study of the effects of managed care on outcomes and quality of psychiatric care.

Does Methodological Guidance Produce Consistency? A Review of Methodological Consistency in Breast Cancer Utility Value Measurement in NICE Single Technology Appraisals.

PubMed

Rose, Micah; Rice, Stephen; Craig, Dawn

2018-06-01

Since 2004, National Institute for Health and Care Excellence (NICE) methodological guidance for technology appraisals has emphasised a strong preference for using the validated EuroQol 5-Dimensions (EQ-5D) quality-of-life instrument, measuring patient health status from patients or carers, and using the general public's preference-based valuation of different health states when assessing health benefits in economic evaluations. The aim of this study was to review all NICE single technology appraisals (STAs) for breast cancer treatments to explore consistency in the use of utility scores in light of NICE methodological guidance. A review of all published breast cancer STAs was undertaken using all publicly available STA documents for each included assessment. Utility scores were assessed for consistency with NICE-preferred methods and original data sources. Furthermore, academic assessment group work undertaken during the STA process was examined to evaluate the emphasis of NICE-preferred quality-of-life measurement methods. Twelve breast cancer STAs were identified, and many STAs used evidence that did not follow NICE's preferred utility score measurement methods. Recent STA submissions show companies using EQ-5D and mapping. Academic assessment groups rarely emphasized NICE-preferred methods, and queries about preferred methods were rare. While there appears to be a trend in recent STA submissions towards following NICE methodological guidance, historically STA guidance in breast cancer has generally not used NICE's preferred methods. Future STAs in breast cancer and reviews of older guidance should ensure that utility measurement methods are consistent with the NICE reference case to help produce consistent, equitable decision making.

Methodology of management of dredging operations II. Applications.

PubMed

Junqua, G; Abriak, N E; Gregoire, P; Dubois, V; Mac Farlane, F; Damidot, D

2006-04-01

This paper presents the new methodology of management of dredging operations. Derived partly from existing methodologies (OECD, PNUE, AIPCN), it aims to be more comprehensive, mixing the qualities and the complementarities of previous methodologies. The application of the methodology has been carried out on the site of the Port of Dunkirk (FRANCE). Thus, a characterization of the sediments of this site has allowed a zoning of the Port to be established in to zones of probable homogeneity of sediments. Moreover, sources of pollution have been identified, with an aim of prevention. Ways of waste improvement have also been developed, to answer regional needs, from a point of view of competitive and territorial intelligence. Their development has required a mutualisation of resources between professionals, research centres and local communities, according to principles of industrial ecology. Lastly, a tool of MultiCriteria Decision-Making Aid (M.C.D.M.A.) has been used to determine the most relevant scenario (or alternative, or action) for a dredging operation intended by the Port of Dunkirk. These applications have confirmed the relevance of this methodology for the management of dredging operations.

Urban water infrastructure asset management - a structured approach in four water utilities.

PubMed

Cardoso, M A; Silva, M Santos; Coelho, S T; Almeida, M C; Covas, D I C

2012-01-01

Water services are a strategic sector of large social and economic relevance. It is therefore essential that they are managed rationally and efficiently. Advanced water supply and wastewater infrastructure asset management (IAM) is key in achieving adequate levels of service in the future, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution. This paper presents a methodology for supporting the development of urban water IAM, developed during the AWARE-P project as well as an appraisal of its implementation in four water utilities. Both water supply and wastewater systems were considered. Due to the different contexts and features of the utilities, the main concerns vary from case to case; some problems essentially are related to performance, others to risk. Cost is a common deciding factor. The paper describes the procedure applied, focusing on the diversity of drivers, constraints, benefits and outcomes. It also points out the main challenges and the results obtained through the implementation of a structured procedure for supporting urban water IAM.

Utilization Management in the Blood Transfusion Service

PubMed Central

Peña, Jeremy Ryan Andrew; Dzik, Walter “Sunny”

2015-01-01

The scope of activity of the Blood Transfusion Service (BTS) makes it unique among the clinical laboratories. The combination of therapeutic and diagnostic roles necessitates a multi-faceted approach to utilization management in the BTS. We present our experience in utilization management in large academic medical center. PMID:24080431

Identifying and managing inappropriate hospital utilization: a policy synthesis.

PubMed Central

Payne, S M

1987-01-01

Utilization review, the assessment of the appropriateness and efficiency of hospital care through review of the medical record, and utilization management, deliberate action by payers or hospital administrators to influence providers of hospital services to increase the efficiency and effectiveness with which services are provided, are valuable but relatively unfamiliar strategies for containing hospital costs. The purpose of this synthesis is to increase awareness of the scope of and potential for these approaches among health services managers and administrators, third-party payers, policy analysts, and health services researchers. The synthesis will assist the reader to trace the conceptual context and the historical development of utilization review from unstructured methods using individual physicians' professional judgment to structured methods using explicit criteria; to establish the context of utilization review and clarify its uses; to understand the concepts and tools used in assessing the efficiency of hospital use; and to select, design, and evaluate utilization review and utilization management programs. The extent of inappropriate (medical unnecessary) hospital utilization and the factors associated with it are described. Implications for managers, providers, and third-party payers in targeting utilization review and in designing and evaluating utilization management programs are discussed. PMID:3121538

Development of Management Methodology for Engineering Production Quality

NASA Astrophysics Data System (ADS)

Gorlenko, O.; Miroshnikov, V.; Borbatc, N.

2016-04-01

The authors of the paper propose four directions of the methodology developing the quality management of engineering products that implement the requirements of new international standard ISO 9001:2015: the analysis of arrangement context taking into account stakeholders, the use of risk management, management of in-house knowledge, assessment of the enterprise activity according to the criteria of effectiveness

Knowledge management performance methodology regarding manufacturing organizations

NASA Astrophysics Data System (ADS)

Istrate, C.; Herghiligiu, I. V.

2016-08-01

The current business situation is extremely complicated. Business must adapt to the changes in order (a) to survive on the increasingly dynamic markets, (b) to meet customers’ new request for complex, customized and innovative products. In modern manufacturing organizations it can be seen a substantial improvement regarding the management of knowledge. This occurs due to the fact that organizations realized that knowledge and an efficient management of knowledge generates the highest value. Even it could be said that the manufacturing organizations were and are the biggest beneficiary of KM science. Knowledge management performance (KMP) evaluation in manufacturing organizations can be considered as extremely important because without measuring it, they are unable to properly assess (a) what goals, targets and activities must have continuity, (b) what must be improved and (c) what must be completed. Therefore a proper KM will generate multiple competitive advantages for organizations. This paper presents a developed methodological framework regarding the KMP importance regarding manufacturing organizations. This methodological framework was developed using as research methods: bibliographical research and a panel of specialists. The purpose of this paper is to improve the evaluation process of KMP and to provide a viable tool for manufacturing organizations managers.

Calculating cost savings in utilization management.

PubMed

MacMillan, Donna

2014-01-01

A major motivation for managing the utilization of laboratory testing is to reduce the cost of medical care. For this reason it is important to understand the basic principles of cost accounting in the clinical laboratory. The process of laboratory testing includes three distinct components termed the pre-analytic, analytic and post-analytic phases. Utilization management efforts may impact the cost structure of these three phases in different ways depending on the specific details of the initiative. Estimates of cost savings resulting from utilization management programs reported in the literature have often been fundamentally flawed due to a failure to understand basic concepts such as the difference between laboratory costs versus charges and the impact of reducing laboratory test volumes on the average versus marginal cost structure in the laboratory. This article will provide an overview of basic cost accounting principles in the clinical laboratory including both job order and process cost accounting. Specific examples will be presented to illustrate these concepts in various different scenarios. © 2013.

A methodology to incorporate life cycle analysis and the triple bottom line mechanism for sustainable management of industrial enterprises

NASA Astrophysics Data System (ADS)

Wang, Ling; Lin, Li

2004-02-01

Since 1970"s, the environmental protection movement has challenged industries to increase their investment in Environmentally Conscious Manufacturing (ECM) techniques and management tools. Social considerations for global citizens and their descendants also motivated the examination on the complex issues of sustainable development beyond the immediate economic impact. Consequently, industrial enterprises have started to understand sustainable development in considering the Triple Bottom Line (TBL): economic prosperity, environmental quality and social justice. For the management, however, a lack of systematic ECM methodologies hinders their effort in planning, evaluating, reporting and auditing of sustainability. To address this critical need, this research develops a framework of a sustainable management system by incorporating a Life Cycle Analysis (LCA) of industrial operations with the TBL mechanism. A TBL metric system with seven sets of indices for the TBL elements and their complex relations is identified for the comprehensive evaluation of a company"s sustainability performance. Utilities of the TBL indices are estimated to represent the views of various stakeholders, including the company, investors, employees and the society at large. Costs of these indices are also captured to reflect the company"s effort in meeting the utilities. An optimization model is formulated to maximize the economic, environmental and social benefits by the company"s effort in developing sustainable strategies. To promote environmental and social consciousness, the methodology can significantly facilitate management decisions by its capabilities of including "non-business" values and external costs that the company has not contemplated before.

Economics of Red Pine Management for Utility Pole Timber

Treesearch

Gerald H. Grossman; Karen Potter-Witter

1991-01-01

Including utility poles in red pine management regimes leads to distinctly different management recommendations. Where utility pole markets exist, managing for poles will maximize net returns. To do so, plantations should be maintained above 110 ft2/ac, higher than usually recommended. In Michigan's northern lower peninsula, approximately...

Energy management of a university campus utilizing short-term load forecasting with an artificial neural network

NASA Astrophysics Data System (ADS)

Palchak, David

Electrical load forecasting is a tool that has been utilized by distribution designers and operators as a means for resource planning and generation dispatch. The techniques employed in these predictions are proving useful in the growing market of consumer, or end-user, participation in electrical energy consumption. These predictions are based on exogenous variables, such as weather, and time variables, such as day of week and time of day as well as prior energy consumption patterns. The participation of the end-user is a cornerstone of the Smart Grid initiative presented in the Energy Independence and Security Act of 2007, and is being made possible by the emergence of enabling technologies such as advanced metering infrastructure. The optimal application of the data provided by an advanced metering infrastructure is the primary motivation for the work done in this thesis. The methodology for using this data in an energy management scheme that utilizes a short-term load forecast is presented. The objective of this research is to quantify opportunities for a range of energy management and operation cost savings of a university campus through the use of a forecasted daily electrical load profile. The proposed algorithm for short-term load forecasting is optimized for Colorado State University's main campus, and utilizes an artificial neural network that accepts weather and time variables as inputs. The performance of the predicted daily electrical load is evaluated using a number of error measurements that seek to quantify the best application of the forecast. The energy management presented utilizes historical electrical load data from the local service provider to optimize the time of day that electrical loads are being managed. Finally, the utilization of forecasts in the presented energy management scenario is evaluated based on cost and energy savings.

Use of multiattribute utility theory for formulary management in a health system.

PubMed

Chung, Seonyoung; Kim, Sooyon; Kim, Jeongmee; Sohn, Kieho

2010-01-15

The application, utility, and flexibility of the multiattribute utility theory (MAUT) when used as a formulary decision methodology in a Korean medical center were evaluated. A drug analysis model using MAUT consisting of 10 steps was designed for two drug classes of dihydropyridine calcium channel blockers (CCBs) and angiotensin II receptor blockers (ARBs). These two drug classes contain the most diverse agents among cardiovascular drugs on Samsung Medical Center's drug formulary. The attributes identified for inclusion in the drug analysis model were effectiveness, safety, patient convenience, and cost, with relative weights of 50%, 30%, 10%, and 10%, respectively. The factors were incorporated into the model to quantify the contribution of each attribute. For each factor, a utility scale of 0-100 was established, and the total utility score for each alternative was calculated. An attempt was made to make the model adaptable to changing health care and regulatory circumstances. The analysis revealed amlodipine besylate to be an alternative agent, with the highest total utility score among the dihydropyridine CCBs, while barnidipine hydrochloride had the lowest score. For ARBs, losartan potassium had the greatest total utility score, while olmesartan medoxomil had the lowest. A drug analysis model based on the MAUT was successfully developed and used in making formulary decisions for dihydropyridine CCBs and ARBs for a Korean health system. The model incorporates sufficient utility and flexibility of a drug's attributes and can be used as an alternative decision-making tool for formulary management in health systems.

Integrated Management System - Scope, Possibilities And Methodology

NASA Astrophysics Data System (ADS)

Čekanová, Katarína

2015-06-01

Organizations are becoming more aware of the importance of integrated management systems (IMS). Interest in this subject indicates that IMS are seen as "management systems of the future". Based on this, the aim of this articles characterizes the possibility of building IMS through the identification of common elements and specific requirements in accordance with the ISO 9001, ISO 14001 and OHSAS 18001 professional references. Part of the article is the methodology of building IMS in the organization.

SLURM: Simple Linux Utility for Resource Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jette, M; Grondona, M

2002-12-19

Simple Linux Utility for Resource Management (SLURM) is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for Linux clusters of thousands of nodes. Components include machine status, partition management, job management, scheduling and stream copy modules. This paper presents an overview of the SLURM architecture and functionality.

SLURM: Simplex Linux Utility for Resource Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jette, M; Grondona, M

2003-04-22

Simple Linux Utility for Resource Management (SLURM) is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for Linux clusters of thousands of nodes. Components include machine status, partition management, job management, scheduling, and stream copy modules. This paper presents an overview of the SLURM architecture and functionality.

Management of health care expenditure by soft computing methodology

NASA Astrophysics Data System (ADS)

Maksimović, Goran; Jović, Srđan; Jovanović, Radomir; Aničić, Obrad

2017-01-01

In this study was managed the health care expenditure by soft computing methodology. The main goal was to predict the gross domestic product (GDP) according to several factors of health care expenditure. Soft computing methodologies were applied since GDP prediction is very complex task. The performances of the proposed predictors were confirmed with the simulation results. According to the results, support vector regression (SVR) has better prediction accuracy compared to other soft computing methodologies. The soft computing methods benefit from the soft computing capabilities of global optimization in order to avoid local minimum issues.

A Quantitative Examination of Critical Success Factors Comparing Agile and Waterfall Project Management Methodologies

ERIC Educational Resources Information Center

Pedersen, Mitra

2013-01-01

This study investigated the rate of success for IT projects using agile and standard project management methodologies. Any successful project requires use of project methodology. Specifically, large projects require formal project management methodologies or models, which establish a blueprint of processes and project planning activities. This…

SLURM: Simple Linux Utility for Resource Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jette, M; Dunlap, C; Garlick, J

2002-07-08

Simple Linux Utility for Resource Management (SLURM) is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for Linux clusters of thousands of nodes. Components include machine status, partition management, job management, scheduling and stream copy modules. The design also includes a scalable, general-purpose communication infrastructure. This paper presents a overview of the SLURM architecture and functionality.

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

Current decision making involves numerous possible combinations of technology elements, safety and health issues, operational aspects and process considerations to satisfy program goals. Identifying potential risk considerations as part of the management decision making process provides additional tools to make more informed management decision. Adapting and using risk assessment methodologies can generate new perspectives on various risk and safety concerns that are not immediately apparent. Safety and operational risks can be identified and final decisions can balance these considerations with cost and schedule risks. Additional assessments can also show likelihood of event occurrence and event consequence to provide a more informed basis for decision making, as well as cost effective mitigation strategies. Methodologies available to perform Risk Assessments range from qualitative identification of risk potential, to detailed assessments where quantitative probabilities are calculated. Methodology used should be based on factors that include: 1) type of industry and industry standards, 2) tasks, tools, and environment 3) type and availability of data and 4) industry views and requirements regarding risk & reliability. Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures.

A multicriteria-based methodology for site prioritisation in sediment management.

PubMed

Alvarez-Guerra, Manuel; Viguri, Javier R; Voulvoulis, Nikolaos

2009-08-01

Decision-making for sediment management is a complex task that incorporates the selections of areas for remediation and the assessment of options for any mitigation required. The application of Multicriteria Analysis (MCA) to rank different areas, according to their need for sediment management, provides a great opportunity for prioritisation, a first step in an integrated methodology that finally aims to assess and select suitable alternatives for managing the identified priority sites. This paper develops a methodology that starts with the delimitation of management units within areas of study, followed by the application of MCA methods that allows ranking of these management units, according to their need for remediation. This proposed process considers not only scientific evidence on sediment quality, but also other relevant aspects such as social and economic criteria associated with such decisions. This methodology is illustrated with its application to the case study area of the Bay of Santander, in northern Spain, highlighting some of the implications of utilising different MCA methods in the process. It also uses site-specific data to assess the subjectivity in the decision-making process, mainly reflected through the assignment of the criteria weights and uncertainties in the criteria scores. Analysis of the sensitivity of the results to these factors is used as a way to assess the stability and robustness of the ranking as a first step of the sediment management decision-making process.

Pathologists' roles in clinical utilization management. A financing model for managed care.

PubMed

Zhao, J J; Liberman, A

2000-03-01

In ancillary or laboratory utilization management, the roles of pathologists have not been explored fully in managed care systems. Two possible reasons may account for this: pathologists' potential contributions have not been defined clearly, and effective measurement of and reasonable compensation for the pathologist's contribution remains vague. The responsibilities of pathologists in clinical practice may include clinical pathology and laboratory services (which have long been well-defined and are compensated according to a resource-based relative value system-based coding system), laboratory administration, clinical utilization management, and clinical research. Although laboratory administration services have been compensated with mechanisms such as percentage of total service revenue or fixed salary, the involvement of pathologists seems less today than in the past, owing to increased clinical workload and time constraints in an expanding managed care environment, especially in community hospital settings. The lack of financial incentives or appropriate compensation mechanisms for the services likely accounts for the current situation. Furthermore, the importance of pathologist-driven utilization management in laboratory services lacks recognition among hospital administrators, managed care executives, and pathologists themselves, despite its potential benefits for reducing cost and enhancing quality of care. We propose a financial compensation model for such services and summarize its advantages.

Methodology for assessing the effectiveness of access management techniques : executive summary.

DOT National Transportation Integrated Search

1998-09-14

A methodology for assessing the effectiveness of access management techniques on suburban arterial highways is developed. The methodology is described as a seven-step process as follows: (1) establish the purpose of the analysis (2) establish the mea...

Individual patient's preferences for hypertension management: a Q-methodological approach.

PubMed

Morecroft, Charles; Cantrill, Judy; Tully, Mary P

2006-06-01

To systematically explore and elicit individual patient's preferences in the management of their hypertension using Q-methodology. Using Q-methodology, 120 patients ranking 42 statements according to their agreement or disagreement when considering appropriate hypertension management. The statements were derived from an earlier qualitative study. Factor analysis of the data was undertaken using PQMethod software to determine if any patterns were discernible. Ninety-two patients clustered to five factors, which all varied in the degree of involvement patients had, or wished to have, in their hypertension management. The 42 patients who loaded to factor 1 considered that appropriate antihypertensive treatment involved leaving medical decisions to their GPs and trusting their judgement in such matters. The patients (n = 31) who positively loaded to factor 2 suggested that an autonomous relationship with their healthcare professional(s) was an important issue when considering treatment. It is concluded that this study has successfully used Q-methodology to systematically investigate people's subjectivity and developed a novel approach to elicit the views of individual patients, as well as explore and differentiate between groups of patients. The formation of true partnerships between patients and healthcare professionals which will enhance individual patients' ability to self-manage chronic disease.

Propulsion integration of hypersonic air-breathing vehicles utilizing a top-down design methodology

NASA Astrophysics Data System (ADS)

Kirkpatrick, Brad Kenneth

In recent years, a focus of aerospace engineering design has been the development of advanced design methodologies and frameworks to account for increasingly complex and integrated vehicles. Techniques such as parametric modeling, global vehicle analyses, and interdisciplinary data sharing have been employed in an attempt to improve the design process. The purpose of this study is to introduce a new approach to integrated vehicle design known as the top-down design methodology. In the top-down design methodology, the main idea is to relate design changes on the vehicle system and sub-system level to a set of over-arching performance and customer requirements. Rather than focusing on the performance of an individual system, the system is analyzed in terms of the net effect it has on the overall vehicle and other vehicle systems. This detailed level of analysis can only be accomplished through the use of high fidelity computational tools such as Computational Fluid Dynamics (CFD) or Finite Element Analysis (FEA). The utility of the top-down design methodology is investigated through its application to the conceptual and preliminary design of a long-range hypersonic air-breathing vehicle for a hypothetical next generation hypersonic vehicle (NHRV) program. System-level design is demonstrated through the development of the nozzle section of the propulsion system. From this demonstration of the methodology, conclusions are made about the benefits, drawbacks, and cost of using the methodology.

Methodological challenges collecting parent phone-call healthcare utilization data.

PubMed

Moreau, Paula; Crawford, Sybil; Sullivan-Bolyai, Susan

2016-02-01

Recommendations by the National Institute of Nursing Research and other groups have strongly encouraged nurses to pay greater attention to cost-effectiveness analysis when conducting research. Given the increasing prominence of translational science and comparative effective research, cost-effective analysis has become a basic tool in determining intervention value in research. Tracking phone-call communication (number of calls and context) with cross-checks between parents and healthcare providers is an example of this type of healthcare utilization data collection. This article identifies some methodological challenges that have emerged in the process of collecting this type of data in a randomized controlled trial: Parent education Through Simulation-Diabetes (PETS-D). We also describe ways in which those challenges have been addressed with comparison data results, and make recommendations for future research. Copyright © 2015 Elsevier Inc. All rights reserved.

42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

Code of Federal Regulations, 2010 CFR

2010-10-01

... PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.153 Drug utilization... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE...

Load Management - Methods to Reduce Electric Utilities Peak Loads.

DTIC Science & Technology

1983-08-01

for electric utilities.1 The largest impact came in 1978 when the Public Utilities Regulatory Policies Act ( PURPA ) was enacted which required state...management option. 7 CHAPTER VII CONCLUSION Since PURPA was enacted in 1978, utilities have been required to investigate methods in which to more effectively

Impact of HMO ownership on management processes and utilization outcomes.

PubMed

Ahern, M; Molinari, C

2001-05-01

To examine the effects of health maintenance organization (HMO) ownership characteristics on selected utilization outcomes and management processes affecting utilization. We used 1995 HMO data from the American Association of Health Plans. Using regression analysis, we examined the relation between HMO utilization (hospital discharges, days, and average length of stay; cardiac catheterization procedures; and average cost of outpatient prescriptions) and the structural characteristics of HMOs: ownership type (insurance company, hospital, physician, independent, and national managed care company), HMO size, for-profit status, model type, geographic region, and payer mix. HMO ownership type is significantly associated with medical management processes, including risk sharing by providers, risk sharing by consumers, and other management strategies. Relative to hospital-owned HMOs, insurance company-owned HMOs have fewer hospital discharges, fewer hospital days, and longer lengths of stay. National managed care organization-owned HMOs have fewer cardiac catheterizations and lower average outpatient prescription costs. Independently owned HMOs have more cardiac catheterizations. For-profit HMOs have lower prescription costs. Relative to hospital-owned HMOs, insurance company-owned HMOs are more likely to use hospital risk sharing and provider capitation and less likely to use out-of-pocket payments for hospital use and a closed formulary. National managed care organization-owned HMOs are less likely to use provider capitation, out-of-pocket payments for hospital use, catastrophic case management, and hospital risk sharing. Physician-hospital-owned HMOs are less likely to use catastrophic case management. For-profit HMOs are more likely to use hospital risk sharing and catastrophic case management. HMO ownership type affects utilization outcomes and management strategies.

Utilization and management of alder.

Treesearch

David G. Briggs; Dean S. DeBell; William A. Atkinson

1978-01-01

In the Pacific Northwest and British Columbia, red alder often grows on forest lands following natural or man-caused disturbances. Frequently ignored as a pest or weed, many alder stands have developed to the point where important utilization and management questions are being asked. It is recognized that alder is a fast growing species, and that its rapid early growth...

A Clustering Methodology of Web Log Data for Learning Management Systems

ERIC Educational Resources Information Center

Valsamidis, Stavros; Kontogiannis, Sotirios; Kazanidis, Ioannis; Theodosiou, Theodosios; Karakos, Alexandros

2012-01-01

Learning Management Systems (LMS) collect large amounts of data. Data mining techniques can be applied to analyse their web data log files. The instructors may use this data for assessing and measuring their courses. In this respect, we have proposed a methodology for analysing LMS courses and students' activity. This methodology uses a Markov…

Optimizing value utilizing Toyota Kata methodology in a multidisciplinary clinic.

PubMed

Merguerian, Paul A; Grady, Richard; Waldhausen, John; Libby, Arlene; Murphy, Whitney; Melzer, Lilah; Avansino, Jeffrey

2015-08-01

Value in healthcare is measured in terms of patient outcomes achieved per dollar expended. Outcomes and cost must be measured at the patient level to optimize value. Multidisciplinary clinics have been shown to be effective in providing coordinated and comprehensive care with improved outcomes, yet tend to have higher cost than typical clinics. We sought to lower individual patient cost and optimize value in a pediatric multidisciplinary reconstructive pelvic medicine (RPM) clinic. The RPM clinic is a multidisciplinary clinic that takes care of patients with anomalies of the pelvic organs. The specialties involved include Urology, General Surgery, Gynecology, and Gastroenterology/Motility. From May 2012 to November 2014 we performed time-driven activity-based costing (TDABC) analysis by measuring provider time for each step in the patient flow. Using observed time and the estimated hourly cost of each of the providers we calculated the final cost at the individual patient level, targeting clinic preparation. We utilized Toyota Kata methodology to enhance operational efficiency in an effort to optimize value. Variables measured included cost, time to perform a task, number of patients seen in clinic, percent value-added time (VAT) to patients (face to face time) and family experience scores (FES). At the beginning of the study period, clinic costs were $619 per patient. We reduced conference time from 6 min/patient to 1 min per patient, physician preparation time from 8 min to 6 min and increased Medical Assistant (MA) preparation time from 9.5 min to 20 min, achieving a cost reduction of 41% to $366 per patient. Continued improvements further reduced the MA preparation time to 14 min and the MD preparation time to 5 min with a further cost reduction to $194 (69%) (Figure). During this study period, we increased the number of appointments per clinic. We demonstrated sustained improvement in FES with regards to the families overall experience with their providers

Asset Management for Water and Wastewater Utilities

EPA Pesticide Factsheets

Renewing and replacing the nation's public water infrastructure is an ongoing task. Asset management can help a utility maximize the value of its capital as well as its operations and maintenance dollars.

Clinical governance and operations management methodologies.

PubMed

Davies, C; Walley, P

2000-01-01

The clinical governance mechanism, introduced since 1998 in the UK National Health Service (NHS), aims to deliver high quality care with efficient, effective and cost-effective patient services. Scally and Donaldson recognised that new approaches are needed, and operations management techniques comprise potentially powerful methodologies in understanding the process of care, which can be applied both within and across professional boundaries. This paper summarises four studies in hospital Trusts which took approaches to improving process that were different from and less structured than business process re-engineering (BPR). The problems were then amenable to change at a relatively low cost and short timescale, producing significant improvement to patient care. This less structured approach to operations management avoided incurring overhead costs of large scale and costly change such as new information technology (IT) systems. The most successful changes were brought about by formal tools to control quantity, content and timing of changes.

SLURM: Simple Linux Utility for Resource Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jette, M; Dunlap, C; Garlick, J

2002-04-24

Simple Linux Utility for Resource Management (SLURM) is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for Linux clusters of thousands of nodes. Components include machine status, partition management, job management, and scheduling modules. The design also includes a scalable, general-purpose communication infrastructure. Development will take place in four phases: Phase I results in a solid infrastructure; Phase II produces a functional but limited interactive job initiation capability without use of the interconnect/switch; Phase III provides switch support and documentation; Phase IV provides job status, fault-tolerance, and job queuing and control through Livermore's Distributed Productionmore » Control System (DPCS), a meta-batch and resource management system.« less

Evaluation in health: participatory methodology and involvement of municipal managers

PubMed Central

de Almeida, Cristiane Andrea Locatelli; Tanaka, Oswaldo Yoshimi

2016-01-01

ABSTRACT OBJECTIVE To analyze scopes and limits of the use of participatory methodology of evaluation with municipal health managers and administrators. METHODS Qualitative research with health policymakers and managers of the Comissão Intergestores Regional (CIR – Regional Interagency Commission) of a health region of the state of Sao Paulo in Brazil. Representatives from seven member cities participated in seven workshops facilitated by the researchers, with the aim of assessing a specific problem of the care line, which would be used as a tracer of the system integrality. The analysis of the collected empirical material was based on the hermeneutic-dialectic methodology and aimed at the evaluation of the applied participatory methodology, according to its capacity of promoting a process of assessment capable to be used as a support for municipal management. RESULTS With the participatory approach of evaluation, we were able to promote in-depth discussions with the group, especially related to the construction of integral care and to the inclusion of the user’s perspective in decision-making, linked to the search for solution to concrete problems of managers. By joint exploration, the possibility of using data from electronic information systems was opened, as well as information coming directly from the users of the services, to enhance discussions and negotiations between partners. The participants were disbelievers of the replication potential of this type of evaluation without the direct monitoring of the academy, given the difficulty of organizing the process in everyday life, already taken by emergency and political issues. CONCLUSIONS Evaluations of programs and services carried out within the Regional Interagency Commission, starting from the local interest and facilitating the involvement of its members by the use of participatory methodologies, can contribute to the construction of integral care. To the extent that the act of evaluating stay

Design, Development and Utilization Perspectives on Database Management Systems

ERIC Educational Resources Information Center

Shneiderman, Ben

1977-01-01

This paper reviews the historical development of integrated data base management systems and examines competing approaches. Topics include management and utilization, implementation and design, query languages, security, integrity, privacy and concurrency. (Author/KP)

Intelligent systems/software engineering methodology - A process to manage cost and risk

NASA Technical Reports Server (NTRS)

Friedlander, Carl; Lehrer, Nancy

1991-01-01

A systems development methodology is discussed that has been successfully applied to the construction of a number of intelligent systems. This methodology is a refinement of both evolutionary and spiral development methodologies. It is appropriate for development of intelligent systems. The application of advanced engineering methodology to the development of software products and intelligent systems is an important step toward supporting the transition of AI technology into aerospace applications. A description of the methodology and the process model from which it derives is given. Associated documents and tools are described which are used to manage the development process and record and report the emerging design.

Development of a utility conflict management system.

DOT National Transportation Integrated Search

2009-02-01

A critical process for the timely development and delivery of highway construction projects is the early : identification and depiction of utility interests that may interfere with proposed highway facilities. The : effective management of such utili...

Novel thermal management system design methodology for power lithium-ion battery

NASA Astrophysics Data System (ADS)

Nieto, Nerea; Díaz, Luis; Gastelurrutia, Jon; Blanco, Francisco; Ramos, Juan Carlos; Rivas, Alejandro

2014-12-01

Battery packs conformed by large format lithium-ion cells are increasingly being adopted in hybrid and pure electric vehicles in order to use the energy more efficiently and for a better environmental performance. Safety and cycle life are two of the main concerns regarding this technology, which are closely related to the cell's operating behavior and temperature asymmetries in the system. Therefore, the temperature of the cells in battery packs needs to be controlled by thermal management systems (TMSs). In the present paper an improved design methodology for developing TMSs is proposed. This methodology involves the development of different mathematical models for heat generation, transmission, and dissipation and their coupling and integration in the battery pack product design methodology in order to improve the overall safety and performance. The methodology is validated by comparing simulation results with laboratory measurements on a single module of the battery pack designed at IK4-IKERLAN for a traction application. The maximum difference between model predictions and experimental temperature data is 2 °C. The models developed have shown potential for use in battery thermal management studies for EV/HEV applications since they allow for scalability with accuracy and reasonable simulation time.

Drug utilization review: mechanisms to improve its effectiveness and broaden its scope. The U.S. Pharmacopeia Drug Utilization Review Advisory Panel.

PubMed

2000-01-01

To address important problems and needed changes in online and retrospective drug utilization review (DUR) programs. Emphasis is placed on reliability of DUR criteria and the shift of traditional retrospective DUR programs toward disease management and health care outcomes. Published literature evaluating the role of online and retrospective DUR programs. Particular attention was given to studies assessing DUR criteria reliability and new interventions with retrospective DUR programs. A literature review was conducted along with an expert summary from the U.S. Pharmacopeia Drug Utilization Review Advisory Panel. Studies have revealed variations in DUR criteria that could be affecting clinical practice and patient care. Appropriate formal methodologies and use of consistent procedures in developing online prospective DUR programs and systems could help resolve these problems. Traditional retrospective DUR is also shifting to incorporate disease management and methodologies from health outcomes and pharmacoeconomics studies. Refinements are needed to improve the reliability and validity of online DUR criteria and to minimize false positive messages. Databases created as a result of DUR efforts have been used in new and innovative ways to incorporate health outcomes data and disease management interventions. Additional outcomes data, combined with quality assurance efforts, should increase the utility of DUR/disease management efforts in evaluating health systems while improving the effectiveness and efficiency of pharmacists' health care interventions.

Utilizing Radiofrequency Identification Technology to Improve Safety and Management of Blood Bank Supply Chains.

PubMed

Coustasse, Alberto; Meadows, Pamela; Hall, Robert S; Hibner, Travis; Deslich, Stacie

2015-11-01

The importance of efficiency in the supply chain of perishable products, such as the blood products used in transfusion services, cannot be overstated. Many problems can occur, such as the outdating of products, inventory management issues, patient misidentification, and mistransfusion. The purpose of this article was to identify the benefits and barriers associated with radiofrequency identification (RFID) usage in improving the blood bank supply chain. The methodology for this study was a qualitative literature review following a systematic approach. The review was limited to sources published from 2000 to 2014 in the English language. Sixty-five sources were found, and 56 were used in this research study. According to the finding of the present study, there are numerous benefits and barriers to RFID utilization in blood bank supply chains. RFID technology offers several benefits with regard to blood bank product management, including decreased transfusion errors, reduction of product loss, and more efficient inventory management. Barriers to RFID implementation include the cost associated with system implementation and patient privacy issues. Implementation of an RFID system can be a significant investment. However, when observing the positive impact that such systems may have on transfusion safety and inventory management, the cost associated with RFID systems can easily be justified. RFID in blood bank inventory management is vital to ensuring efficient product inventory management and positive patient outcomes.

Utilization management in radiology, part 2: perspectives and future directions.

PubMed

Duszak, Richard; Berlin, Jonathan W

2012-10-01

Increased utilization of medical imaging in the early part of the last decade has resulted in numerous efforts to reduce associated spending. Recent initiatives have focused on managing utilization with radiology benefits managers and real-time order entry decision support systems. Although these approaches might seem mutually exclusive and their application to radiology appears unique, the historical convergence and broad acceptance of both programs within the pharmacy sector may offer parallels for their potential future in medical imaging. In this second installment of a two-part series, anticipated trends in radiology utilization management are reviewed. Perspectives on current and future potential roles of radiologists in such initiatives are discussed, particularly in light of emerging physician payment models. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Evaluative methodology for comprehensive water quality management planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dyer, H. L.

Computer-based evaluative methodologies have been developed to provide for the analysis of coupled phenomena associated with natural resource comprehensive planning requirements. Provisions for planner/computer interaction have been included. Each of the simulation models developed is described in terms of its coded procedures. An application of the models for water quality management planning is presented; and the data requirements for each of the models are noted.

Managed Utility Services Contracts | Climate Neutral Research Campuses |

Science.gov Websites

the energy cost savings generated by the project. Managed Utility Services Contracts In a Managed . The owner, in this case the research campus, bears no upfront cost through this agreement, pays the revenue to capital cost repayment and maintenance costs. In addition to removing the burden of an upfront

The methodology of database design in organization management systems

NASA Astrophysics Data System (ADS)

Chudinov, I. L.; Osipova, V. V.; Bobrova, Y. V.

2017-01-01

The paper describes the unified methodology of database design for management information systems. Designing the conceptual information model for the domain area is the most important and labor-intensive stage in database design. Basing on the proposed integrated approach to design, the conceptual information model, the main principles of developing the relation databases are provided and user’s information needs are considered. According to the methodology, the process of designing the conceptual information model includes three basic stages, which are defined in detail. Finally, the article describes the process of performing the results of analyzing user’s information needs and the rationale for use of classifiers.

Documenting Living Monuments in Indonesia: Methodology for Sustainable Utility

NASA Astrophysics Data System (ADS)

Suryaningsih, F.; Purwestri, N.

2013-07-01

The systematic documentation of cultural heritage in Indonesia has been developed after the establishment of Bataviaasch Genootschap van Kunsten en Wetenschappen (1778) and De Oudheidkundige Dienst (1913) by the Netherlands Indies government. After Indonesian independent, the tasks of cultural heritage documentation take over by The Ministry of Culture (now become The Ministry of Education of Culture) with focus on the ancient and classical heritage, so called dead monument. The needed of comprehensive documentation data regarding cultural heritage become significant issues since the government and private sector pay attention to the preservation of heritage building in the urban site, so called living monument. The archives of original drawing plan many times do not fit with the existing condition, while the conservation plan demands a document such as built drawing plan to work on. The technology, methodology and system to provide such comprehensive document of heritage building and site become important, to produce good conservation plan and heritage building regular maintenance. It means the products will have a sustainable and various utility values. Since 1994, Documentation Centre for Architecture - Indonesia (PDA), has established to meet the needs of a comprehensive data of heritage building (living monuments), to utilized as basic document for conservation planning. Not only provide document of the digital drawing such site plan, plan, elevation, section and details of architecture elements, but also document of historic research, material analysis and completed with diagnosis and mapping of building damages. This manuscript is about PDA field experience, working in this subject issue

Water Utility Management Strategies in Turkey: The current situation and the challenges

NASA Astrophysics Data System (ADS)

Alp, E.; Aksoy, M. N.; Koçer, B.

2013-12-01

As the effects of climate change becomes more prominent, current challenges related to water and wastewater management is becoming more serious. Providing water that satisfies environmental and safety standards in terms of quantity and quality is needed to maintain human life without compromising the need of future generations. Besides providing safe and affordable water, necessary treatment should be achieved according to several important factors such as receiving body standards, discharge standards, water reuse options. Therefore, management of water becomes more crucial than ever that states have to provide accessibility of safe water with affordable cost to its citizens with the means of effective utility management, including water treatment facilities, wastewater treatment facilities, water supply facilities and water distribution systems. Water utilities encounter with several challenges related to cost, infrastructure, population, legislation, workforce and resource. This study aims to determine the current situation and the necessary strategies to improve utility management in Turkish municipalities in a sustainable manner. US Environment Protection Agency (EPA) has formed a tool on effective utility management that assists utilities to provide a solution for both current and future challenges. In this study, we used EPA's guidelines and developed a survey consists of 60 questions under 10 sub-topics (Product Quality, Employee & Leadership Development, Stakeholder Understanding & Support, Operational Optimization, Infrastructure Stability, Financial Viability, Community Sustainability, Customer Satisfaction, Operational Resiliency, and Water Resource Adequacy). This survey was sent to the managers of 25 metropolitan municipalities in Turkey to assess the current condition of municipalities. After the evaluation of the survey results for each topic, including the importance given by managers, facilities were rated according to their level of achievement

Specification of Energy Assessment Methodologies to Satisfy ISO 50001 Energy Management Standard

NASA Astrophysics Data System (ADS)

Kanneganti, Harish

Energy management has become more crucial for industrial sector as a way to lower their cost of production and in reducing their carbon footprint. Environmental regulations also force the industrial sector to increase the efficiency of their energy usage. Hence industrial sector started relying on energy management consultancies for improvements in energy efficiency. With the development of ISO 50001 standard, the entire energy management took a new dimension involving top level management and getting their commitment on energy efficiency. One of the key requirements of ISO 50001 is to demonstrate continual improvement in their (industry) energy efficiency. The major aim of this work is to develop an energy assessment methodology and reporting format to tailor the needs of ISO 50001. The developed methodology integrates the energy reduction aspect of an energy assessment with the requirements of sections 4.4.3 (Energy Review) to 4.4.6 (Objectives, Targets and Action Plans) in ISO 50001 and thus helping the facilities in easy implementation of ISO 50001.

Opportunities for increasing utility of models for rangeland management

USDA-ARS?s Scientific Manuscript database

A tremendous need exists for ecosystem models to assist in rangeland management, but the utility of models developed to date has been minimal for enterprise-level decision making. Three areas in which models have had limited effectiveness for land managers are 1) addressing contemporary needs associ...

Methodology for assessing the effectiveness of access management techniques : final report, September 14, 1998.

DOT National Transportation Integrated Search

1998-09-14

A methodology for assessing the effectiveness of access management techniques on suburban arterial highways is developed. The methodology is described as a seven-step process as follows: (1) establish the purpose of the analysis (2) establish the mea...

Integrating fisheries approaches and household utility models for improved resource management.

PubMed

Milner-Gulland, E J

2011-01-25

Natural resource management is littered with cases of overexploitation and ineffectual management, leading to loss of both biodiversity and human welfare. Disciplinary boundaries stifle the search for solutions to these issues. Here, I combine the approach of management strategy evaluation, widely applied in fisheries, with household utility models from the conservation and development literature, to produce an integrated framework for evaluating the effectiveness of competing management strategies for harvested resources against a range of performance metrics. I demonstrate the strengths of this approach with a simple model, and use it to examine the effect of manager ignorance of household decisions on resource management effectiveness, and an allocation tradeoff between monitoring resource stocks to reduce observation uncertainty and monitoring users to improve compliance. I show that this integrated framework enables management assessments to consider household utility as a direct metric for system performance, and that although utility and resource stock conservation metrics are well aligned, harvest yield is a poor proxy for both, because it is a product of household allocation decisions between alternate livelihood options, rather than an end in itself. This approach has potential far beyond single-species harvesting in situations where managers are in full control; I show that the integrated approach enables a range of management intervention options to be evaluated within the same framework.

The derivation of scenic utility functions and surfaces and their role in landscape management

Treesearch

John W. Hamilton; Gregory J. Buhyoff; J. Douglas Wellman

1979-01-01

This paper outlines a methodological approach for determining relevant physical landscape features which people use in formulating judgments about scenic utility. This information, coupled with either empirically derived or rationally stipulated regression techniques, may be used to produce scenic utility functions and surfaces. These functions can provide a means for...

Optimal Energy Management for a Smart Grid using Resource-Aware Utility Maximization

NASA Astrophysics Data System (ADS)

Abegaz, Brook W.; Mahajan, Satish M.; Negeri, Ebisa O.

2016-06-01

Heterogeneous energy prosumers are aggregated to form a smart grid based energy community managed by a central controller which could maximize their collective energy resource utilization. Using the central controller and distributed energy management systems, various mechanisms that harness the power profile of the energy community are developed for optimal, multi-objective energy management. The proposed mechanisms include resource-aware, multi-variable energy utility maximization objectives, namely: (1) maximizing the net green energy utilization, (2) maximizing the prosumers' level of comfortable, high quality power usage, and (3) maximizing the economic dispatch of energy storage units that minimize the net energy cost of the energy community. Moreover, an optimal energy management solution that combines the three objectives has been implemented by developing novel techniques of optimally flexible (un)certainty projection and appliance based pricing decomposition in an IBM ILOG CPLEX studio. A real-world, per-minute data from an energy community consisting of forty prosumers in Amsterdam, Netherlands is used. Results show that each of the proposed mechanisms yields significant increases in the aggregate energy resource utilization and welfare of prosumers as compared to traditional peak-power reduction methods. Furthermore, the multi-objective, resource-aware utility maximization approach leads to an optimal energy equilibrium and provides a sustainable energy management solution as verified by the Lagrangian method. The proposed resource-aware mechanisms could directly benefit emerging energy communities in the world to attain their energy resource utilization targets.

Failure mode effect analysis and fault tree analysis as a combined methodology in risk management

NASA Astrophysics Data System (ADS)

Wessiani, N. A.; Yoshio, F.

2018-04-01

There have been many studies reported the implementation of Failure Mode Effect Analysis (FMEA) and Fault Tree Analysis (FTA) as a method in risk management. However, most of the studies usually only choose one of these two methods in their risk management methodology. On the other side, combining these two methods will reduce the drawbacks of each methods when implemented separately. This paper aims to combine the methodology of FMEA and FTA in assessing risk. A case study in the metal company will illustrate how this methodology can be implemented. In the case study, this combined methodology will assess the internal risks that occur in the production process. Further, those internal risks should be mitigated based on their level of risks.

The Application of Failure Modes and Effects Analysis Methodology to Intrathecal Drug Delivery for Pain Management

PubMed Central

Patel, Teresa; Fisher, Stanley P.

2016-01-01

Objective This study aimed to utilize failure modes and effects analysis (FMEA) to transform clinical insights into a risk mitigation plan for intrathecal (IT) drug delivery in pain management. Methods The FMEA methodology, which has been used for quality improvement, was adapted to assess risks (i.e., failure modes) associated with IT therapy. Ten experienced pain physicians scored 37 failure modes in the following categories: patient selection for therapy initiation (efficacy and safety concerns), patient safety during IT therapy, and product selection for IT therapy. Participants assigned severity, probability, and detection scores for each failure mode, from which a risk priority number (RPN) was calculated. Failure modes with the highest RPNs (i.e., most problematic) were discussed, and strategies were proposed to mitigate risks. Results Strategic discussions focused on 17 failure modes with the most severe outcomes, the highest probabilities of occurrence, and the most challenging detection. The topic of the highest‐ranked failure mode (RPN = 144) was manufactured monotherapy versus compounded combination products. Addressing failure modes associated with appropriate patient and product selection was predicted to be clinically important for the success of IT therapy. Conclusions The methodology of FMEA offers a systematic approach to prioritizing risks in a complex environment such as IT therapy. Unmet needs and information gaps are highlighted through the process. Risk mitigation and strategic planning to prevent and manage critical failure modes can contribute to therapeutic success. PMID:27477689

The cost of energy from utility-owned solar electric systems. A required revenue methodology for ERDA/EPRI evaluations

NASA Technical Reports Server (NTRS)

1976-01-01

This methodology calculates the electric energy busbar cost from a utility-owned solar electric system. This approach is applicable to both publicly- and privately-owned utilities. Busbar cost represents the minimum price per unit of energy consistent with producing system-resultant revenues equal to the sum of system-resultant costs. This equality is expressed in present value terms, where the discount rate used reflects the rate of return required on invested capital. Major input variables describe the output capabilities and capital cost of the energy system, the cash flows required for system operation amd maintenance, and the financial structure and tax environment of the utility.

Reclamation of landfills and dumps of municipal solid waste in a energy efficient waste management system: methodology and practice

NASA Astrophysics Data System (ADS)

Orlova, Tatyana; Melnichuk, Aleksandr; Klimenko, Kseniya; Vitvitskaya, Valentina; Popovych, Valentina; Dunaieva, Ielizaveta; Terleev, Vitaly; Nikonorov, Aleksandr; Togo, Issa; Volkova, Yulia; Mirschel, Wilfried; Garmanov, Vitaly

2017-10-01

The article considers the methodological and practical aspects of reclamation of landfills and dumps of municipal solid waste in a waste management system. The general tendencies of system development in the context of elements of the international concept of waste hierarchy are analyzed. Statistics of the formation and burial of domestic waste indicate a strategic non-alternative to the rejection of landfill technologies in favor of environmentally, energy efficient and economically expedient ways of utilization of municipal waste as a world trend. Practical approaches to the study of territories on which there are dumps and landfills are considered to justify the design solutions for reclamation.

Towards more sustainable management of European food waste: Methodological approach and numerical application.

PubMed

Manfredi, Simone; Cristobal, Jorge

2016-09-01

Trying to respond to the latest policy needs, the work presented in this article aims at developing a life-cycle based framework methodology to quantitatively evaluate the environmental and economic sustainability of European food waste management options. The methodology is structured into six steps aimed at defining boundaries and scope of the evaluation, evaluating environmental and economic impacts and identifying best performing options. The methodology is able to accommodate additional assessment criteria, for example the social dimension of sustainability, thus moving towards a comprehensive sustainability assessment framework. A numerical case study is also developed to provide an example of application of the proposed methodology to an average European context. Different options for food waste treatment are compared, including landfilling, composting, anaerobic digestion and incineration. The environmental dimension is evaluated with the software EASETECH, while the economic assessment is conducted based on different indicators expressing the costs associated with food waste management. Results show that the proposed methodology allows for a straightforward identification of the most sustainable options for food waste, thus can provide factual support to decision/policy making. However, it was also observed that results markedly depend on a number of user-defined assumptions, for example on the choice of the indicators to express the environmental and economic performance. © The Author(s) 2016.

Utilization management in radiology, part 1: rationale, history, and current status.

PubMed

Duszak, Richard; Berlin, Jonathan W

2012-10-01

Previous growth in the utilization of medical imaging has led to numerous efforts to reduce associated spending. Although these have historically been directed toward unit cost reductions, recent interest has emerged by various stakeholders in curbing inappropriate utilization. Radiology benefits managers have widespread market penetration and have been promoted largely by the payer community as effective mechanisms to curb increases in imaging volume. The provider community has tended to favor real-time order entry decision support systems. These have demonstrated comparable effectiveness to radiology benefits managers in early projects but currently have only limited market penetration. In this first of a two-part series, the rationale for the development of utilization management programs will be discussed and their history and current status reviewed. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A Methodology for Conducting Space Utilization Studies within Department of Defense Medical Facilities

DTIC Science & Technology

1992-07-01

database programs, such as dBase or Microsoft Excell, to yield statistical reports that can profile the health care facility . Ladeen (1989) feels that the...service specific space status report would be beneficial to the specific service(s) under study, it would not provide sufficient data for facility -wide...change in the Master Space Plan. The revised methodology also provides a mechanism and forum for spuce management education within the facility . The

Planning "and" Sprinting: Use of a Hybrid Project Management Methodology within a CIS Capstone Course

ERIC Educational Resources Information Center

Baird, Aaron; Riggins, Frederick J.

2012-01-01

An increasing number of information systems projects in industry are managed using hybrid project management methodologies, but this shift in project management methods is not fully represented in our CIS curriculums. CIS capstone courses often include an applied project that is managed with traditional project management methods (plan first,…

A public utility model for managing public land recreation enterprises.

Treesearch

Tom Quinn

2002-01-01

Through review of relevant economic principles and judicial precedent, a case is made that public-land recreation enterprises are analogous to traditionally recognized public utilities. Given the historical concern over the societal value of recreation and associated pricing issues, public-land management policies failing to acknowledge these utility-like...

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

Corporate and program objectives focus on desired performance and results. ?Management decisions that affect how to meet these objectives now involve a complex mix of: technology, safety issues, operations, process considerations, employee considerations, regulatory requirements, financial concerns and legal issues. ?Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures. Using a risk assessment methodology is only a starting point. ?A risk assessment program provides management with important input in the decision making process. ?A pro-active organization looks to the future to avoid problems, a reactive organization can be blindsided by risks that could have been avoided. ?You get out what you put in, how useful your program is will be up to the individual organization.

Selection, management and utilization of biosphere reserves.

Treesearch

Jerry F. Franklin; Stanley L. Krugman

1979-01-01

This publication is directed to the analysis of the selection, management, and utilization of Biosphere Reserves as viewed by scientists from the United States and the Union of Soviet Socialist Republics. Soviet papers focus on types of research and monitoring programs that should be developed on Biosphere Reserves, with emphasis on their use in pollutant monitoring....

LiDAR utility for natural resource managers

Treesearch

Andrew Thomas Hudak; Jeffrey Scott Evans; Alistair Mattthew Stuart Smith

2009-01-01

Applications of LiDAR remote sensing are exploding, while moving from the research to the operational realm. Increasingly, natural resource managers are recognizing the tremendous utility of LiDAR-derived information to make improved decisions. This review provides a cross-section of studies, many recent, that demonstrate the relevance of LiDAR across a suite of...

Methodology for Knowledge Synthesis of the Management of Vaccination Pain and Needle Fear.

PubMed

Taddio, Anna; McMurtry, C Meghan; Shah, Vibhuti; Yoon, Eugene W; Uleryk, Elizabeth; Pillai Riddell, Rebecca; Lang, Eddy; Chambers, Christine T; Noel, Melanie; MacDonald, Noni E

2015-10-01

A knowledge synthesis was undertaken to inform the development of a revised and expanded clinical practice guideline about managing vaccination pain in children to include the management of pain across the lifespan and the management of fear in individuals with high levels of needle fear. This manuscript describes the methodological details of the knowledge synthesis and presents the list of included clinical questions, critical and important outcomes, search strategy, and search strategy results. The Grading of Assessments, Recommendations, Development and Evaluation (GRADE) and Cochrane methodologies provided the general framework. The project team voted on clinical questions for inclusion and critically important and important outcomes. A broad search strategy was used to identify relevant randomized-controlled trials and quasi-randomized-controlled trials. Quality of research evidence was assessed using the Cochrane risk of bias tool and quality across studies was assessed using GRADE. Multiple measures of the same construct within studies (eg, observer-rated and parent-rated infant distress) were combined before pooling. The standardized mean difference and 95% confidence intervals (CI) or relative risk and 95% CI was used to express the effects of an intervention. Altogether, 55 clinical questions were selected for inclusion in the knowledge synthesis; 49 pertained to pain management during vaccine injections and 6 pertained to fear management in individuals with high levels of needle fear. Pain, fear, and distress were typically prioritized as critically important outcomes across clinical questions. The search strategy identified 136 relevant studies. This manuscript describes the methodological details of a knowledge synthesis about pain management during vaccination and fear management in individuals with high levels of needle fear. Subsequent manuscripts in this series will present the results for the included questions.

Research Management--Of What Nature Is the Concept?

ERIC Educational Resources Information Center

Cook, Desmond L.

Research management is defined as the application of both management and management science to a particular field of research and development activities. Seven components of research management include theory and methodology; the planning, implementation, and evaluation of research programs; communications; utilization; and special applications.…

Case formulation and management using pattern-based formulation (PBF) methodology: clinical case 1.

PubMed

Fernando, Irosh; Cohen, Martin

2014-02-01

A tool for psychiatric case formulation known as pattern-based formulation (PBF) has been recently introduced. This paper presents an application of this methodology in formulating and managing complex clinical cases. The symptomatology of the clinical presentation has been parsed into individual clinical phenomena and interpreted by selecting explanatory models. The clinical presentation demonstrates how PBF has been used as a clinical tool to guide clinicians' thinking, that takes a structured approach to manage multiple issues using a broad range of management strategies. In doing so, the paper also introduces a number of patterns related to the observed clinical phenomena that can be re-used as explanatory models when formulating other clinical cases. It is expected that this paper will assist clinicians, and particularly trainees, to better understand PBF methodology and apply it to improve their formulation skills.

A methodology for decisionmaking in project evaluation in land management planning

Treesearch

A. Weintraub

1978-01-01

In order to evaluate alternative plans, wildland management planners must consider many objectives, such as timber production, recreational use, and community stability. The method presented utilizes the type of qualitative and intuitive information widely available to wildland management planners, and structures this information into a format suitable for...

The ICCB Computer Based Facilities Inventory & Utilization Management Information Subsystem.

ERIC Educational Resources Information Center

Lach, Ivan J.

The Illinois Community College Board (ICCB) Facilities Inventory and Utilization subsystem, a part of the ICCB management information system, was designed to provide decision makers with needed information to better manage the facility resources of Illinois community colleges. This subsystem, dependent upon facilities inventory data and course…

Reliability Centered Maintenance - Methodologies

NASA Technical Reports Server (NTRS)

Kammerer, Catherine C.

2009-01-01

Journal article about Reliability Centered Maintenance (RCM) methodologies used by United Space Alliance, LLC (USA) in support of the Space Shuttle Program at Kennedy Space Center. The USA Reliability Centered Maintenance program differs from traditional RCM programs because various methodologies are utilized to take advantage of their respective strengths for each application. Based on operational experience, USA has customized the traditional RCM methodology into a streamlined lean logic path and has implemented the use of statistical tools to drive the process. USA RCM has integrated many of the L6S tools into both RCM methodologies. The tools utilized in the Measure, Analyze, and Improve phases of a Lean Six Sigma project lend themselves to application in the RCM process. All USA RCM methodologies meet the requirements defined in SAE JA 1011, Evaluation Criteria for Reliability-Centered Maintenance (RCM) Processes. The proposed article explores these methodologies.

[Scientific and methodologic approaches to evaluating medical management for workers of Kazakhstan].

PubMed

2012-01-01

The article covers topical problems of workers' health preservation. Complex research results enabled to evaluate and analyze occupational risks in leading industries of Kazakhstan, for improving scientific and methodologic approaches to medical management for workers subjected to hazardous conditions.

The development of a streamlined, coordinated and sustainable evaluation methodology for a diverse chronic disease management program.

PubMed

Berlowitz, David J; Graco, Marnie

2010-05-01

The Northern Alliance Hospital Admission Risk Program-Chronic Disease Management comprises 13 services delivering care to those with chronic disease and older people with complex care needs, who are frequent hospital users. To develop and implement a system-wide approach to the evaluation of this existing program. The Northern Clinical Research Centre audited all existing, routinely collected administrative data within the program and then met with each service to develop service specific outcome measures. The evaluators then developed and implemented a system-wide evaluation approach to measure performance in terms of: client profile; access and entry; service efficiency; client outcomes; and hospital demand. Data are collected electronically and more than 80% are derived from existing, administrative datasets, minimising staff and client burden. Additional data include client outcomes and a health related quality of life measure. The preliminary twelve month data suggest that clients have the equivalent of 'fair' or 'poor' self-reported health status (n = 862) and the average health utility scores are significantly (P < 0.05) worse than population control data. These analyses reveal, for the first time, that the Northern Alliance Hospital Admission Risk Program-Chronic Disease Management program is targeting appropriate clients. This methodology will enable many prospective assessments to be performed including; client outcome evaluation, service model comparisons, and cost-utility analyses. This evaluation approach demonstrates the feasibility of a highly coordinated 'whole of system' evaluation. Such an approach may ultimately contribute to the development of evidence-based policy.

Physician organization care management capabilities associated with effective inpatient utilization management: a fuzzy set qualitative comparative analysis.

PubMed

Sheehy, Thomas J; Thygeson, N Marcus

2014-12-03

We studied the relationship between physician organization (PO) care management capabilities and inpatient utilization in order to identify PO characteristics or capabilities associated with low inpatient bed-days per thousand. We used fuzzy-set qualitative comparative analysis (fsQCA) to conduct an exploratory comparative case series study. Data about PO capabilities were collected using structured interviews with medical directors at fourteen California POs that are delegated to provide inpatient utilization management (UM) for HMO members of a California health plan. Health plan acute hospital claims from 2011 were extracted from a reporting data warehouse and used to calculate inpatient utilization statistics. Supplementary analyses were conducted using Fisher's Exact Test and Student's T-test. POs with low inpatient bed-days per thousand minimized length of stay and surgical admissions by actively engaging in concurrent review, discharge planning, and surgical prior authorization, and by contracting directly with hospitalists to provide UM-related services. Disease and case management were associated with lower medical admissions and readmissions, respectively, but not lower bed-days per thousand. Care management methods focused on managing length of stay and elective surgical admissions are associated with low bed-days per thousand in high-risk California POs delegated for inpatient UM. Reducing medical admissions alone is insufficient to achieve low bed-days per thousand. California POs with high bed-days per thousand are not applying care management best practices.

Fleet management performance monitoring.

DOT National Transportation Integrated Search

2013-05-01

The principle goal of this project was to enhance and expand the analytical modeling methodology previously developed as part of the Fleet Management Criteria: Disposal Points and Utilization Rates project completed in 2010. The enhanced and ex...

Is strategic asset management applicable to small and medium utilities?

PubMed

Alegre, Helena

2010-01-01

Urban water infrastructures provide essential services to modern societies and represent a major portion of the value of municipal physical assets. Managing these assets rationally is therefore fundamental for the sustainability of the services and to the economy of societies. "Asset Management" (AM) is a modern term for an old practice--assets have always been managed. In recent years, significant evolution occurred in terms of the AM formal approaches, of the monitoring and decision support tools and of the implementation success cases. However, most tools developed are too sophisticated and data seek for small utilities. The European R&D network COST Action C18 ( E-mail: www.costc18.org) identified key research problems related to the management of urban water infrastructures, currently not covered by on-going projects of the European Framework Program. The top 1 topic is "Efficient management of small community". This paper addresses challenges and opportunities for small and medium utilities with regard to infrastructure AM (IAM). To put this into context, the first sections discuss the need for IAM, highlight key recent developments, and present IAM drivers, as well as research and development gaps, priorities and products needed.

When the 'soft-path' gets hard: demand management and financial instability for water utilities

NASA Astrophysics Data System (ADS)

Zeff, H. B.; Characklis, G. W.

2014-12-01

In the past, cost benefit analysis (CBA) has been viewed as an effective means of evaluating water utility strategies, particularly those that were dependent on the construction of new supply infrastructure. As water utilities have begun to embrace 'soft-path' approaches as a way to reduce the need for supply-centric development, CBA fails to recognize some important financial incentives affected by reduced water consumption. Demand management, both as a short-term response to drought and in longer-term actions to accommodate demand growth, can introduce revenue risks that adversely affect a utility's ability to repay debt, re-invest in aging infrastructure, or maintain reserve funds for use in a short-term emergency. A utility that does not generate sufficient revenue to support these functions may be subject to credit rating downgrades, which in turn affect the interest rate it pays on its debt. Interest rates are a critical consideration for utility managers in the capital-intensive water sector, where debt payments for infrastructure often account for a large portion of a utility's overall costs. Even a small increase in interest rates can add millions of dollars to the cost of new infrastructure. Recent studies have demonstrated that demand management techniques can lead to significant revenue variability, and credit rating agencies have begun to take notice of drought response plans when evaluating water utility credit ratings, providing utilities with a disincentive to fully embrace soft-path approaches. This analysis examines the impact of demand management schemes on key credit rating metrics for a water utility in Raleigh, North Carolina. The utility's consumer base is currently experiencing rapid population growth, and demand management has the potential to reduce the dependence on costly new supply infrastructure but could lead to financial instability that will significantly increase the costs of financing future projects. This work analyzes how 'soft

Risk Assessment Methodology for Water utilities (RAM-W) : the foundation for emergency response planning.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Danneels, Jeffrey John

2005-03-01

Concerns about acts of terrorism against critical infrastructures have been on the rise for several years. Critical infrastructures are those physical structures and information systems (including cyber) essential to the minimum operations of the economy and government. The President's Commission on Critical Infrastructure Protection (PCCIP) probed the security of the nation's critical infrastructures. The PCCIP determined the water infrastructure is highly vulnerable to a range of potential attacks. In October 1997, the PCCIP proposed a public/private partnership between the federal government and private industry to improve the protection of the nation's critical infrastructures. In early 2000, the EPA partnered withmore » the Awwa Research Foundation (AwwaRF) and Sandia National Laboratories to create the Risk Assessment Methodology for Water Utilities (RAM-W{trademark}). Soon thereafter, they initiated an effort to create a template and minimum requirements for water utility Emergency Response Plans (ERP). All public water utilities in the US serving populations greater than 3,300 are required to undertaken both a vulnerability assessment and the development of an emergency response plan. This paper explains the initial steps of RAM-W{trademark} and then demonstrates how the security risk assessment is fundamental to the ERP. During the development of RAM-W{trademark}, Sandia performed several security risk assessments at large metropolitan water utilities. As part of the scope of that effort, ERPs at each utility were reviewed to determine how well they addressed significant vulnerabilities uncovered during the risk assessment. The ERP will contain responses to other events as well (e.g. natural disasters) but should address all major findings in the security risk assessment.« less

Disruption of Information Technology Projects: The Reactive Decoupling of Project Management Methodologies

ERIC Educational Resources Information Center

Schmitz, Kurt W.

2013-01-01

Information Technology projects have migrated toward two dominant Project Management (PM) methodologies. Plan-driven practices provide organizational control through highly structured plans, schedules, and specifications that facilitate oversight by hierarchical bureaucracies. In contrast, agile practices emphasize empowered teams using flexible…

Applications of harvesting system simulation to timber management and utilization analyses

Treesearch

John E. Baumgras; Chris B. LeDoux

1990-01-01

Applications of timber harvesting system simulation to the economic analysis of forest management and wood utilization practices are presented. These applications include estimating thinning revenue by stand age, estimating impacts of minimum merchantable tree diameter on harvesting revenue, and evaluating wood utilization alternatives relative to pulpwood quotas and...

76 FR 54216 - Pacific Fishery Management Council (Council); Work Session To Review Proposed Salmon Methodology...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-31

... Fishery Management Council (Council); Work Session To Review Proposed Salmon Methodology Changes AGENCY.... ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management Council's Salmon Technical Team (STT), Scientific and Statistical Committee (SSC) Salmon Subcommittee, and Model Evaluation...

A methodology model for quality management in a general hospital.

PubMed

Stern, Z; Naveh, E

1997-01-01

A reappraisal is made of the relevance of industrial modes of quality management to the issues of medical care. Analysis of the nature of medical care, which differentiates it from the supplier-client relationships of industry, presents the main intrinsic characteristics, which create problems in application of the industrial quality management approaches to medical care. Several examples are the complexity of the relationship between the medical action and the result obtained, the client's nonacceptance of economic profitability as a value in his medical care, and customer satisfaction biased by variable standards of knowledge. The real problems unique to hospitals are addressed, and a methodology model for their quality management is offered. Included is a sample of indicator vectors, measurements of quality care, cost of medical care, quality of service, and human resources. These are based on the trilogy of planning quality, quality control, and improving quality. The conclusions confirm the inadequacy of industrial quality management approaches for medical institutions and recommend investment in formulation of appropriate concepts.

Ergonomics program management in Tucuruí Hydropower Plant using TPM methodology.

PubMed

Santos, R M; Sassi, A C; Sá, B M; Miguez, S A; Pardauil, A A

2012-01-01

This paper aims to present the benefits achieved in the ergonomics process management with the use of the TPM methodology (Total Productive Maintenance) in Tucuruí Hydropower Plant. The methodology is aligned with the corporate guidelines, moreover with the Strategic Planning of the company, it is represented in the TPM Pillars including the Health Pillar in which is inserted the ergonomics process. The results of the ergonomic actions demonstrated a 12% reduction over the absenteeism rate due to musculoskeletal disorders, solving 77,0% of ergonomic non-conformities, what favored the rise of the Organizational Climate in 44,8%, impacting on the overall performance of the company. Awards confirmed the success of the work by the achievement of the Award for TPM Excellence in 2001, Award for Excellence in Consistent TPM Commitment in 2009 and more recently the Special Award for TPM Achievement, 2010. The determination of the high rank administration and workers, allied with the involvement/dynamism of Pillars, has assured the success of this management practice in Tucuruí Hydropower Plant.

On Robust Methodologies for Managing Public Health Care Systems

PubMed Central

Nimmagadda, Shastri L.; Dreher, Heinz V.

2014-01-01

Authors focus on ontology-based multidimensional data warehousing and mining methodologies, addressing various issues on organizing, reporting and documenting diabetic cases and their associated ailments, including causalities. Map and other diagnostic data views, depicting similarity and comparison of attributes, extracted from warehouses, are used for understanding the ailments, based on gender, age, geography, food-habits and other hereditary event attributes. In addition to rigor on data mining and visualization, an added focus is on values of interpretation of data views, from processed full-bodied diagnosis, subsequent prescription and appropriate medications. The proposed methodology, is a robust back-end application, for web-based patient-doctor consultations and e-Health care management systems through which, billions of dollars spent on medical services, can be saved, in addition to improving quality of life and average life span of a person. Government health departments and agencies, private and government medical practitioners including social welfare organizations are typical users of these systems. PMID:24445953

Planning and managing market research: Electric utility market research monograph series: Monograph 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Whitelaw, R.W.

1987-01-01

The market research techniques available now to the electric utility industry have evolved over the last thirty years into a set of sophisticated tools that permit complex behavioral analyses that earlier had been impossible. The marketing questions facing the electric utility industry now are commensurately more complex than ever before. This document was undertaken to present the tools and techniques needed to start or improve the usefulness of market research activities within electric utilities. It describes proven planning and management techniques as well as decision criteria for structuring effective market research functions for each utility's particular needs. The monograph establishesmore » the parameters of sound utility market research given trade-offs between highly centralized or decentralized organizations, research focus, involvement in decision making, and personnel and management skills necessary to maximize the effectiveness of the structure chosen.« less

The Contribution of Human Factors in Military System Development: Methodological Considerations

DTIC Science & Technology

1980-07-01

Risk/Uncertainty Analysis - Project Scoring - Utility Scales - Relevance Tree Techniques (Reverse Factor Analysis) 2. Computer Simulation Simulation...effectiveness of mathematical models for R&D project selection. Management Science, April 1973, 18. 6-43 .1~ *.-. Souder, W.E. h scoring methodology for...per some interval PROFICIENCY test scores (written) RADIATION radiation effects aircrew performance on radiation environments REACTION TIME 1) (time

Methodology for utilizing survey skid data.

DOT National Transportation Integrated Search

1975-01-01

This report sets forth procedures for utilizing survey skid data with consideration given to testing variabilities and relationships between the three testing devices used in Virginia namely, the Virginia Department of Highways & Transportation's tra...

Building Maintenance and Utilities Management. Florida Vocational Program Guide.

ERIC Educational Resources Information Center

University of South Florida, Tampa. Dept. of Adult and Vocational Education.

This program guide identifies primary concerns in the organization, operation, and evaluation of a building maintenance and utilities management program. It is designed for local school district and community college administrators, instructors, program advisory committees, and regional coordinating councils. The guide begins with the Dictionary…

Methodology of project management at implementation of projects of high-rise construction

NASA Astrophysics Data System (ADS)

Papelniuk, Oksana

2018-03-01

High-rise construction is the perspective direction in urban development. An opportunity to arrange on rather small land plot a huge number of the living and commercial space makes high-rise construction very attractive for developers. However investment projects of high-rise buildings' construction are very expensive and complex that sets a task of effective management of such projects for the company builder. The best tool in this area today is the methodology of project management, which becomes a key factor of efficiency.

Case Study on Project Risk Management Planning Based on Soft System Methodology

NASA Astrophysics Data System (ADS)

Lifang, Xie; Jun, Li

This paper analyzed the soft system characters of construction projects and the applicability on using Soft System Methodology (SSM) for risk analysis after a brief review of SSM. Taking a hydropower project as an example, it constructed the general frame of project risk management planning (PRMP) and established the Risk Management Planning (RMP) system from the perspective of the interests of co-ordination. This paper provided the ideas and methods for construction RMP under the win-win situation through the practice of SSM.

An Effective Methodology for Processing and Analyzing Large, Complex Spacecraft Data Streams

ERIC Educational Resources Information Center

Teymourlouei, Haydar

2013-01-01

The emerging large datasets have made efficient data processing a much more difficult task for the traditional methodologies. Invariably, datasets continue to increase rapidly in size with time. The purpose of this research is to give an overview of some of the tools and techniques that can be utilized to manage and analyze large datasets. We…

Developing a stochastic conflict resolution model for urban runoff quality management: Application of info-gap and bargaining theories

NASA Astrophysics Data System (ADS)

Ghodsi, Seyed Hamed; Kerachian, Reza; Estalaki, Siamak Malakpour; Nikoo, Mohammad Reza; Zahmatkesh, Zahra

2016-02-01

In this paper, two deterministic and stochastic multilateral, multi-issue, non-cooperative bargaining methodologies are proposed for urban runoff quality management. In the proposed methodologies, a calibrated Storm Water Management Model (SWMM) is used to simulate stormwater runoff quantity and quality for different urban stormwater runoff management scenarios, which have been defined considering several Low Impact Development (LID) techniques. In the deterministic methodology, the best management scenario, representing location and area of LID controls, is identified using the bargaining model. In the stochastic methodology, uncertainties of some key parameters of SWMM are analyzed using the info-gap theory. For each water quality management scenario, robustness and opportuneness criteria are determined based on utility functions of different stakeholders. Then, to find the best solution, the bargaining model is performed considering a combination of robustness and opportuneness criteria for each scenario based on utility function of each stakeholder. The results of applying the proposed methodology in the Velenjak urban watershed located in the northeastern part of Tehran, the capital city of Iran, illustrate its practical utility for conflict resolution in urban water quantity and quality management. It is shown that the solution obtained using the deterministic model cannot outperform the result of the stochastic model considering the robustness and opportuneness criteria. Therefore, it can be concluded that the stochastic model, which incorporates the main uncertainties, could provide more reliable results.

A Methodology to Obtain Learning Effective Laboratories with Learning Management System Integration

ERIC Educational Resources Information Center

Ruano, Ildefonso; Gamez, Javier; Dormido, Sebastian; Gomez, Juan

2016-01-01

Online laboratories are useful and valuable resources in high education, especially in engineering studies. This work presents a methodology to create effective laboratories for learning that interact with a Learning Management System (LMS) to achieve advanced integration. It is based on pedagogical aspects and considers not only the laboratory…

Safety assessment methodology in management of spent sealed sources.

PubMed

Mahmoud, Narmine Salah

2005-02-14

Environmental hazards can be caused from radioactive waste after their disposal. It was therefore important that safety assessment methodologies be developed and established to study and estimate the possible hazards, and institute certain safety methodologies that lead and prevent the evolution of these hazards. Spent sealed sources are specific type of radioactive waste. According to IAEA definition, spent sealed sources are unused sources because of activity decay, damage, misuse, loss, or theft. Accidental exposure of humans from spent sealed sources can occur at the moment they become spent and before their disposal. Because of that reason, safety assessment methodologies were tailored to suit the management of spent sealed sources. To provide understanding and confidence of this study, validation analysis was undertaken by considering the scenario of an accident that occurred in Egypt, June 2000 (the Meet-Halfa accident from an iridium-192 source). The text of this work includes consideration related to the safety assessment approaches of spent sealed sources which constitutes assessment context, processes leading an active source to be spent, accident scenarios, mathematical models for dose calculations, and radiological consequences and regulatory criteria. The text also includes a validation study, which was carried out by evaluating a theoretical scenario compared to the real scenario of Meet-Halfa accident depending on the clinical assessment of affected individuals.

Role playing games: a methodology to acquire knowledge for integrated wastewater infrastructures management in a river basin scale.

PubMed

Prat, P; Aulinas, M; Turon, C; Comas, J; Poch, M

2009-01-01

Current management of sanitation infrastructures (sewer systems, wastewater treatment plant, receiving water, bypasses, deposits, etc) is not fulfilling the objectives of up to date legislation, to achieve a good ecological and chemical status of water bodies through integrated management. These made it necessary to develop new methodologies that help decision makers to improve the management in order to achieve that status. Decision Support Systems (DSS) based on Multi-Agent System (MAS) paradigm are promising tools to improve the integrated management. When all the different agents involved interact, new important knowledge emerges. This knowledge can be used to build better DSS and improve wastewater infrastructures management achieving the objectives planned by legislation. The paper describes a methodology to acquire this knowledge through a Role Playing Game (RPG). First of all there is an introduction about the wastewater problems, a definition of RPG, and the relation between RPG and MAS. Then it is explained how the RPG was built with two examples of game sessions and results. The paper finishes with a discussion about the uses of this methodology and future work.

Definition of a methodology for the management of geological heritage. An application to the Azores archipelago (Portugal)

NASA Astrophysics Data System (ADS)

Lima, Eva; Nunes, João; Brilha, José; Calado, Helena

2013-04-01

The conservation of the geological heritage requires the support of appropriate policies, which should be the result of the integration of nature conservation, environmental and land-use planning, and environmental education perspectives. There are several papers about inventory methodologies for geological heritage and its scientific, educational and tourism uses (e.g. Cendrero, 2000, Lago et al., 2000; Brilha, 2005; Carcavilla et al., 2007). However, management methodologies for geological heritage are still poorly developed. They should be included in environmental and land-use planning and nature conservation policies, in order to support a holistic approach to natural heritage. This gap is explained by the fact that geoconservation is a new geoscience still needed of more basic scientific research, like any other geoscience (Henriques et al., 2011). It is necessary to establish protocols and mechanisms for the conservation and management of geological heritage. This is a complex type of management because it needs to address not only the fragile natural features to preserve but also legal, economic, cultural, educational and recreational aspects. In addition, a management methodology should ensure the geosites conservation, the local development and the dissemination of the geological heritage (Carcavilla et al., 2007). This work is part of a PhD project aiming to contribute to fill this gap that exists in the geoconservation domain, specifically in terms of establishing an appropriate methodology for the management of geological heritage, taking into account the natural diversity of geosites and the variety of natural and anthropic threats. The proposed methodology will be applied to the geological heritage of the Azores archipelago, which management acquires particular importance and urgency after the decision of the Regional Government to create the Azores Geopark and its application to the European and Global Geoparks Networks. Acknowledgment This work is

Impact of standardized clinical assessment and management plans on resource utilization and costs in children after the arterial switch operation.

PubMed

Rathod, Rahul H; Jurgen, Brittney; Hamershock, Rose A; Friedman, Kevin G; Marshall, Audrey C; Samnaliev, Mihail; Graham, Dionne A; Jenkins, Kathy; Lock, James E; Powell, Andrew J

2017-12-01

Standardized Clinical Assessment and Management Plans (SCAMPs) are a quality improvement initiative designed to reduce unnecessary utilization, decrease practice variation, and improve patient outcomes. We created a novel methodology, the SCAMP managed episode of care (SMEOC), which encompasses multiple encounters to assess the impact of the arterial switch operation (ASO) SCAMP on total costs. All ASO SCAMP patients (dates March 2009 to July 2015) were compared to a control group of ASO patients (January 2001 to February 2009). Patients were divided into "younger" (<2 years) and "older" (2-18 years) subgroups. Utilization included all cardiology visits, tests, and procedures. Standardized costs were applied to each unit of utilization. There were 100 historical and 63 SCAMP patients in the younger subgroup, and 163 historical and 165 SCAMP patients in the older subgroup. In the younger subgroup, the SCAMP had a 28% reduction in outpatient clinic visits (P < .001), a 52% reduction in chest radiographs (P < .001), a 21% reduction in electrocardiograms (P < .001), and a 30% total reduction in costs. In the older subgroup, the SCAMP had a 21% reduction in outpatient clinic visits (P < .001), a 20% reduction in chest radiographs (P = .05), a 10% reduction in echocardiograms (P = .05), a 25% reduction in exercise stress tests (P = .01), and a 14% total reduction in costs. The total cost savings of the ASO SCAMP was $216 649 in the first 6 years of the SCAMP. There was no difference in clinical outcomes between the historical and SCAMP cohorts. SCAMPs can improve resource utilization and reduce costs after the ASO operation while maintaining quality of care. © 2017 Wiley Periodicals, Inc.

Energy and water quality management systems for water utility's operations: a review.

PubMed

Cherchi, Carla; Badruzzaman, Mohammad; Oppenheimer, Joan; Bros, Christopher M; Jacangelo, Joseph G

2015-04-15

Holistic management of water and energy resources is critical for water utilities facing increasing energy prices, water supply shortage and stringent regulatory requirements. In the early 1990s, the concept of an integrated Energy and Water Quality Management System (EWQMS) was developed as an operational optimization framework for solving water quality, water supply and energy management problems simultaneously. Approximately twenty water utilities have implemented an EWQMS by interfacing commercial or in-house software optimization programs with existing control systems. For utilities with an installed EWQMS, operating cost savings of 8-15% have been reported due to higher use of cheaper tariff periods and better operating efficiencies, resulting in the reduction in energy consumption of ∼6-9%. This review provides the current state-of-knowledge on EWQMS typical structural features and operational strategies and benefits and drawbacks are analyzed. The review also highlights the challenges encountered during installation and implementation of EWQMS and identifies the knowledge gaps that should motivate new research efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Exploring the cost-utility of stratified primary care management for low back pain compared with current best practice within risk-defined subgroups.

PubMed

Whitehurst, David G T; Bryan, Stirling; Lewis, Martyn; Hill, Jonathan; Hay, Elaine M

2012-11-01

Stratified management for low back pain according to patients' prognosis and matched care pathways has been shown to be an effective treatment approach in primary care. The aim of this within-trial study was to determine the economic implications of providing such an intervention, compared with non-stratified current best practice, within specific risk-defined subgroups (low-risk, medium-risk and high-risk). Within a cost-utility framework, the base-case analysis estimated the incremental healthcare cost per additional quality-adjusted life year (QALY), using the EQ-5D to generate QALYs, for each risk-defined subgroup. Uncertainty was explored with cost-utility planes and acceptability curves. Sensitivity analyses were performed to consider alternative costing methodologies, including the assessment of societal loss relating to work absence and the incorporation of generic (ie, non-back pain) healthcare utilisation. The stratified management approach was a cost-effective treatment strategy compared with current best practice within each risk-defined subgroup, exhibiting dominance (greater benefit and lower costs) for medium-risk patients and acceptable incremental cost to utility ratios for low-risk and high-risk patients. The likelihood that stratified care provides a cost-effective use of resources exceeds 90% at willingness-to-pay thresholds of £4000 (≈ 4500; $6500) per additional QALY for the medium-risk and high-risk groups. Patients receiving stratified care also reported fewer back pain-related days off work in all three subgroups. Compared with current best practice, stratified primary care management for low back pain provides a highly cost-effective use of resources across all risk-defined subgroups.

A descriptive review of the methodologies used in household surveys on medicine utilization.

PubMed

Bertoldi, Andréa D; Barros, Aluísio J D; Wagner, Anita; Ross-Degnan, Dennis; Hallal, Pedro C

2008-10-31

Studies carried out in the community enable researchers to understand access to medicines, affordability, and barriers to use from the consumer's point of view, and may stimulate the development of adequate medicines policies. The aim of the present article was to describe methodological and analytical aspects of quantitative studies on medicine utilization carried out at the household level. Systematic review of original papers with data collected in studies in which the household was a sampling unit, published between 1995 and 2008. The electronic review was carried out in Medline/Pubmed, Scielo and Lilacs. The reference lists of the papers identified were examined, as well as other publications by their authors. Studies on the utilization of specific pharmacological groups, or those including only respondents with a given disease were excluded. Out of 4852 papers initially identified in the literature search, 61 fulfilled our inclusion criteria. Most studies were carried out in Europe and North America and used a cross-sectional approach. More than 80% used face-to-face interviews for data collection, and the most frequently used recall period for assessing medicine utilization was 14-15 days. In 59% of the studies, interviewers were trained to request the packaging of the medicines reported by the subjects; medical prescriptions were requested less frequently (15% of the studies). These data will be useful for updating researchers on what methods their peers are currently using. Such information may help overcome challenges in the planning and analyses of future studies. Moreover, this publication may contribute to the improvement of the quality of medicine use data obtained in household surveys.

A comparison of costs associated with utility management options for dry active waste

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hornibrook, C.

1995-12-31

The economics of low level waste management is receiving more attention today than ever before. This is due to four factors: (1) the increases in the cost of processing of these wastes; (2) increases in the cost of disposal; (3) the addition of storage costs for those without access to disposal; and (4) the increasing competitive nature of the electric generation industry. These pressures are forcing the industry to update it`s evaluation of the mix of processing that will afford it the best long term economics and minimize it`s risks for unforeseen costs. Whether disposal is available or not, allmore » utilities face the same challenge of minimizing the costs associated with the management of these wastes. There are a number of variables that will impact how a utility manages their wastes but the problem is the uncertainty of what will actually happen, i.e., will disposal be available, when and at what cost. Using the EPRI-developed WASTECOST: DAW code, this paper explores a variety of LLW management options available to utilities. Along with providing the costs and benefits, other technical considerations which play an important part in the management of these wastes are also addressed.« less

Methodologies for Optimum Capital Expenditure Decisions for New Medical Technology

PubMed Central

Landau, Thomas P.; Ledley, Robert S.

1980-01-01

This study deals with the development of a theory and an analytical model to support decisions regarding capital expenditures for complex new medical technology. Formal methodologies and quantitative techniques developed by applied mathematicians and management scientists can be used by health planners to develop cost-effective plans for the utilization of medical technology on a community or region-wide basis. In order to maximize the usefulness of the model, it was developed and tested against multiple technologies. The types of technologies studied include capital and labor-intensive technologies, technologies whose utilization rates vary with hospital occupancy rate, technologies whose use can be scheduled, and limited-use and large-use technologies.

[Evaluation of medication risk in pregnant women: methodology of evaluation and risk management].

PubMed

Eléfant, E; Sainte-Croix, A

1997-01-01

This round table discussion was devoted to the description of the tools currently available for the evaluation of drug risks and management during pregnancy. Five topics were submitted for discussion: pre-clinical data, methodological tools, benefit/risk ratio before prescription, teratogenic or fetal risk evaluation, legal comments.

A methodology and supply chain management inspired reference ontology for modeling healthcare teams.

PubMed

Kuziemsky, Craig E; Yazdi, Sara

2011-01-01

Numerous studies and strategic plans are advocating more team based healthcare delivery that is facilitated by information and communication technologies (ICTs). However before we can design ICTs to support teams we need a solid conceptual model of team processes and a methodology for using such a model in healthcare settings. This paper draws upon success in the supply chain management domain to develop a reference ontology of healthcare teams and a methodology for modeling teams to instantiate the ontology in specific settings. This research can help us understand how teams function and how we can design ICTs to support teams.

EPRI guide to managing nuclear utility protective clothing programs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kelly, J.J.

1991-05-01

The Electric Power Research Institute (EPRI) commissioned a radioactive waste related project (RP2414-34) during the last quarter of 1989 to produce a guide for developing and managing nuclear protective clothing programs. Every nuclear facility must coordinate some type of protective clothing program for its radiation workers to insure proper and safe protection for the wearer and to maintain control over the spread of contamination. Yet, every nuclear facility has developed its own unique program for managing such clothing. Accordingly, a need existed for a reference guide to assist with the standardization of protective clothing programs and to assist in controllingmore » the potentially runaway economics of such programs. This document is the first known effort to formalize the planning and economic factors surrounding a nuclear utility protective clothing program. It is intended to be informative by addressing the various pieces of information necessary to establish and maintain an effective, professionally managed protective clothing program. It also attempts to provide guidance toward tailoring the information and providing examples within the report to fit each utility's specific needs. This report is further intended to address new issues and trends occurring throughout the nuclear industry in late 1989 which can have either a significant positive or negative impact on the operations or economics of nuclear protective clothing programs. 1 ref., 11 tabs.« less

A robust rotorcraft flight control system design methodology utilizing quantitative feedback theory

NASA Technical Reports Server (NTRS)

Gorder, Peter James

1993-01-01

Rotorcraft flight control systems present design challenges which often exceed those associated with fixed-wing aircraft. First, large variations in the response characteristics of the rotorcraft result from the wide range of airspeeds of typical operation (hover to over 100 kts). Second, the assumption of vehicle rigidity often employed in the design of fixed-wing flight control systems is rarely justified in rotorcraft where rotor degrees of freedom can have a significant impact on the system performance and stability. This research was intended to develop a methodology for the design of robust rotorcraft flight control systems. Quantitative Feedback Theory (QFT) was chosen as the basis for the investigation. Quantitative Feedback Theory is a technique which accounts for variability in the dynamic response of the controlled element in the design robust control systems. It was developed to address a Multiple-Input Single-Output (MISO) design problem, and utilizes two degrees of freedom to satisfy the design criteria. Two techniques were examined for extending the QFT MISO technique to the design of a Multiple-Input-Multiple-Output (MIMO) flight control system (FCS) for a UH-60 Black Hawk Helicopter. In the first, a set of MISO systems, mathematically equivalent to the MIMO system, was determined. QFT was applied to each member of the set simultaneously. In the second, the same set of equivalent MISO systems were analyzed sequentially, with closed loop response information from each loop utilized in subsequent MISO designs. The results of each technique were compared, and the advantages of the second, termed Sequential Loop Closure, were clearly evident.

Remote-sensing applications as utilized in Florida's coastal zone management program

NASA Technical Reports Server (NTRS)

Worley, D. R.

1975-01-01

Land use maps were developed from photomaps obtained by remote sensing in order to develop a comprehensive state plan for the protection, development, and zoning of coastal regions. Only photographic remote sensors have been used in support of the coastal council's planning/management methodology. Standard photointerpretation and cartographic application procedures for map compilation were used in preparing base maps.

Does Medicaid Managed Care Help Equalize Racial and Ethnic Disparities in Utilization?

PubMed

Marton, James; Yelowitz, Aaron; Shores, Meredith; Talbert, Jeffery C

2016-06-01

To estimate the impact of different forms of Medicaid managed care (MMC) delivery on racial and ethnic disparities in utilization. Longitudinal, administrative data on 101,649 children in Kentucky continuously enrolled in Medicaid between January 1997 and June 1999. Outcomes considered are monthly professional, outpatient, and inpatient utilization. We apply an intent-to-treat, instrumental variables analysis using the staggered geographic implementation of MMC to create treatment and control groups of children. The implementation of MMC reduced monthly professional visits by a smaller degree for non-whites than whites (3.8 percentage points vs. 6.2 percentage points), thereby helping to equalize the initial racial/ethnic disparity in utilization. The Passport MMC program in the Louisville-centered region statistically significantly reduced disparities for professional visits (closing the gap by 8.0 percentage points), while the Kentucky Health Select MMC program in the Lexington-centered region did not. No substantive impact on disparities was found for either outpatient or inpatient utilization in either program. We find evidence that MMC has the possibility to reduce racial/ethnic disparities in professional utilization. More work is needed to determine which managed care program characteristics drive this result. © 2015 The Authors. Health Services Research published by Wiley Periodicals, Inc. on behalf of Health Research and Educational Trust.

Evaluating the statistical methodology of randomized trials on dentin hypersensitivity management.

PubMed

Matranga, Domenica; Matera, Federico; Pizzo, Giuseppe

2017-12-27

The present study aimed to evaluate the characteristics and quality of statistical methodology used in clinical studies on dentin hypersensitivity management. An electronic search was performed for data published from 2009 to 2014 by using PubMed, Ovid/MEDLINE, and Cochrane Library databases. The primary search terms were used in combination. Eligibility criteria included randomized clinical trials that evaluated the efficacy of desensitizing agents in terms of reducing dentin hypersensitivity. A total of 40 studies were considered eligible for assessment of quality statistical methodology. The four main concerns identified were i) use of nonparametric tests in the presence of large samples, coupled with lack of information about normality and equality of variances of the response; ii) lack of P-value adjustment for multiple comparisons; iii) failure to account for interactions between treatment and follow-up time; and iv) no information about the number of teeth examined per patient and the consequent lack of cluster-specific approach in data analysis. Owing to these concerns, statistical methodology was judged as inappropriate in 77.1% of the 35 studies that used parametric methods. Additional studies with appropriate statistical analysis are required to obtain appropriate assessment of the efficacy of desensitizing agents.

Thru-life impacts of driver aggression, climate, cabin thermal management, and battery thermal management on battery electric vehicle utility

NASA Astrophysics Data System (ADS)

Neubauer, Jeremy; Wood, Eric

2014-08-01

Battery electric vehicles (BEVs) offer the potential to reduce both oil imports and greenhouse gas emissions, but have a limited utility that is affected by driver aggression and effects of climate-both directly on battery temperature and indirectly through the loads of cabin and battery thermal management systems. Utility is further affected as the battery wears through life in response to travel patterns, climate, and other factors. In this paper we apply the National Renewable Energy Laboratory's Battery Lifetime Analysis and Simulation Tool for Vehicles (BLAST-V) to examine the sensitivity of BEV utility to driver aggression and climate effects over the life of the vehicle. We find the primary challenge to cold-climate BEV operation to be inefficient cabin heating systems, and to hot-climate BEV operation to be high peak on-road battery temperatures and excessive battery degradation. Active cooling systems appear necessary to manage peak battery temperatures of aggressive, hot-climate drivers, which can then be employed to maximize thru-life vehicle utility.

Security Vulnerability and Patch Management in Electric Utilities: A Data-Driven Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Qinghua; Zhang, Fengli

This paper explores a real security vulnerability and patch management dataset from an electric utility in order to shed light on characteristics of the vulnerabilities that electric utility assets have and how they are remediated in practice. Specifically, it first analyzes the distribution of vulnerabilities over software, assets, and other metric. Then it analyzes how vulnerability features affect remediate actions.

Quantitative evaluation of geodiversity: development of methodological procedures with application to territorial management

NASA Astrophysics Data System (ADS)

Forte, J.; Brilha, J.; Pereira, D.; Nolasco, M.

2012-04-01

Although geodiversity is considered the setting for biodiversity, there is still a huge gap in the social recognition of these two concepts. The concept of geodiversity, less developed, is now making its own way as a robust and fundamental idea concerning the abiotic component of nature. From a conservationist point of view, the lack of a broader knowledge concerning the type and spatial variation of geodiversity, as well as its relationship with biodiversity, makes the protection and management of natural or semi-natural areas incomplete. There is a growing need to understand the patterns of geodiversity in different landscapes and to translate this knowledge for territorial management in a practical and effective point of view. This kind of management can also represent an important tool for the development of sustainable tourism, particularly geotourism, which can bring benefits not only for the environment, but also for social and economic purposes. The quantification of geodiversity is an important step in all this process but still few researchers are investing in the development of a proper methodology. The assessment methodologies that were published so far are mainly focused on the evaluation of geomorphological elements, sometimes complemented with information about lithology, soils, hidrology, morphometric variables, climatic surfaces and geosites. This results in very dissimilar areas at very different spatial scales, showing the complexity of the task and the need of further research. This current work aims the development of an effective methodology for the assessment of the maximum elements of geodiversity possible (rocks, minerals, fossils, landforms, soils), based on GIS routines. The main determinant factor for the quantitative assessment is scale, but other factors are also very important, such as the existence of suitable spatial data with sufficient degree of detail. It is expected to attain the proper procedures in order to assess geodiversity

Effect of diabetic case management intervention on health service utilization in Korea.

PubMed

Shin, Soon Ae; Kim, Hyeongsu; Lee, Kunsei; Lin, Vivian; Liu, George

2015-12-01

This study is to estimate the effectiveness of a diabetic case management programme on health-care service utilization. The study population included 6007 as the intervention group and 956,766 as the control group. As the indicators of health-care service utilization, numbers of medical ambulatory consultations, days of medication prescribed and medical expenses for one year were used, and we analysed the claim data of the health insurance from 2005 to 2007. The study population was classified into three subgroups based on the number of medical ambulatory consultations per year before this intervention. In the under-serviced subgroup, the intervention group showed a significant increase in the number of consultations (3.2), days of prescribed medication (66.4) and medical expenses (287,900 KRW) compared with the control group. Conversely, in the over-serviced subgroup, the intervention group showed a less decrease days of prescribed medication (1.6) compared with the control group. This showed that the case management programme led the intervention group to optimize their utilization of health-care services by subgroups. It is necessary to evaluate the appropriateness of health-care usage and clinical outcome to show the direct effectiveness of the case management programme by subgroups. © 2014 Wiley Publishing Asia Pty Ltd.

Do Italian Companies Manage Work-Related Stress Effectively? A Process Evaluation in Implementing the INAIL Methodology

PubMed Central

Di Tecco, Cristina; Ronchetti, Matteo; Ghelli, Monica; Russo, Simone; Persechino, Benedetta

2015-01-01

Studies on Intervention Process Evaluation are attracting growing attention in the literature on interventions linked to stress and the wellbeing of workers. There is evidence that some elements relating to the process and content of an intervention may have a decisive role in implementing it by facilitating or hindering the effectiveness of the results. This study aimed to provide a process evaluation on interventions to assess and manage risks related to work-related stress using a methodological path offered by INAIL. The final sample is composed of 124 companies participating to an interview on aspects relating to each phase of the INAIL methodological path put in place to implement the intervention. INAIL methodology has been defined as useful in the process of assessing and managing the risks related to work-related stress. Some factors related to the process (e.g., implementation of a preliminary phase, workers' involvement, and use of external consultants) showed a role in significant differences that emerged in the levels of risk, particularly in relation to findings from the preliminary assessment. Main findings provide information on the key aspects of process and content that are useful in implementing an intervention for assessing and managing risks related to work-related stress. PMID:26504788

Do Italian Companies Manage Work-Related Stress Effectively? A Process Evaluation in Implementing the INAIL Methodology.

PubMed

Di Tecco, Cristina; Ronchetti, Matteo; Ghelli, Monica; Russo, Simone; Persechino, Benedetta; Iavicoli, Sergio

2015-01-01

Studies on Intervention Process Evaluation are attracting growing attention in the literature on interventions linked to stress and the wellbeing of workers. There is evidence that some elements relating to the process and content of an intervention may have a decisive role in implementing it by facilitating or hindering the effectiveness of the results. This study aimed to provide a process evaluation on interventions to assess and manage risks related to work-related stress using a methodological path offered by INAIL. The final sample is composed of 124 companies participating to an interview on aspects relating to each phase of the INAIL methodological path put in place to implement the intervention. INAIL methodology has been defined as useful in the process of assessing and managing the risks related to work-related stress. Some factors related to the process (e.g., implementation of a preliminary phase, workers' involvement, and use of external consultants) showed a role in significant differences that emerged in the levels of risk, particularly in relation to findings from the preliminary assessment. Main findings provide information on the key aspects of process and content that are useful in implementing an intervention for assessing and managing risks related to work-related stress.

Eutrophication assessment and management methodology of multiple pollution sources of a landscape lake in North China.

PubMed

Chen, Yanxi; Niu, Zhiguang; Zhang, Hongwei

2013-06-01

Landscape lakes in the city suffer high eutrophication risk because of their special characters and functions in the water circulation system. Using a landscape lake HMLA located in Tianjin City, North China, with a mixture of point source (PS) pollution and non-point source (NPS) pollution, we explored the methodology of Fluent and AQUATOX to simulate and predict the state of HMLA, and trophic index was used to assess the eutrophication state. Then, we use water compensation optimization and three scenarios to determine the optimal management methodology. Three scenarios include ecological restoration scenario, best management practices (BMPs) scenario, and a scenario combining both. Our results suggest that the maintenance of a healthy ecosystem with ecoremediation is necessary and the BMPs have a far-reaching effect on water reusing and NPS pollution control. This study has implications for eutrophication control and management under development for urbanization in China.

Developing and Managing University-Industry Research Collaborations through a Process Methodology/Industrial Sector Approach

ERIC Educational Resources Information Center

Philbin, Simon P.

2010-01-01

A management framework has been successfully utilized at Imperial College London in the United Kingdom to improve the process for developing and managing university-industry research collaborations. The framework has been part of a systematic approach to increase the level of research contracts from industrial sources, to strengthen the…

Development of an integrated methodology for the sustainable environmental and socio-economic management of river ecosystems.

PubMed

Koundouri, P; Ker Rault, P; Pergamalis, V; Skianis, V; Souliotis, I

2016-01-01

The development of the Water Framework Directive aimed to establish an integrated framework of water management at European level. This framework revolves around inland surface waters, transitional waters, coastal waters and ground waters. In the process of achieving the environment and ecological objectives set from the Directive, the role of economics is put in the core of the water management. An important feature of the Directive is the recovery of total economic cost of water services by all users. The total cost of water services can be disaggregated into environmental, financial and resource costs. Another important aspect of the directive is the identification of major drivers and pressures in each River Basin District. We describe a methodology that is aiming to achieve sustainable and environmental and socioeconomic management of freshwater ecosystem services. The Ecosystem Services Approach is in the core of the suggested methodology for the implementation of a more sustainable and efficient water management. This approach consists of the following three steps: (i) socio-economic characterization of the River Basin area, (ii) assessment of the current recovery of water use cost, and (iii) identification and suggestion of appropriate programs of measures for sustainable water management over space and time. This methodology is consistent with a) the economic principles adopted explicitly by the Water Framework Directive (WFD), b) the three-step WFD implementation approach adopted in the WATECO document, c) the Ecosystem Services Approach to valuing freshwater goods and services to humans. Furthermore, we analyze how the effects of multiple stressors and socio-economic development can be quantified in the context of freshwater resources management. We also attempt to estimate the value of four ecosystem services using the benefit transfer approach for the Anglian River Basin, which showed the significance of such services. Copyright © 2015. Published by

Utilization Management in Department of Defense Military Treatment Facilities

DTIC Science & Technology

1992-07-01

Health Affairs) Mendez (1992) clearly states that his plan is for the military health services system’s quality assessment and criteria to become more...also worthy of note that second surgical opinions are not part of Assistant Secretary of Defense (Health Affairs) Mendez ’ (1992) memonrandur on...Affairs) Mendez ’ (1992) quality management policy already states that military medical treatment facilities will begin to implement utilization

Mobile and Web 2.0 interventions for weight management: an overview of review evidence and its methodological quality

PubMed Central

Smith, Jane R.; Samaha, Laya; Abraham, Charles

2016-01-01

Abstract Background : The use of Internet and related technologies for promoting weight management (WM), physical activity (PA), or dietary-related behaviours has been examined in many articles and systematic reviews. This overview aims to summarize and assess the quality of the review evidence specifically focusing on mobile and Web 2.0 technologies, which are the most utilized, currently available technologies. Methods: Following a registered protocol (CRD42014010323), we searched 16 databases for articles published in English until 31 December 2014 discussing the use of either mobile or Web 2.0 technologies to promote WM or related behaviors, i.e. diet and physical activity (PA). Two reviewers independently selected reviews and assessed their methodological quality using the AMSTAR checklist. Citation matrices were used to determine the overlap among reviews. Results: Forty-four eligible reviews were identified, 39 of which evaluated the effects of interventions using mobile or Web 2.0 technologies. Methodological quality was generally low with only 7 reviews (16%) meeting the highest standards. Suggestive evidence exists for positive effects of mobile technologies on weight-related outcomes and, to a lesser extent, PA. Evidence is inconclusive regarding Web 2.0 technologies. Conclusions : Reviews on mobile and Web 2.0 interventions for WM and related behaviors suggest that these technologies can, under certain circumstances, be effective, but conclusions are limited by poor review quality based on a heterogeneous evidence base. PMID:27335330

A Retention Assessment Process: Utilizing Total Quality Management Principles and Focus Groups

ERIC Educational Resources Information Center

Codjoe, Henry M.; Helms, Marilyn M.

2005-01-01

Retaining students is a critical topic in higher education. Methodologies abound to gather attrition data as well as key variables important to retention. Using the theories of total quality management and focus groups, this case study gathers and reports data from current college students. Key results, suggestions for replication, and areas for…

Methodology to Estimate the Quantity, Composition, and Management of Construction and Demolition Debris in the United States

EPA Science Inventory

This report, Methodology to Estimate the Quantity, Composition and Management of Construction and Demolition Debris in the US, was developed to expand access to data on CDD in the US and to support research on CDD and sustainable materials management. Since past US EPA CDD estima...

Centralized care management support for "high utilizers" in primary care practices at an academic medical center.

PubMed

Williams, Brent C; Paik, Jamie L; Haley, Laura L; Grammatico, Gina M

2014-01-01

Although evidence of effectiveness is limited, care management based outside primary care practices or hospitals is receiving increased attention. The University of Michigan (UM) Complex Care Management Program (CCMP) provides care management for uninsured and underinsured, high-utilizing patients in multiple primary care practices. To inform development of optimal care management models, we describe the CCMP model and characteristics and health care utilization patterns of its patients. Of a consecutive series of 49 patients enrolled at CCMP in 2011, the mean (SD) age was 48 (+/- 14); 23 (47%) were women; and 29 (59%) were White. Twenty-eight (57%) had two or more chronic medical conditions, 39 (80%) had one or more psychiatric condition, 28 (57%) had a substance abuse disorder, and 11 (22%) were homeless. Through phone, e-mail, and face-to-face contact with patients and primary care providers (PCPs), care managers coordinated health and social services and facilitated access to medical and mental health care. Patients had a mean (SD) number of hospitalizations and emergency room (ER) visits in 6 months prior to enrollment of2.2 (2.5) and 4.2 (4.3), respectively, with a nonstatistically significant decrease in hospitalizations, hospital days, and emergency room visits in 6 months following enrollment in CCMP. Centralized care management support for primary care practices engages high-utilizing patients with complex medical and behavioral conditions in care management that would be difficult to provide through individual practices and may decrease health care utilization by these patients.

Utilization of Computer Technology To Facilitate Money Management by Individuals with Mental Retardation.

ERIC Educational Resources Information Center

Davies, Daniel K.; Stock, Steven E.; Wehmeyer, Michael L.

2003-01-01

This report describes results of an initial investigation of the utility of a specially designed money management software program for improving management of personal checking accounts for individuals with mental retardation. Use with 19 adults with mental retardation indicated the software resulted in significant reduction in check writing and…

Classroom Management Strategies to Address the Needs of Sudanese Refugee Learners: Support Document--Methodology and Literature Review

ERIC Educational Resources Information Center

Burgoyne, Ursula; Hull, Oksana

2007-01-01

This document presents the methodology and literature review for the research report "Classroom Management Strategies to Address the Needs of Sudanese Refugee Learners" (ED499673), which examined the extent to which English language, literacy and numeracy teachers used classroom management strategies to meet the needs of adult Sudanese…

Need for evaluative methodologies in land use, regional resource and waste management planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Croke, E. J.

The transfer of planning methodology from the research community to the practitioner very frequently takes the form of analytical and evaluative techniques and procedures. In the end, these become operational in the form of data acquisition, management and display systems, computational schemes that are codified in the form of manuals and handbooks, and computer simulation models. The complexity of the socioeconomic and physical processes that govern environmental resource and waste management have reinforced the need for computer assisted, scientifically sophisticated planning models that are fully operational, dependent on an attainable data base and accessible in terms of the resources normallymore » available to practitioners of regional resource management, waste management, and land use planning. A variety of models and procedures that attempt to meet one or more of the needs of these practitioners are discussed.« less

Utilizing Technology Effectively to Improve Millennials' Educational Performance: An Exploratory Look at Business Students' Perceptions

ERIC Educational Resources Information Center

Aviles, Maria; Eastman, Jacqueline K.

2012-01-01

Purpose: The purpose of this paper is to discuss how technological tools, such as Web 2.0 and online learning management systems, can be utilized to improve Millennials' educational performance. Design/methodology/approach: An exploratory survey of Millennial business students was conducted to measure their self-reported use and perceived…

Changing Management of the Patent Ductus Arteriosus: Effect on Neonatal Outcomes and Resource Utilization.

PubMed

Chock, Valerie Y; Goel, Veena V; Palma, Jonathan P; Luh, Thomas M; Wang, Nichole A; Gaskari, Shabnam; Punn, Rajesh; Silverman, Norman H; Benitz, William E

2017-08-01

Objective  This historical cohort study investigated how a shift toward a more conservative approach of awaiting spontaneous closure of the patent ductus arteriosus (PDA) in preterm infants has affected neonatal outcomes and resource utilization. Methods  We retrospectively studied very low birth weight infants diagnosed with a PDA by echocardiogram (ECHO) in 2006-2008 (era 1), when medical or surgical PDA management was emphasized, to those born in 2010-2012 (era 2) when conservative PDA management was encouraged. Multiple regression analyses adjusted for gestational age were performed to assess differences in clinical outcomes and resource utilization between eras. Results  More infants in era 2 (35/89, 39%) compared with era 1 (22/120, 18%) had conservative PDA management ( p  < 0.01). Despite no difference in surgical ligation rate, infants in era 2 had ligation later (median 24 vs. 8 days, p  < 0.0001). There was no difference in clinical outcomes between eras, while number of ECHOs per patient was the only resource measure that increased in era 2 (median 3 vs. 2 ECHOs, p  = 0.003). Conclusion  In an era of more conservative PDA management, no increase in adverse clinical outcomes or significant change in resource utilization was found. Conservative PDA management may be a safe alternative for preterm infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The effects of organizational flexibility on nurse utilization and vacancy statistics in Ontario hospitals.

PubMed

Fisher, Anita; Baumann, Andrea; Blythe, Jennifer

2007-01-01

Social and economic changes in industrial societies during the past quarter-century encouraged organizations to develop greater flexibility in their employment systems in order to adapt to organizational restructuring and labour market shifts (Kallenberg 2003). During the 1990s this trend became evident in healthcare organizations. Before healthcare restructuring, employment in the acute hospital sector was more stable, with higher levels of full-time staff. However, in the downsizing era, employers favoured more flexible, contingent workforces (Zeytinoglu 1999). As healthcare systems evolved, staffing patterns became more chaotic and predicting staffing requirements more complex. Increased use of casual and part-time staff, overtime and agency nurses, as well as alterations in skills mix, masked vacancy counts and thus rendered this measurement of nursing demand increasingly difficult. This study explores flexible nurse staffing practices and demonstrates how data such as nurse vacancy statistics, considered in isolation from nurse utilization information, are inaccurate indicators of nursing demand and nurse shortage. It develops an algorithm that provides a standard methodology for improved monitoring and management of nurse utilization data and better quantification of vacancy statistics. Use of standard methodology promotes more accurate measurement of nurse utilization and shortage. Furthermore, it provides a solid base for improved nursing workforce planning, production and management.

Experimental Methodology for Measuring Combustion and Injection-Coupled Responses

NASA Technical Reports Server (NTRS)

Cavitt, Ryan C.; Frederick, Robert A.; Bazarov, Vladimir G.

2006-01-01

A Russian scaling methodology for liquid rocket engines utilizing a single, full scale element is reviewed. The scaling methodology exploits the supercritical phase of the full scale propellants to simplify scaling requirements. Many assumptions are utilized in the derivation of the scaling criteria. A test apparatus design is presented to implement the Russian methodology and consequently verify the assumptions. This test apparatus will allow researchers to assess the usefulness of the scaling procedures and possibly enhance the methodology. A matrix of the apparatus capabilities for a RD-170 injector is also presented. Several methods to enhance the methodology have been generated through the design process.

Business resilience: Reframing healthcare risk management.

PubMed

Simeone, Cynthia L

2015-09-01

The responsibility of risk management in healthcare is fractured, with multiple stakeholders. Most hospitals and healthcare systems do not have a fully integrated risk management system that spans the entire organizational and operational structure for the delivery of key services. This article provides insight toward utilizing a comprehensive Business Resilience program and associated methodology to understand and manage organizational risk leading to organizational effectiveness and operational efficiencies, with the fringe benefit of realizing sustainable operational capability during adverse conditions. © 2015 American Society for Healthcare Risk Management of the American Hospital Association.

The Validity and Utility of the Positive Presentation Management and Negative Presentation Management Scales for the Revised NEO Personality Inventory

ERIC Educational Resources Information Center

Sellbom, Martin; Bagby, R. Michael

2008-01-01

Schinka, Kinder, and Kremer developed "validity" scales for the "Revised NEO Personality Inventory" (NEO PI-R; Costa & McCrae) to detect underreporting--the Positive Presentation Management (PPM) Scale and overreporting--the Negative Presentation Management (NPM) Scale. In this investigation, the clinical utility of these…

Utilizing Lean Six Sigma Methodology to Improve the Authored Works Command Approval Process at Naval Medical Center San Diego.

PubMed

Valdez, Michelle M; Liwanag, Maureen; Mount, Charles; Rodriguez, Rechell; Avalos-Reyes, Elisea; Smith, Andrew; Collette, David; Starsiak, Michael; Green, Richard

2018-03-14

Inefficiencies in the command approval process for publications and/or presentations negatively impact DoD Graduate Medical Education (GME) residency programs' ability to meet ACGME scholarly activity requirements. A preliminary review of the authored works approval process at Naval Medical Center San Diego (NMCSD) disclosed significant inefficiency, variation in process, and a low level of customer satisfaction. In order to facilitate and encourage scholarly activity at NMCSD, and meet ACGME requirements, the Executive Steering Council (ESC) chartered an interprofessional team to lead a Lean Six Sigma (LSS) Rapid Improvement Event (RIE) project. Two major outcome metrics were identified: (1) the number of authored works submissions containing all required signatures and (2) customer satisfaction with the authored works process. Primary metric baseline data were gathered utilizing a Clinical Investigations database tracking publications and presentations. Secondary metric baseline data were collected via a customer satisfaction survey to GME faculty and residents. The project team analyzed pre-survey data and utilized LSS tools and methodology including a "gemba" (environment) walk, cause and effect diagram, critical to quality tree, voice of the customer, "muda" (waste) chart, and a pre- and post-event value stream map. The team selected an electronic submission system as the intervention most likely to positively impact the RIE project outcome measures. The number of authored works compliant with all required signatures improved from 52% to 100%. Customer satisfaction rated as "completely or mostly satisfied" improved from 24% to 97%. For both outcomes, signature compliance and customer satisfaction, statistical significance was achieved with a p < 0.0001. This RIE project utilized LSS methodology and tools to improve signature compliance and increase customer satisfaction with the authored works approval process, leading to 100% signature compliance, a

The methodological quality of health economic evaluations for the management of hip fractures: A systematic review of the literature.

PubMed

Sabharwal, Sanjeeve; Carter, Alexander; Darzi, Lord Ara; Reilly, Peter; Gupte, Chinmay M

2015-06-01

Approximately 76,000 people a year sustain a hip fracture in the UK and the estimated cost to the NHS is £1.4 billion a year. Health economic evaluations (HEEs) are one of the methods employed by decision makers to deliver healthcare policy supported by clinical and economic evidence. The objective of this study was to (1) identify and characterize HEEs for the management of patients with hip fractures, and (2) examine their methodological quality. A literature search was performed in MEDLINE, EMBASE and the NHS Economic Evaluation Database. Studies that met the specified definition for a HEE and evaluated hip fracture management were included. Methodological quality was assessed using the Consensus on Health Economic Criteria (CHEC). Twenty-seven publications met the inclusion criteria of this study and were included in our descriptive and methodological analysis. Domains of methodology that performed poorly included use of an appropriate time horizon (66.7% of studies), incremental analysis of costs and outcomes (63%), future discounting (44.4%), sensitivity analysis (40.7%), declaration of conflicts of interest (37%) and discussion of ethical considerations (29.6%). HEEs for patients with hip fractures are increasing in publication in recent years. Most of these studies fail to adopt a societal perspective and key aspects of their methodology are poor. The development of future HEEs in this field must adhere to established principles of methodology, so that better quality research can be used to inform health policy on the management of patients with a hip fracture. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Integrated EAP/Managed Behavioral Health Plan Utilization by Persons with Substance Use Disorders

PubMed Central

Levy Merrick, Elizabeth S.; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M.; Greenfield, Shelly F.; McCann, Bernard

2011-01-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral healthcare organization's integrated EAP/managed behavioral health care product (N=1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. PMID:21185684

Is control through utilization a cost effective Prosopis juliflora management strategy?

PubMed

Wakie, Tewodros T; Hoag, Dana; Evangelista, Paul H; Luizza, Matthew; Laituri, Melinda

2016-03-01

The invasive tree Prosopis juliflora is known to cause negative impacts on invaded ranges. High P. juliflora eradication costs have swayed developing countries to follow a new and less expensive approach known as control through utilization. However, the net benefits of this new approach have not been thoroughly evaluated. Our objective was to assess the economic feasibility of selected P. juliflora eradication and utilization approaches that are currently practiced in one of the severely affected developing countries, Ethiopia. The selected approaches include converting P. juliflora infested lands into irrigated farms (conversion), charcoal production, and seed flour production. We estimate the costs and revenues of the selected P. juliflora eradication and utilization approaches by interviewing 19 enterprise owners. We assess the economic feasibility of the enterprises by performing enterprise, break-even, investment, sensitivity, and risk analyses. Our results show that conversion to irrigated cotton is economically profitable, with Net Present Value (NPV) of 5234 US$/ha over 10 years and an interest rate of 10% per year. Conversion greatly reduces the spread of P. juliflora on farmlands. Managing P. juliflora infested lands for charcoal production with a four-year harvest cycle is profitable, with NPV of 805 US$/ha. However, the production process needs vigilant regulation to protect native plants from exploitation and caution should be taken to prevent charcoal production sites from becoming potential seed sources. Though flour from P. juliflora pods can reduce invasions by destroying viable seeds, flour enterprises in Ethiopia are unprofitable. Conversion and charcoal production can be undertaken with small investment costs, while flour production requires high investment costs. Introducing new changes in the production and management steps of P. juliflora flour might be considered to make the enterprise profitable. Our study shows that control

Resource utilization after introduction of a standardized clinical assessment and management plan.

PubMed

Friedman, Kevin G; Rathod, Rahul H; Farias, Michael; Graham, Dionne; Powell, Andrew J; Fulton, David R; Newburger, Jane W; Colan, Steven D; Jenkins, Kathy J; Lock, James E

2010-01-01

A Standardized Clinical Assessment and Management Plan (SCAMP) is a novel quality improvement initiative that standardizes the assessment and management of all patients who carry a predefined diagnosis. Based on periodic review of systemically collected data the SCAMP is designed to be modified to improve its own algorithm. One of the objectives of a SCAMP is to identify and reduce resource utilization and patient care costs. We retrospectively reviewed resource utilization in the first 93 arterial switch operation (ASO) SCAMP patients and 186 age-matched control ASO patients. We compared diagnostic and laboratory testing obtained at the initial SCAMP clinic visit and control patient visits. To evaluate the effect of the SCAMP over time, the number of clinic visits per patient year and echocardiograms per patient year in historical control ASO patients were compared to the projected rates for ASO SCAMP participants. Cardiac magnetic resonance imaging (MRI), stress echocardiogram, and lipid profile utilization were higher in the initial SCAMP clinic visit group than in age-matched control patients. Total echocardiogram and lung scan usage were similar. Chest X-ray and exercise stress testing were obtained less in SCAMP patients. ASO SCAMP patients are projected to have 0.5 clinic visits and 0.5 echocardiograms per year. Historical control patients had more clinic visits (1.2 vs. 0.5 visits/patient year, P<.01) and a higher echocardiogram rate (0.92 vs. 0.5 echocardiograms/patient year, P<.01) Implementation of a SCAMP may initially lead to increased resource utilization, but over time resource utilization is projected to decrease.

10 CFR 766.102 - Calculation methodology.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Calculation methodology. 766.102 Section 766.102 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.102 Calculation methodology. (a...

10 CFR 766.102 - Calculation methodology.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Calculation methodology. 766.102 Section 766.102 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.102 Calculation methodology. (a...

10 CFR 766.102 - Calculation methodology.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Calculation methodology. 766.102 Section 766.102 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.102 Calculation methodology. (a...

10 CFR 766.102 - Calculation methodology.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Calculation methodology. 766.102 Section 766.102 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.102 Calculation methodology. (a...

Managing water utility financial risks through third-party index insurance contracts

NASA Astrophysics Data System (ADS)

Zeff, Harrison B.; Characklis, Gregory W.

2013-08-01

As developing new supply capacity has become increasingly expensive and difficult to permit (i.e., regulatory approval), utilities have become more reliant on temporary demand management programs, such as outdoor water use restrictions, for ensuring reliability during drought. However, a significant fraction of water utility income is often derived from the volumetric sale of water, and such restrictions can lead to substantial revenue losses. Given that many utilities set prices at levels commensurate with recovering costs, these revenue losses can leave them financially vulnerable to budgetary shortfalls. This work explores approaches for mitigating drought-related revenue losses through the use of third-party financial insurance contracts based on streamflow indices. Two different types of contracts are developed, and their efficacy is compared against two more traditional forms of financial hedging used by water utilities: Drought surcharges and contingency funds (i.e., self-insurance). Strategies involving each of these approaches, as well as their use in combination, are applied under conditions facing the water utility serving Durham, North Carolina. A multireservoir model provides information on the scale and timing of droughts, and the financial effects of these events are simulated using detailed data derived from utility billing records. Results suggest that third-party index insurance contracts, either independently or in combination with more traditional hedging tools, can provide an effective means of reducing a utility's financial vulnerability to drought.

Fish and chips: Various methodologies demonstrate utility of a 16,006-gene salmonid microarray

PubMed Central

von Schalburg, Kristian R; Rise, Matthew L; Cooper, Glenn A; Brown, Gordon D; Gibbs, A Ross; Nelson, Colleen C; Davidson, William S; Koop, Ben F

2005-01-01

Background We have developed and fabricated a salmonid microarray containing cDNAs representing 16,006 genes. The genes spotted on the array have been stringently selected from Atlantic salmon and rainbow trout expressed sequence tag (EST) databases. The EST databases presently contain over 300,000 sequences from over 175 salmonid cDNA libraries derived from a wide variety of tissues and different developmental stages. In order to evaluate the utility of the microarray, a number of hybridization techniques and screening methods have been developed and tested. Results We have analyzed and evaluated the utility of a microarray containing 16,006 (16K) salmonid cDNAs in a variety of potential experimental settings. We quantified the amount of transcriptome binding that occurred in cross-species, organ complexity and intraspecific variation hybridization studies. We also developed a methodology to rapidly identify and confirm the contents of a bacterial artificial chromosome (BAC) library containing Atlantic salmon genomic DNA. Conclusion We validate and demonstrate the usefulness of the 16K microarray over a wide range of teleosts, even for transcriptome targets from species distantly related to salmonids. We show the potential of the use of the microarray in a variety of experimental settings through hybridization studies that examine the binding of targets derived from different organs and tissues. Intraspecific variation in transcriptome expression is evaluated and discussed. Finally, BAC hybridizations are demonstrated as a rapid and accurate means to identify gene content. PMID:16164747

Appraising longitudinal trends in the strategic risks cited by risk managers in the international water utility sector, 2005-2015.

PubMed

Chalker, Rosemary T C; Pollard, Simon J T; Leinster, Paul; Jude, Simon

2018-03-15

We report dynamic changes in the priorities for strategic risks faced by international water utilities over a 10year period, as cited by managers responsible for managing them. A content analysis of interviews with three cohorts of risk managers in the water sector was undertaken. Interviews probed the focus risk managers' were giving to strategic risks within utilities, as well as specific questions on risk analysis tools (2005); risk management cultures (2011) and the integration of risk management with corporate decision-making (2015). The coding frequency of strategic (business, enterprise, corporate) risk terms from 18 structured interviews (2005) and 28 semi-structured interviews (12 in 2011; 16 in 2015) was used to appraise changes in the perceived importance of strategic risks within the sector. The aggregated coding frequency across the study period, and changes in the frequency of strategic risks cited at three interview periods identified infrastructure assets as the most significant risk over the period and suggests an emergence of extrinsic risk over time. Extended interviews with three utility risk managers (2016) from the UK, Canada and the US were then used to contextualise the findings. This research supports the ongoing focus on infrastructure resilience and the increasing prevalence of extrinsic risk within the water sector, as reported by the insurance sector and by water research organisations. The extended interviews provided insight into how strategic risks are now driving the implementation agenda within utilities, and into how utilities can secure tangible business value from proactive risk governance. Strategic external risks affecting the sector are on the rise, involve more players and are less controllable from within a utility's own organisational boundaries. Proportionate risk management processes and structures provide oversight and assurance, whilst allowing a focus on the tangible business value that comes from managing strategic

Assessment of perceptions of clinical management in courses oriented by competency.

PubMed

Gomes, Romeu; Padilha, Roberto de Queiroz; Lima, Valéria Vernaschi; Silva, Cosme Marcelo Furtado Passos da

2018-01-01

The study aims to assess perceptions of mastery of abilities in clinical management in participants of courses oriented by competency and based on active methodologies of teaching and learning, before and after the offered training process. Three conceptual frameworks were utilized: clinical management, expectation of auto-efficacy, and the holistic concept of competency. Methodologically, an electronic instrument was made available to students of the training courses, adapted to the Likert scale, in two stages: before the courses were undertaken and after their completion. The group of subjects that participated simultaneously in both stages was comprised of 825 trainees. Average, mean, standard deviation, and the Wilcoxon test were utilized in the analysis. Generally, in terms of findings, the perception of mastery of abilities in clinical management increased after the courses, proving a positive contribution of the training process of the students. Among other aspects of their results, it is concluded that the educational initiatives studied, oriented by competency and based in active methodologies of teaching and learning, can obtain the increase in perception of their participants regarding the mastery of abilities present in the competency profile, confirming the study's hypothesis.

Participation, Retention, and Utilization of a Web-Based Chronic Disease Self-Management Intervention Among Older Adults.

PubMed

Portz, Jennifer Dickman; LaMendola, Walter F

2018-05-21

Web-based self-management (web-based SM) interventions provide a potential resource for older adults to engage in their own chronic disease management. The purpose of this study is to investigate the effect of age on participation, retention, and utilization of a web-based SM intervention. This study reports the results of a secondary data analysis of the effects of age in a randomized trial of a web-based diabetes SM intervention. Participation, reasons for nonenrollment, retention, reasons for disenrollment, and website utilization were examined by age using discriminant function, survival analysis, and multivariate analysis of variance as appropriate. Website utilization by all participants dropped after 6 months but did not vary significantly with age. Though older adults (>60 of age) were less likely to choose to participate (F = 57.20, p < 0.001), a slight majority of participants in the experiment (53%) were over 66 years of age. Enrolled older adults utilized website management tools at a rate equivalent to younger participants. At termination, they often reported the experiment as burdensome, but tended to stay in the study longer than younger participants. Web-based SM offers a feasible approach for older adults with chronic disease to engage in their health management, but it needs to be improved. Those older adults who passed the rigorous screens for this experiment and chose to participate may have been more likely than younger participants to utilize web-based SM intervention tools. They were more persistent in their use of the web-based SM to try to improve health outcomes and formed definitive opinions about its utility before termination.

Opioid management strategy decreases admissions in high-utilizing adults with sickle cell disease.

PubMed

Mager, Amy; Pelot, Kristin; Koch, Kathryn; Miller, Lawrence; Hubler, Collin; Ndifor, Anisah; Coan, Canice; Leonard, Cynthia; Field, Joshua J

A subset of adults with sickle cell disease (SCD) heavily utilizes the emergency department (ED) and hospital. The objective of our study was to determine the efficacy of a multidisciplinary strategy to address unmet needs in highly utilizing adults with SCD. In a prospective study, adults with SCD with ≥10 admissions per year were assessed by a multidisciplinary team for gaps in medical, social, and psychological care. Thereafter, the team decided upon the subject's predominant domain that drove admissions and instituted an interventional plan. All plans included an opioid management strategy. Preintervention and postintervention admission rate, as well as opioid use, was compared. Twelve subjects were enrolled. Median rate of ED and hospital admissions preintervention was 25 per year. The predominant domains identified were social needs (n = 6), psychological disorder (n = 1), and substance use disorder (n = 5). Multifaceted interventional plans were developed to address a wide range of gaps in care, but an opioid management strategy was the only intervention successfully completed. Even so, when the preintervention versus postintervention admission rate was compared, regardless of the domain, there was a 40 percent decline in hospital admissions (p = 0.03). Consistent with the successful implementation of an opioid management plan, the decrease in admissions was accompanied by a 37 percent decrease in intravenous opioid use (p = 0.02) and 10 percent decrease in oral opioid use (p = 0.04). An opioid management strategy, as part of a larger effort to improve care for high-utilizing adults with SCD, decreased rate of admissions and opioid use.

Managing cognitive impairment in the elderly: conceptual, intervention and methodological issues.

PubMed

Buckwalter, K C; Stolley, J M; Farran, C J

1999-11-11

With the aging of society, the incidence of dementia in the elderly is also increasing, and thus results in increased numbers of individuals with cognitive impairment. Nurses and other researchers have investigated issues concerning the management of cognitive impairment. This article highlights conceptual, intervention and methodological issues associated with this phenomenon. Cognitive change is a multivariate construct that includes alterations in a variety of information processing mechanisms such as problem solving ability, memory, perception, attention and learning, and judgement. Although there is a large body of research, conceptual, intervention and methodological issues remain. Much of the clinical research on cognitive impairment is atheoretical, with this issue only recently being addressed. While many clinical interventions have been proposed, few have been adequately tested. There are also various methodological concerns, such as small sample sizes and limited statistical power; study design issues (experimental vs. non-experimental), and internal and external validity problems. Clearly, additional research designed to intervene with these difficult behaviors is needed. A variety of psychosocial, environmental and physical parameters must be considered in the nursing care of persons with cognitive impairment. Special attention has been given to interventions associated with disruptive behaviors. Interventions are complex and knowledge must be integrated from both the biomedical and behavioral sciences in order to deal effectively with the numerous problems that can arise over a long and changing clinical course. Some researchers and clinicians have suggested that a new culture regarding dementia care is needed, one that focuses on changing attitudes and beliefs about persons with dementia and one that changes how organizations deliver that care. This review identifies key conceptual, intervention and methodological issues and recommends how these

Prognostics and health management design for rotary machinery systems—Reviews, methodology and applications

NASA Astrophysics Data System (ADS)

Lee, Jay; Wu, Fangji; Zhao, Wenyu; Ghaffari, Masoud; Liao, Linxia; Siegel, David

2014-01-01

Much research has been conducted in prognostics and health management (PHM), an emerging field in mechanical engineering that is gaining interest from both academia and industry. Most of these efforts have been in the area of machinery PHM, resulting in the development of many algorithms for this particular application. The majority of these algorithms concentrate on applications involving common rotary machinery components, such as bearings and gears. Knowledge of this prior work is a necessity for any future research efforts to be conducted; however, there has not been a comprehensive overview that details previous and on-going efforts in PHM. In addition, a systematic method for developing and deploying a PHM system has yet to be established. Such a method would enable rapid customization and integration of PHM systems for diverse applications. To address these gaps, this paper provides a comprehensive review of the PHM field, followed by an introduction of a systematic PHM design methodology, 5S methodology, for converting data to prognostics information. This methodology includes procedures for identifying critical components, as well as tools for selecting the most appropriate algorithms for specific applications. Visualization tools are presented for displaying prognostics information in an appropriate fashion for quick and accurate decision making. Industrial case studies are included in this paper to show how this methodology can help in the design of an effective PHM system.

Systematic review of the methodological quality of clinical guideline development for the management of chronic disease in Europe.

PubMed

Knai, Cécile; Brusamento, Serena; Legido-Quigley, Helena; Saliba, Vanessa; Panteli, Dimitra; Turk, Eva; Car, Josip; McKee, Martin; Busse, Reinhard

2012-10-01

The use of evidence-based clinical guidelines is an essential component of chronic disease management. However, there is well-documented concern about variability in the quality of clinical guidelines, with evidence of persisting methodological shortcomings. The most widely accepted approach to assessing the quality of guidelines is the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. We have conducted a systematic review of the methodological quality (as assessed by AGREE) of clinical guidelines developed in Europe for the management of chronic diseases published since 2000. The systematic review was undertaken in accordance with the Cochrane methodology. The inclusion criteria were that studies should have appraised European clinical guidelines for certain selected chronic disorders using the AGREE instrument. We searched five databases (Cab Abstracts, EMBASE, MEDLINE, Trip and EPPI). Nine studies reported in 10 papers, analysing a total of 28 European guidelines from eight countries as well as pan-European, were included. There was considerable variation in the quality of clinical guidelines across the AGREE domains. The least well addressed domains were 'editorial independence' (with a mean domain score of 41%), 'applicability' (44%), 'stakeholder involvement' (55%), and 'rigour of development' (64%), while 'clarity of presentation' (80%) and 'scope and purpose' (84%) were less problematic. This review indicates that there is considerable scope for improvement in the methods used to develop clinical guidelines for the prevention, management and treatment of chronic diseases in Europe. Given the importance of decision support strategies such as clinical guidelines in chronic disease management, improvement measures should include the explicit and transparent involvement of key stakeholders (especially scientific experts, guideline users and methodological specialists) and consideration of the implications for guideline implementation and

The use of geospatial web services for exchanging utilities data

NASA Astrophysics Data System (ADS)

Kuczyńska, Joanna

2013-04-01

Geographic information technologies and related geo-information systems currently play an important role in the management of public administration in Poland. One of these tasks is to maintain and update Geodetic Evidence of Public Utilities (GESUT), part of the National Geodetic and Cartographic Resource, which contains an important for many institutions information of technical infrastructure. It requires an active exchange of data between the Geodesy and Cartography Documentation Centers and institutions, which administrate transmission lines. The administrator of public utilities, is legally obliged to provide information about utilities to GESUT. The aim of the research work was to develop a universal data exchange methodology, which can be implemented on a variety of hardware and software platforms. This methodology use Unified Modeling Language (UML), eXtensible Markup Language (XML), and Geography Markup Language (GML). The proposed methodology is based on the two different strategies: Model Driven Architecture (MDA) and Service Oriented Architecture (SOA). Used solutions are consistent with the INSPIRE Directive and ISO 19100 series standards for geographic information. On the basis of analysis of the input data structures, conceptual models were built for both databases. Models were written in the universal modeling language: UML. Combined model that defines a common data structure was also built. This model was transformed into developed for the exchange of geographic information GML standard. The structure of the document describing the data that may be exchanged is defined in the .xsd file. Network services were selected and implemented in the system designed for data exchange based on open source tools. Methodology was implemented and tested. Data in the agreed data structure and metadata were set up on the server. Data access was provided by geospatial network services: data searching possibilities by Catalog Service for the Web (CSW), data

Methodology to Estimate the Quantity, Composition, and ...

EPA Pesticide Factsheets

This report, Methodology to Estimate the Quantity, Composition and Management of Construction and Demolition Debris in the US, was developed to expand access to data on CDD in the US and to support research on CDD and sustainable materials management. Since past US EPA CDD estimates have been limited to building-related CDD, a goal in the development of this methodology was to use data originating from CDD facilities and contractors to better capture the current picture of total CDD management, including materials from roads, bridges and infrastructure. This report, Methodology to Estimate the Quantity, Composition and Management of Construction and Demolition Debris in the US, was developed to expand access to data on CDD in the US and to support research on CDD and sustainable materials management. Since past US EPA CDD estimates have been limited to building-related CDD, a goal in the development of this methodology was to use data originating from CDD facilities and contractors to better capture the current picture of total CDD management, including materials from roads, bridges and infrastructure.

Lbs Augmented Reality Assistive System for Utilities Infrastructure Management Through Galileo and Egnos

NASA Astrophysics Data System (ADS)

Stylianidis, E.; Valaria, E.; Smagas, K.; Pagani, A.; Henriques, J.; Garca, A.; Jimeno, E.; Carrillo, I.; Patias, P.; Georgiadis, C.; Kounoudes, A.; Michail, K.

2016-06-01

There is a continuous and increasing demand for solutions, both software and hardware-based, that are able to productively handle underground utilities geospatial data. Innovative approaches that are based on the use of the European GNSS, Galileo and EGNOS, sensor technologies and LBS, are able to monitor, document and manage utility infrastructures' data with an intuitive 3D augmented visualisation and navigation/positioning technology. A software and hardware-based system called LARA, currently under develop- ment through a H2020 co-funded project, aims at meeting that demand. The concept of LARA is to integrate the different innovative components of existing technologies in order to design and develop an integrated navigation/positioning and information system which coordinates GNSS, AR, 3D GIS and geodatabases on a mobile platform for monitoring, documenting and managing utility infrastruc- tures on-site. The LARA system will guide utility field workers to locate the working area by helping them see beneath the ground, rendering the complexity of the 3D models of the underground grid such as water, gas and electricity. The capacity and benefits of LARA are scheduled to be tested in two case studies located in Greece and the United Kingdom with various underground utilities. The paper aspires to present the first results from this initiative. The project leading to this application has received funding from the European GNSS Agency under the European Union's Horizon 2020 research and innovation programme under grant agreement No 641460.

Effects of diabetic case management on knowledge, self-management abilities, health behaviors, and health service utilization for diabetes in Korea.

PubMed

Shin, Soon Ae; Kim, Hyeongsu; Lee, Kunsei; Lin, Vivian; Liu, George; Shin, Eunyoung

2015-01-01

This study aimed to evaluate the effects of a case management program for diabetics, using a pre-post comparison design. The study population comprised 6007 diabetics who received case management intervention in 2006 and were sampled nationwide in Korea. Before and after the intervention, the study population answered questions regarding their knowledge of diabetes, self-management ability, and health behaviors. Body mass index (BMI) was also calculated. Healthcare service utilization for diabetes was extracted from health insurance claim data from 2005 to 2007. The case management program significantly improved the study population's knowledge of diabetes and ability to self-manage nutrition, blood glucose monitoring, foot and oral care, and medications. This program also significantly changed the study population's health behaviors regarding smoking, alcohol drinking, and exercise, and BMI was positively affected. In the over-serviced subgroup, there was a significant decrease in the number of consultations (mean=7.0; SD=19.5) after intervention. Conversely, in the under-serviced subgroup, there was a significant increase in the number of consultations (mean=3.2; SD=7.9) and the days of prescribed medication (mean=66.4; SD=120.3) after intervention. This study showed that the case management program led the study population to improve their knowledge, self-management ability, health behaviors, and utilization of health care. It is necessary in future studies to evaluate the appropriateness of healthcare usage and clinical outcome by using a control group to determine the direct effectiveness of this case management program.

Utilization of lean management principles in the ambulatory clinic setting.

PubMed

Casey, Jessica T; Brinton, Thomas S; Gonzalez, Chris M

2009-03-01

The principles of 'lean management' have permeated many sectors of today's business world, secondary to the success of the Toyota Production System. This management method enables workers to eliminate mistakes, reduce delays, lower costs, and improve the overall quality of the product or service they deliver. These lean management principles can be applied to health care. Their implementation within the ambulatory care setting is predicated on the continuous identification and elimination of waste within the process. The key concepts of flow time, inventory and throughput are utilized to improve the flow of patients through the clinic, and to identify points that slow this process -- so-called bottlenecks. Nonessential activities are shifted away from bottlenecks (i.e. the physician), and extra work capacity is generated from existing resources, rather than being added. The additional work capacity facilitates a more efficient response to variability, which in turn results in cost savings, more time for the physician to interact with patients, and faster completion of patient visits. Finally, application of the lean management principle of 'just-in-time' management can eliminate excess clinic inventory, better synchronize office supply with patient demand, and reduce costs.

Change management methodologies trained for automotive infotainment projects

NASA Astrophysics Data System (ADS)

Prostean, G.; Volker, S.; Hutanu, A.

2017-01-01

An Automotive Electronic Control Units (ECU) development project embedded within a car Environment is constantly under attack of a continuous flow of modifications of specifications throughout the life cycle. Root causes for those modifications are for instance simply software or hardware implementation errors or requirement changes to satisfy the forthcoming demands of the market to ensure the later commercial success. It is unavoidable that from the very beginning until the end of the project “requirement changes” will “expose” the agreed objectives defined by contract specifications, which are product features, budget, schedule and quality. The key discussions will focus upon an automotive radio-navigation (infotainment) unit, which challenges aftermarket devises such as smart phones. This competition stresses especially current used automotive development processes, which are fit into a 4 Year car development (introduction) cycle against a one-year update cycle of a smart phone. The research will focus the investigation of possible impacts of changes during all phases of the project: the Concept-Validation, Development and Debugging-Phase. Building a thorough understanding of prospective threats is of paramount importance in order to establish the adequate project management process to handle requirement changes. Personal automotive development experiences and Literature review of change- and configuration management software development methodologies led the authors to new conceptual models, which integrates into the structure of traditional development models used in automotive projects, more concretely of radio-navigation projects.

Water level management of lakes connected to regulated rivers: An integrated modeling and analytical methodology

NASA Astrophysics Data System (ADS)

Hu, Tengfei; Mao, Jingqiao; Pan, Shunqi; Dai, Lingquan; Zhang, Peipei; Xu, Diandian; Dai, Huichao

2018-07-01

Reservoir operations significantly alter the hydrological regime of the downstream river and river-connected lake, which has far-reaching impacts on the lake ecosystem. To facilitate the management of lakes connected to regulated rivers, the following information must be provided: (1) the response of lake water levels to reservoir operation schedules in the near future and (2) the importance of different rivers in terms of affecting the water levels in different lake regions of interest. We develop an integrated modeling and analytical methodology for the water level management of such lakes. The data-driven method is used to model the lake level as it has the potential of producing quick and accurate predictions. A new genetic algorithm-based synchronized search is proposed to optimize input variable time lags and data-driven model parameters simultaneously. The methodology also involves the orthogonal design and range analysis for extracting the influence of an individual river from that of all the rivers. The integrated methodology is applied to the second largest freshwater lake in China, the Dongting Lake. The results show that: (1) the antecedent lake levels are of crucial importance for the current lake level prediction; (2) the selected river discharge time lags reflect the spatial heterogeneity of the rivers' impacts on lake level changes; (3) the predicted lake levels are in very good agreement with the observed data (RMSE ≤ 0.091 m; R2 ≥ 0.9986). This study demonstrates the practical potential of the integrated methodology, which can provide both the lake level responses to future dam releases and the relative contributions of different rivers to lake level changes.

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain

PubMed Central

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D.; Hirsch, Joshua A.

2017-01-01

Background:Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design:Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives:To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results:The results showed direct procedural

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.

PubMed

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D; Hirsch, Joshua A

2017-01-01

Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design: Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives: To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results: The results showed direct

Distributed File System Utilities to Manage Large DatasetsVersion 0.5

DOE Office of Scientific and Technical Information (OSTI.GOV)

2014-05-21

FileUtils provides a suite of tools to manage large datasets typically created by large parallel MPI applications. They are written in C and use standard POSIX I/Ocalls. The current suite consists of tools to copy, compare, remove, and list. The tools provide dramatic speedup over existing Linux tools, which often run as a single process.

A user-centred methodology for designing an online social network to motivate health behaviour change.

PubMed

Kamal, Noreen; Fels, Sidney

2013-01-01

Positive health behaviour is critical to preventing illness and managing chronic conditions. A user-centred methodology was employed to design an online social network to motivate health behaviour change. The methodology was augmented by utilizing the Appeal, Belonging, Commitment (ABC) Framework, which is based on theoretical models for health behaviour change and use of online social networks. The user-centred methodology included four phases: 1) initial user inquiry on health behaviour and use of online social networks; 2) interview feedback on paper prototypes; 2) laboratory study on medium fidelity prototype; and 4) a field study on the high fidelity prototype. The points of inquiry through these phases were based on the ABC Framework. This yielded an online social network system that linked to external third party databases to deploy to users via an interactive website.

Managed Care for Children: Effect on Access to Care and Utilization of Health Services.

ERIC Educational Resources Information Center

Szilagyi, Peter G.

1998-01-01

Reviews what is known about the effect of managed care on access to health services, as well as utilization of hospital care, emergency department visits, primary care services, and specialty pediatric services. The effect of managed care appears dependent on several factors and, thus, is likely to vary according to the population served. (SLD)

Working memory management and predicted utility

PubMed Central

Chatham, Christopher H.; Badre, David

2013-01-01

Given the limited capacity of working memory (WM), its resources should be allocated strategically. One strategy is filtering, whereby access to WM is granted preferentially to items with the greatest utility. However, reallocation of WM resources might be required if the utility of maintained information subsequently declines. Here, we present behavioral, computational, and neuroimaging evidence that human participants track changes in the predicted utility of information in WM. First, participants demonstrated behavioral costs when the utility of items already maintained in WM declined and resources should be reallocated. An adapted Q-learning model indicated that these costs scaled with the historical utility of individual items. Finally, model-based neuroimaging demonstrated that frontal cortex tracked the utility of items to be maintained in WM, whereas ventral striatum tracked changes in the utility of items maintained in WM to the degree that these items are no longer useful. Our findings suggest that frontostriatal mechanisms track the utility of information in WM, and that these dynamics may predict delays in the removal of information from WM. PMID:23882196

How Knowledge Management Is Affected by Organizational Structure

ERIC Educational Resources Information Center

Mahmoudsalehi, Mehdi; Moradkhannejad, Roya; Safari, Khalil

2012-01-01

Purpose: Identifying the impact of organizational structure on knowledge management (KM) is the aim of this study, as well as recognizing the importance of each variable indicator in creating, sharing and utility of knowledge. Design/methodology/approach: For understanding relationships between the main variables (organizational structure-KM), the…

Health economic evaluation: important principles and methodology.

PubMed

Rudmik, Luke; Drummond, Michael

2013-06-01

To discuss health economic evaluation and improve the understanding of common methodology. This article discusses the methodology for the following types of economic evaluations: cost-minimization, cost-effectiveness, cost-utility, cost-benefit, and economic modeling. Topics include health-state utility measures, the quality-adjusted life year (QALY), uncertainty analysis, discounting, decision tree analysis, and Markov modeling. Economic evaluation is the comparative analysis of alternative courses of action in terms of both their costs and consequences. With increasing health care expenditure and limited resources, it is important for physicians to consider the economic impact of their interventions. Understanding common methodology involved in health economic evaluation will improve critical appraisal of the literature and optimize future economic evaluations. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

Dose-response effects for depression and Schizophrenia management on hospital utilization in Illinois Medicaid: a multivariate regression analysis.

PubMed

Berg, Gregory D; Donnelly, Shawn; Warnick, Kathleen; Medina, Wendie; Miller, Mary

2014-07-03

The prevalence of schizophrenia and depression in the United States is far higher among Medicaid recipients than in the general population. Individuals suffering from mental illness, including schizophrenia and depression, also have higher rates of emergency department utilization, which is costly and may not generate the positive health outcomes desired. Disease management programs strive to help individuals suffering from chronic illnesses better manage their condition(s) and seek health care in the appropriate settings. The objective of this manuscript is to estimate a dose-response impact on hospital inpatient and emergency room utilizations for any reason by Medicaid recipients with depression or schizophrenia who received disease management contacts. Multivariate regression analysis of panel data taken from administrative claims was conducted to test the hypothesis that increased contacts lower the likelihood of all-cause inpatient admissions and emergency room visits. Subjects included 6,274 members of Illinois' non-institutionalized Medicaid-only aged, blind or disabled population diagnosed with depression or schizophrenia. The statistical measure is the odds ratio. The odds ratio association is between the monthly utilization indicators and the number of contacts (doses) a member had for each particular disease management intervention. Higher numbers of intervention contacts for Medicaid recipients diagnosed with depression or schizophrenia were associated with statistically significant reductions in all-cause inpatient admissions and emergency room utilizations. There is a high correlation between depression and schizophrenia disease management contacts and lowered all-cause hospital inpatient and emergency room utilizations.

Impact of 2 employer-sponsored population health management programs on medical care cost and utilization.

PubMed

Mattke, Soeren; Serxner, Seth A; Zakowski, Sarah L; Jain, Arvind K; Gold, Daniel B

2009-02-01

Integrated health management programs combining disease prevention and disease management services, although popular with employers, have been insufficiently researched with respect to their effect on costs. To estimate the overall impact of a population health management program and its components on cost and utilization. STUDY DESIGN, SETTING, AND PARTICIPANTS: Observational study of 2 employer-sponsored health management programs involving more than 200,000 health plan members. We used claims data for the first program year and the 2 preceding years to calculate cost and utilization metrics, and program activity data to determine program uptake. Using an intent-to-treat approach and regression-based risk adjustment, we estimated whether the program was associated with changes in cost and utilization. Data on program fees were unavailable. Overall, the program was associated with a nonsignificant cost increase of $13.75 per member per month (PMPM). The wellness component alone was associated with a significant increase of $20.14 PMPM. Case and disease management were associated with a significant decrease in hospital admissions of 4 and 1 per 1000 patient-years, respectively. Our results suggest that the programs did not reduce medical cost in their first year, despite a beneficial effect on hospital admissions. If we had been able to include program fees, it is likely that the overall cost would have increased significantly. Although this study had important limitations, the results suggest that a belief that these programs will save money may be too optimistic and better evaluation is needed.

Multicriteria methodological approach to manage urban air pollution

NASA Astrophysics Data System (ADS)

Vlachokostas, Ch.; Achillas, Ch.; Moussiopoulos, N.; Banias, G.

2011-08-01

Managing urban air pollution necessitates a feasible and efficient abatement strategy which is characterised as a defined set of specific control measures. In practice, hard budget constraints are present in any decision-making process and therefore available alternatives need to be hierarchised in a fast but still reliable manner. Moreover, realistic strategies require adequate information on the available control measures, taking also into account the area's special characteristics. The selection of the most applicable bundle of measures rests in achieving stakeholders' consensus, while taking into consideration mutually conflicting views and criteria. A preliminary qualitative comparison of alternative control measures would be most handy for decision-makers, forming the grounds for an in-depth analysis of the most promising ones. This paper presents an easy-to-follow multicriteria methodological approach in order to include and synthesise multi-disciplinary knowledge from various stakeholders so as to result into a priority list of abatement options, achieve consensus and secure the adoption of the resulting optimal solution. The approach relies on the active involvement of public authorities and local stakeholders in order to incorporate their environmental, economic and social preferences. The methodological scheme is implemented for the case of Thessaloniki, Greece, an area considered among the most polluted cities within Europe, especially with respect to airborne particles. Intense police control, natural gas penetration in buildings and metro construction equally result into the most "promising" alternatives in order to control air pollution in the GTA. The three optimal alternatives belong to different thematic areas, namely road transport, thermal heating and infrastructure. Thus, it is obvious that efforts should spread throughout all thematic areas. Natural gas penetration in industrial units, intense monitoring of environmental standards and regular

Effects of Diabetic Case Management on Knowledge, Self-Management Abilities, Health Behaviors, and Health Service Utilization for Diabetes in Korea

PubMed Central

Shin, Soon Ae; Lee, Kunsei; Lin, Vivian; Liu, George; Shin, Eunyoung

2015-01-01

Purpose This study aimed to evaluate the effects of a case management program for diabetics, using a pre-post comparison design. Materials and Methods The study population comprised 6007 diabetics who received case management intervention in 2006 and were sampled nationwide in Korea. Before and after the intervention, the study population answered questions regarding their knowledge of diabetes, self-management ability, and health behaviors. Body mass index (BMI) was also calculated. Healthcare service utilization for diabetes was extracted from health insurance claim data from 2005 to 2007. Results The case management program significantly improved the study population's knowledge of diabetes and ability to self-manage nutrition, blood glucose monitoring, foot and oral care, and medications. This program also significantly changed the study population's health behaviors regarding smoking, alcohol drinking, and exercise, and BMI was positively affected. In the over-serviced subgroup, there was a significant decrease in the number of consultations (mean=7.0; SD=19.5) after intervention. Conversely, in the under-serviced subgroup, there was a significant increase in the number of consultations (mean=3.2; SD=7.9) and the days of prescribed medication (mean=66.4; SD=120.3) after intervention. Conclusion This study showed that the case management program led the study population to improve their knowledge, self-management ability, health behaviors, and utilization of health care. It is necessary in future studies to evaluate the appropriateness of healthcare usage and clinical outcome by using a control group to determine the direct effectiveness of this case management program. PMID:25510771

Plastic solid waste utilization technologies: A Review

NASA Astrophysics Data System (ADS)

Awasthi, Arun Kumar; Shivashankar, Murugesh; Majumder, Suman

2017-11-01

Plastics are used in more number of applications in worldwide and it becomes essential part of our daily life. In Indian cities and villages people use the plastics in buying vegetable as a carry bag, drinking water bottle, use of plastic furniture in home, plastics objects uses in kitchen, plastic drums in packing and storage of the different chemicals for industrial use, use plastic utensils in home and many more uses. After usage of plastics it will become part of waste garbage and create pollution due to presence of toxic chemicals and it will be spread diseases and give birth to uncontrolled issues in social society. In current scenario consumption of plastic waste increasing day by day and it is very difficult to manage the plastic waste. There are limited methodologies available for reutilization of plastic waste again. Such examples are recycling, landfill, incineration, gasification and hydrogenation. In this paper we will review the existing methodologies of utilization of plastic waste in current scenario

Evaluation in health: participatory methodology and involvement of municipal managers.

PubMed

Almeida, Cristiane Andrea Locatelli de; Tanaka, Oswaldo Yoshimi

2016-08-04

To analyze scopes and limits of the use of participatory methodology of evaluation with municipal health managers and administrators. Qualitative research with health policymakers and managers of the Comissão Intergestores Regional (CIR - Regional Interagency Commission) of a health region of the state of Sao Paulo in Brazil. Representatives from seven member cities participated in seven workshops facilitated by the researchers, with the aim of assessing a specific problem of the care line, which would be used as a tracer of the system integrality. The analysis of the collected empirical material was based on the hermeneutic-dialectic methodology and aimed at the evaluation of the applied participatory methodology, according to its capacity of promoting a process of assessment capable to be used as a support for municipal management. With the participatory approach of evaluation, we were able to promote in-depth discussions with the group, especially related to the construction of integral care and to the inclusion of the user's perspective in decision-making, linked to the search for solution to concrete problems of managers. By joint exploration, the possibility of using data from electronic information systems was opened, as well as information coming directly from the users of the services, to enhance discussions and negotiations between partners. The participants were disbelievers of the replication potential of this type of evaluation without the direct monitoring of the academy, given the difficulty of organizing the process in everyday life, already taken by emergency and political issues. Evaluations of programs and services carried out within the Regional Interagency Commission, starting from the local interest and facilitating the involvement of its members by the use of participatory methodologies, can contribute to the construction of integral care. To the extent that the act of evaluating stay invested with greater significance to the local actors

Cost Utility Analysis of Percutaneous Adhesiolysis in Managing Pain of Post-lumbar Surgery Syndrome and Lumbar Central Spinal Stenosis.

PubMed

Manchikanti, Laxmaiah; Helm, Standiford; Pampati, Vidyasagar; Racz, Gabor B

2015-06-01

The increase in the number of interventions for the management of chronic pain and associated escalation of healthcare costs has captured the attention of health policymakers, in no small part due to the lack of documentation of efficacy, cost-effectiveness, or cost utility analysis. A recent cost utility analysis of caudal epidural injections in managing chronic low back pain of various pathologies showed a high cost utility with improvement in quality of life years, competitive with various other modalities of treatments. However, there are no analyses derived from high-quality controlled studies related to the cost utility of percutaneous adhesiolysis in the treatment of post-lumbar surgery syndrome or lumbar central spinal stenosis. This analysis is based on 2 previously published controlled studies. To assess the cost utility of percutaneous adhesiolysis procedures in managing chronic low back and lower extremity pain secondary to post-lumbar surgery syndrome and lumbar central spinal stenosis. A private, specialty referral interventional pain management center in the United States. Two controlled studies were conducted assessing the clinical effectiveness of percutaneous adhesiolysis for post-lumbar surgery syndrome and lumbar central spinal stenosis in an interventional pain management setting utilizing contemporary interventional pain management practices. A cost utility analysis was performed with direct payment data for a total of 130 patients in treatment groups over a 2-year period. Various outcome measures were included with significant improvement, defined as at least 50% improvement with reduction in pain and disability status. The results of 2 controlled studies of low back pain with 60 and 70 patients and a 2-year follow-up with the actual reimbursement data showed cost utility for 1 year of quality-adjusted life year (QALY) of USD $2,652 for post-lumbar surgery syndrome and USD $2,649 for lumbar central spinal stenosis. The results of this

A design and implementation methodology for diagnostic systems

NASA Technical Reports Server (NTRS)

Williams, Linda J. F.

1988-01-01

A methodology for design and implementation of diagnostic systems is presented. Also discussed are the advantages of embedding a diagnostic system in a host system environment. The methodology utilizes an architecture for diagnostic system development that is hierarchical and makes use of object-oriented representation techniques. Additionally, qualitative models are used to describe the host system components and their behavior. The methodology architecture includes a diagnostic engine that utilizes a combination of heuristic knowledge to control the sequence of diagnostic reasoning. The methodology provides an integrated approach to development of diagnostic system requirements that is more rigorous than standard systems engineering techniques. The advantages of using this methodology during various life cycle phases of the host systems (e.g., National Aerospace Plane (NASP)) include: the capability to analyze diagnostic instrumentation requirements during the host system design phase, a ready software architecture for implementation of diagnostics in the host system, and the opportunity to analyze instrumentation for failure coverage in safety critical host system operations.

Managing Team Learning in a Spanish Commercial Bank

ERIC Educational Resources Information Center

Doving, Erik; Martin-Rubio, Irene

2013-01-01

Purpose: The purpose of this paper is to analyze how team management affects team-learning activities. Design/methodology/approach: The authors empirically study 68 teams as they operate in the natural business context of a major Spanish bank. Quantitative research utilizing multiple regression analyses is used to test hypotheses. Findings: The…

Efficient harvesting of marine Chlorella vulgaris microalgae utilizing cationic starch nanoparticles by response surface methodology.

PubMed

Bayat Tork, Mahya; Khalilzadeh, Rasoul; Kouchakzadeh, Hasan

2017-11-01

Harvesting involves nearly thirty percent of total production cost of microalgae that needs to be done efficiently. Utilizing inexpensive and highly available biopolymer-based flocculants can be a solution for reducing the harvest costs. Herein, flocculation process of Chlorella vulgaris microalgae using cationic starch nanoparticles (CSNPs) was evaluated and optimized through the response surface methodology (RSM). pH, microalgae and CSNPs concentrations were considered as the main independent variables. Under the optimum conditions of microalgae concentration 0.75gdry weight/L, CSNPs concentration 7.1mgdry weight/L and pH 11.8, the maximum flocculation efficiency (90%) achieved. Twenty percent increase in flocculation efficiency observed with the use of CSNPs instead of the non-particulate starch which can be due to the more electrostatic interactions between the cationic nanoparticles and the microalgae. Therefore, the synthesized CSNPs can be employed as a convenient and economical flocculants for efficient harvest of Chlorella vulgaris microalgae at large scale. Copyright © 2017 Elsevier Ltd. All rights reserved.

Managing Academic Tasks in Junior High School: Background, Design, and Methodology. (R & D Rep. No. 6185).

ERIC Educational Resources Information Center

Doyle, Walter; And Others

This report describes the conceptual background, design, and methodology for a study of management of academic tasks in junior high school. Previous research suggests that tasks students accomplish in classrooms determine what they actually learn, and acquisition of higher cognitive skills related to interpretation and planning is essential for…

10 CFR 436.14 - Methodological assumptions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Methodological assumptions. 436.14 Section 436.14 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.14 Methodological assumptions. (a) Each Federal Agency shall...

10 CFR 436.14 - Methodological assumptions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Methodological assumptions. 436.14 Section 436.14 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.14 Methodological assumptions. (a) Each Federal Agency shall...

10 CFR 436.14 - Methodological assumptions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Methodological assumptions. 436.14 Section 436.14 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.14 Methodological assumptions. (a) Each Federal Agency shall...

10 CFR 436.14 - Methodological assumptions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Methodological assumptions. 436.14 Section 436.14 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.14 Methodological assumptions. (a) Each Federal Agency shall...

10 CFR 436.14 - Methodological assumptions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Methodological assumptions. 436.14 Section 436.14 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.14 Methodological assumptions. (a) Each Federal Agency shall...

Poor methodological quality and reporting standards of systematic reviews in burn care management.

PubMed

Wasiak, Jason; Tyack, Zephanie; Ware, Robert; Goodwin, Nicholas; Faggion, Clovis M

2017-10-01

The methodological and reporting quality of burn-specific systematic reviews has not been established. The aim of this study was to evaluate the methodological quality of systematic reviews in burn care management. Computerised searches were performed in Ovid MEDLINE, Ovid EMBASE and The Cochrane Library through to February 2016 for systematic reviews relevant to burn care using medical subject and free-text terms such as 'burn', 'systematic review' or 'meta-analysis'. Additional studies were identified by hand-searching five discipline-specific journals. Two authors independently screened papers, extracted and evaluated methodological quality using the 11-item A Measurement Tool to Assess Systematic Reviews (AMSTAR) tool and reporting quality using the 27-item Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Characteristics of systematic reviews associated with methodological and reporting quality were identified. Descriptive statistics and linear regression identified features associated with improved methodological quality. A total of 60 systematic reviews met the inclusion criteria. Six of the 11 AMSTAR items reporting on 'a priori' design, duplicate study selection, grey literature, included/excluded studies, publication bias and conflict of interest were reported in less than 50% of the systematic reviews. Of the 27 items listed for PRISMA, 13 items reporting on introduction, methods, results and the discussion were addressed in less than 50% of systematic reviews. Multivariable analyses showed that systematic reviews associated with higher methodological or reporting quality incorporated a meta-analysis (AMSTAR regression coefficient 2.1; 95% CI: 1.1, 3.1; PRISMA regression coefficient 6·3; 95% CI: 3·8, 8·7) were published in the Cochrane library (AMSTAR regression coefficient 2·9; 95% CI: 1·6, 4·2; PRISMA regression coefficient 6·1; 95% CI: 3·1, 9·2) and included a randomised control trial (AMSTAR regression

A Review of Citation Analysis Methodologies for Collection Management

ERIC Educational Resources Information Center

Hoffmann, Kristin; Doucette, Lise

2012-01-01

While there is a considerable body of literature that presents the results of citation analysis studies, most researchers do not provide enough detail in their methodology to reproduce the study, nor do they provide rationale for methodological decisions. In this paper, we review the methodologies used in 34 recent articles that present a…

Constraints, Resources, and Interpretative Schema: Explorations of Teachers' Decisions to Utilize, Under-Utilize or Ignore Technology

ERIC Educational Resources Information Center

Pereira-Leon, Maura J.

2010-01-01

This three-year study examined how participation in a 10-month technology-enhanced professional development program (PDP) influenced K-12 teachers' decisions to utilize or ignore technology into teaching practices. Carspecken's (1996) qualitative research methodology of Critical Ethnography provided the theoretical and methodological framework to…

A methodological framework to support the initiation, design and institutionalization of participatory modeling processes in water resources management

NASA Astrophysics Data System (ADS)

Halbe, Johannes; Pahl-Wostl, Claudia; Adamowski, Jan

2018-01-01

Multiple barriers constrain the widespread application of participatory methods in water management, including the more technical focus of most water agencies, additional cost and time requirements for stakeholder involvement, as well as institutional structures that impede collaborative management. This paper presents a stepwise methodological framework that addresses the challenges of context-sensitive initiation, design and institutionalization of participatory modeling processes. The methodological framework consists of five successive stages: (1) problem framing and stakeholder analysis, (2) process design, (3) individual modeling, (4) group model building, and (5) institutionalized participatory modeling. The Management and Transition Framework is used for problem diagnosis (Stage One), context-sensitive process design (Stage Two) and analysis of requirements for the institutionalization of participatory water management (Stage Five). Conceptual modeling is used to initiate participatory modeling processes (Stage Three) and ensure a high compatibility with quantitative modeling approaches (Stage Four). This paper describes the proposed participatory model building (PMB) framework and provides a case study of its application in Québec, Canada. The results of the Québec study demonstrate the applicability of the PMB framework for initiating and designing participatory model building processes and analyzing barriers towards institutionalization.

Sandia National Laboratories performance assessment methodology for long-term environmental programs : the history of nuclear waste management.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marietta, Melvin Gary; Anderson, D. Richard; Bonano, Evaristo J.

2011-11-01

Sandia National Laboratories (SNL) is the world leader in the development of the detailed science underpinning the application of a probabilistic risk assessment methodology, referred to in this report as performance assessment (PA), for (1) understanding and forecasting the long-term behavior of a radioactive waste disposal system, (2) estimating the ability of the disposal system and its various components to isolate the waste, (3) developing regulations, (4) implementing programs to estimate the safety that the system can afford to individuals and to the environment, and (5) demonstrating compliance with the attendant regulatory requirements. This report documents the evolution of themore » SNL PA methodology from inception in the mid-1970s, summarizing major SNL PA applications including: the Subseabed Disposal Project PAs for high-level radioactive waste; the Waste Isolation Pilot Plant PAs for disposal of defense transuranic waste; the Yucca Mountain Project total system PAs for deep geologic disposal of spent nuclear fuel and high-level radioactive waste; PAs for the Greater Confinement Borehole Disposal boreholes at the Nevada National Security Site; and PA evaluations for disposal of high-level wastes and Department of Energy spent nuclear fuels stored at Idaho National Laboratory. In addition, the report summarizes smaller PA programs for long-term cover systems implemented for the Monticello, Utah, mill-tailings repository; a PA for the SNL Mixed Waste Landfill in support of environmental restoration; PA support for radioactive waste management efforts in Egypt, Iraq, and Taiwan; and, most recently, PAs for analysis of alternative high-level radioactive waste disposal strategies including repositories deep borehole disposal and geologic repositories in shale and granite. Finally, this report summarizes the extension of the PA methodology for radioactive waste disposal toward development of an enhanced PA system for carbon sequestration and storage

Construction of a Conceptualization of Personal Knowledge within a Knowledge Management Perspective Using Grounded Theory Methodology

ERIC Educational Resources Information Center

Straw, Eric M.

2013-01-01

The current research used grounded theory methodology (GTM) to construct a conceptualization of personal knowledge within a knowledge management (KM) perspective. The need for the current research was based on the use of just two categories of knowledge, explicit and tacit, within KM literature to explain diverse characteristics of personal…

Human-Computer System Development Methodology for the Dialogue Management System.

DTIC Science & Technology

1982-05-01

methodologies [HOSIJ78] are given below: I. The Michael Jackson Methodology [JACKM75] 2. The Warnier-Orr Methodolgy [HOSIJ78] 3. SADT (Structured...All the mentioned methodologies use top-down development strategy. The first two methodologies above ( Michael Jackson and Warnier-Orr) use data as the

Impact of the residential conservation service program on natural gas and electric utilities. Appendix B

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

An assessment of the RCS program is provided from the perspective of eleven case study utilities. First, an introduction to the role and value of conservation in utility strategic planning is presented. The interplay of various utility system characteristics is shown to be the primary determinant of the value of conservation efforts from the utility's point of view. Simplified typologies of utilities are developed to aid in the identification of those combinations of the utility characteristics that will favor the adoption of the utility sponsored strategic conservation efforts. The integration of the RCS program with other utility conservation and loadmore » management programs is explored for the eleven case study utilities. Reference is made to the simplified typologies in order to show, through actual program experience, how the strategic position of the utility company affects its adoption of this federal program. Evaluative studies done by the eleven case study utilities of the RCS program are reviewed. Results are presented and the methodologies are critiqued. Conclusions regarding the RCS program from the utility perspective are presented.« less

Collaboration Across Worldviews: Managers and Scientists on Hawai'i Island Utilize Knowledge Coproduction to Facilitate Climate Change Adaptation.

PubMed

Laursen, Scott; Puniwai, Noelani; Genz, Ayesha S; Nash, Sarah A B; Canale, Lisa K; Ziegler-Chong, Sharon

2018-05-30

Complex socio-ecological issues, such as climate change have historically been addressed through technical problem solving methods. Yet today, climate science approaches are increasingly accounting for the roles of diverse social perceptions, experiences, cultural norms, and worldviews. In support of this shift, we developed a research program on Hawai'i Island that utilizes knowledge coproduction to integrate the diverse worldviews of natural and cultural resource managers, policy professionals, and researchers within actionable science products. Through their work, local field managers regularly experience discrete land and waterscapes. Additionally, in highly interconnected rural communities, such as Hawai'i Island, managers often participate in the social norms and values of communities that utilize these ecosystems. Such local manager networks offer powerful frameworks within which to co-develop and implement actionable science. We interviewed a diverse set of local managers with the aim of incorporating their perspectives into the development of a collaborative climate change research agenda that builds upon existing professional networks utilized by managers and scientists while developing new research products. We report our manager needs assessment, the development process of our climate change program, our interactive forums, and our ongoing research products. Our needs assessment showed that the managers' primary source of information were other professional colleagues, and our in-person forums informed us that local managers are very interested in interacting with a wider range of networks to build upon their management capacities. Our initial programmatic progress suggests that co-created research products and in-person forums strengthen the capacities of local managers to adapt to change.

U.S. Department of Energy worker health risk evaluation methodology for assessing risks associated with environmental restoration and waste management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blaylock, B.P.; Legg, J.; Travis, C.C.

1995-06-01

This document describes a worker health risk evaluation methodology for assessing risks associated with Environmental Restoration (ER) and Waste Management (WM). The methodology is appropriate for estimating worker risks across the Department of Energy (DOE) Complex at both programmatic and site-specific levels. This document supports the worker health risk methodology used to perform the human health risk assessment portion of the DOE Programmatic Environmental Impact Statement (PEIS) although it has applications beyond the PEIS, such as installation-wide worker risk assessments, screening-level assessments, and site-specific assessments.

Knowledge Management and the Competitive Strategy of the Firm

ERIC Educational Resources Information Center

Halawi, Leila A.; McCarthy, Richard V.; Aronson, Jay E.

2006-01-01

Purpose: Knowledge management (KM) has emerged as a strategy to improve organizational competitiveness. Our purpose is to identify the relationship between KM and the firm's competitive advantage. Design/methodology/approach: We review the existing literature on KM and strategy formulation. We utilize the resource-based view approach as a lens for…

Flash memory management system and method utilizing multiple block list windows

NASA Technical Reports Server (NTRS)

Chow, James (Inventor); Gender, Thomas K. (Inventor)

2005-01-01

The present invention provides a flash memory management system and method with increased performance. The flash memory management system provides the ability to efficiently manage and allocate flash memory use in a way that improves reliability and longevity, while maintaining good performance levels. The flash memory management system includes a free block mechanism, a disk maintenance mechanism, and a bad block detection mechanism. The free block mechanism provides efficient sorting of free blocks to facilitate selecting low use blocks for writing. The disk maintenance mechanism provides for the ability to efficiently clean flash memory blocks during processor idle times. The bad block detection mechanism provides the ability to better detect when a block of flash memory is likely to go bad. The flash status mechanism stores information in fast access memory that describes the content and status of the data in the flash disk. The new bank detection mechanism provides the ability to automatically detect when new banks of flash memory are added to the system. Together, these mechanisms provide a flash memory management system that can improve the operational efficiency of systems that utilize flash memory.

Utility analysis and calibration of QOL assessment in disease management.

PubMed

Liu, Mo

2018-05-02

In clinical trials, the assessment of health-related quality of life (QOL) (or patient-reported outcome [PRO] measure) has become very popular especially for clinical studies conducted for evaluating clinical benefits of patients with chronic, severe, and/or life threatening diseases. Health-related QOL information and PRO measures are useful for disease management for achieving best clinical practice. In this article, we will focus on health-related QOL assessment. The concept, design, and analysis of health-related QOL in clinical trials are reviewed. Validation of the use of health-related QOL instrument in terms of some key performance characteristics such as accuracy, reliability, sensitivity, and responsibility for assuring quality, integrity, and validity of collected QOL data are discussed. The concept of utility analysis and calibration (e.g., with respect to life events) for achieving the optimization of disease management are proposed. The change of the QOL could be translated into different life events for effective disease management. These translations could evaluate the treatment effect by more directly displaying the change of the QOL.

Outsourcing decision factors in publicly owned electric utilities

NASA Astrophysics Data System (ADS)

Gonzales, James Edward

Purpose. The outsourcing of services in publicly owned electric utilities has generated some controversy. The purpose of this study was to explore this controversy by investigating the relationships between eight key independent variables and a dependent variable, "manager perceptions of overall value of outsourced services." The intent was to provide data so that utilities could make better decisions regarding outsourcing efforts. Theoretical framework. Decision theory was used as the framework for analyzing variables and alternatives used to support the outsourcing decision-making process. By reviewing these eight variables and the projected outputs and outcomes, a more predictive and potentially successful outsourcing effort can be realized. Methodology. A survey was distributed to a sample of 323 publicly owned electric utilities randomly selected from a population of 2,020 in the United States. Analysis of the data was made using statistical techniques including the Chi-Square, Lambda, Spearman's coefficient of rank correlation, as well as the Hypothesis Test, Rank Correlation, to test for relationships among the variables. Findings. Relationships among the eight key variables and perceptions of the overall value of outsourced services were generally weak. The notable exception was with the driving force (reason) for outsourcing decisions where the relationship was strongly positive. Conclusions and recommendations. The data in support of the research questions suggest that seven of the eight key variables may be weakly predictive of perceptions of the overall value of outsourced services. However, the primary driving force for outsourcing was strongly predictive. The data also suggest that many of the sampled utilities did not formally address these variables and alternatives, and therefore may not be achieving maximal results. Further studies utilizing customer perceptions rather than those of outsourcing service managers are recommended. In addition, it is

Applying Systems Thinking to Law Enforcement Safety: Recommendation for a Comprehensive Safety Management Framework

DTIC Science & Technology

2015-12-01

Occupational Injuries COPS Community Oriented Policing Services CRM Crew Resource Management DA Department of the Army FEMA Federal Emergency...establishes composite risk management ( CRM ), also known as crew resource management, “as the Army’s principal risk reduction methodology and assures...regulatory and statutory compliance.”106 CRM , also utilized by other branches within the military and by the aviation industry, is intended “to minimize

A narrative method for analyzing transitions in urban water management: The case of the Miami-Dade Water and Sewer Department

NASA Astrophysics Data System (ADS)

Treuer, Galen; Koebele, Elizabeth; Deslatte, Aaron; Ernst, Kathleen; Garcia, Margaret; Manago, Kim

2017-01-01

Although the water management sector is often characterized as resistant to risk and change, urban areas across the United States are increasingly interested in creating opportunities to transition toward more sustainable water management practices. These transitions are complex and difficult to predict - the product of water managers acting in response to numerous biophysical, regulatory, political, and financial factors within institutional constraints. Gaining a better understanding of how these transitions occur is crucial for continuing to improve water management. This paper presents a replicable methodology for analyzing how urban water utilities transition toward sustainability. The method combines standardized quantitative measures of variables that influence transitions with contextual qualitative information about a utility's unique decision making context to produce structured, data-driven narratives. Data-narratives document the broader context, the utility's pretransition history, key events during an accelerated period of change, and the consequences of transition. Eventually, these narratives should be compared across cases to develop empirically-testable hypotheses about the drivers of and barriers to utility-level urban water management transition. The methodology is illustrated through the case of the Miami-Dade Water and Sewer Department (WASD) in Miami-Dade County, Florida, and its transition toward more sustainable water management in the 2000s, during which per capita water use declined, conservation measures were enacted, water rates increased, and climate adaptive planning became the new norm.

The utility of computed tomography in the management of fever and neutropenia in pediatric oncology.

PubMed

Rao, Avani D; Sugar, Elizabeth A; Barrett, Neil; Mahesh, Mahadevappa; Arceci, Robert J

2015-10-01

Despite the frequent use and radiation exposure of computed tomography (CT) scans, there is little information on patterns of CT use and their utility in the management of pediatric patients with fever and neutropenia (FN). We examined the contribution of either the commonly employed pan-CT (multiple anatomical locations) or targeted CT (single location) scanning to identify possible infectious etiologies in this challenging clinical scenario. Procedure Pediatric patients with an underlying malignancy admitted for fever (temperature ≥ 38.3 °C) and an absolute neutrophil count <500 cells/μL from 2003-2009 were included. Risk factors associated with utilization, results, and effects on clinical management of CT scans were identified. Results Charts for 635 admissions for FN from 263 patients were reviewed. Overall, 139 (22%) admissions (93 individuals) had at least one scan. Of 188 scans, 103 (55%) were pan-scans. Changes in management were most strongly associated with the identification of evidence consistent with infection (OR = 12.64, 95% CI: 5.05-31.60, P < 0.001). Seventy-eight (41%) of all CT scans led to a change in clinical management, most commonly relating to use of antibiotic (N = 41, 53%) or antifungal/antiviral medications (N = 33, 42%). The odds of a change in clinical management did not differ for those receiving a pan-scan compared to those receiving a targeted scan (OR = 1.23; 95% CI, 0.61-2.46; P = 0.57). Conclusions When CT is clinically indicated, it is important for clinicians to strongly consider utilizing a targeted scan to reduce radiation exposure to patients as well as to decrease costs without compromising care. © 2015 Wiley Periodicals, Inc.

Effectiveness of the Nursing Methodology in Pain Management after Major Ambulatory Surgery.

PubMed

Porras-González, María Helena; Barón-López, Francisco Javier; García-Luque, María José; Morales-Gil, Isabel María

2015-08-01

Patients undergoing a surgical intervention for the first time are unfamiliar with the perioperative context, and they usually have no knowledge of postoperative pain management. In the preoperative circuit, there is no time to educate the patient in these terms. The professional profile of nurses allows this need to be addressed, and provides a regulated language to evaluate their effectiveness. This study evaluates the effectiveness of nursing counseling during a preoperative consultation for the management of postoperative pain and its effects on patient satisfaction at hospital discharge. This quasi-experimental study assesses the efficacy of preoperative nursing intervention in two groups, control (n = 185) and intervention (n = 195). Those in the intervention group attended a preoperative session during which they received information from nursing staff and took part in activities to learn about postoperative pain management and the perioperative circuit. Control group patients underwent the standard preoperative protocol. Data were compiled from January to December 2009. Statistically significant differences existed between the two groups regarding postoperative pain (visual analogue scale >3, 20.5% versus 11.5%; p = .023), patient satisfaction (87.1% versus 78.7%; p = .041), and surgical wound complications (13.9% versus 5.5%; p = .010). The results confirm the benefits of applying the nursing methodology in preoperative clinics. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Federated and Cloud Enabled Resources for Data Management and Utilization

NASA Astrophysics Data System (ADS)

Rankin, R.; Gordon, M.; Potter, R. G.; Satchwill, B.

2011-12-01

The emergence of cloud computing over the past three years has led to a paradigm shift in how data can be managed, processed and made accessible. Building on the federated data management system offered through the Canadian Space Science Data Portal (www.cssdp.ca), we demonstrate how heterogeneous and geographically distributed data sets and modeling tools have been integrated to form a virtual data center and computational modeling platform that has services for data processing and visualization embedded within it. We also discuss positive and negative experiences in utilizing Eucalyptus and OpenStack cloud applications, and job scheduling facilitated by Condor and Star Cluster. We summarize our findings by demonstrating use of these technologies in the Cloud Enabled Space Weather Data Assimilation and Modeling Platform CESWP (www.ceswp.ca), which is funded through Canarie's (canarie.ca) Network Enabled Platforms program in Canada.

Utilization of accident databases and fuzzy sets to estimate frequency of HazMat transport accidents.

PubMed

Qiao, Yuanhua; Keren, Nir; Mannan, M Sam

2009-08-15

Risk assessment and management of transportation of hazardous materials (HazMat) require the estimation of accident frequency. This paper presents a methodology to estimate hazardous materials transportation accident frequency by utilizing publicly available databases and expert knowledge. The estimation process addresses route-dependent and route-independent variables. Negative binomial regression is applied to an analysis of the Department of Public Safety (DPS) accident database to derive basic accident frequency as a function of route-dependent variables, while the effects of route-independent variables are modeled by fuzzy logic. The integrated methodology provides the basis for an overall transportation risk analysis, which can be used later to develop a decision support system.

What is heartburn worth? A cost-utility analysis of management strategies.

PubMed

Heudebert, G R; Centor, R M; Klapow, J C; Marks, R; Johnson, L; Wilcox, C M

2000-03-01

To determine the best treatment strategy for the management of patients presenting with symptoms consistent with uncomplicated heartburn. We performed a cost-utility analysis of 4 alternatives: empirical proton pump inhibitor, empirical histamine2-receptor antagonist, and diagnostic strategies consisting of either esophagogastroduodenoscopy (EGD) or an upper gastrointestinal series before treatment. The time horizon of the model was 1 year. The base case analysis assumed a cohort of otherwise healthy 45-year-old individuals in a primary care practice. Empirical treatment with a proton pump inhibitor was projected to provide the greatest quality-adjusted survival for the cohort. Empirical treatment with a histamine2 receptor antagonist was projected to be the least costly of the alternatives. The marginal cost-effectiveness of using a proton pump inhibitor over a histamine2-receptor antagonist was approximately $10,400 per quality-adjusted life year (QALY) gained in the base case analysis and was less than $50,000 per QALY as long as the utility for heartburn was less than 0.95. Both diagnostic strategies were dominated by proton pump inhibitor alternative. Empirical treatment seems to be the optimal initial management strategy for patients with heartburn, but the choice between a proton pump inhibitor or histamine2-receptor antagonist depends on the impact of heartburn on quality of life.

Leadership skills for the California electric utility industry: A qualitative study

NASA Astrophysics Data System (ADS)

Hubbell, Michael

The purpose of this qualitative study was to determine the skills and knowledge necessary for leaders in the California electric utility industry in 2020. With rapid industry changes, skills to effectively lead and stay competitive are undetermined. Leaders must manage an increasingly hostile social and political environment, incorporate new technology, and deal with an aging workforce and infrastructure. Methodology. This study utilized a qualitative case study design to determine the factors that influence the skills leaders will require in 2020. It incorporated the perspectives of current electric utility leaders while looking with a future lens. Findings. Interviews were conducted with transmission and distribution (T&D) directors at 3 investor-owned public electric utilities headquartered in California. The questions followed an open-ended format to gather responses as perceived by electric utility leaders for each research question category: overall skills, aging workforce, regulation, technology, and leading younger generations. The research resulted in 18 major themes: 5 for overall skills, 3 for aging workforce, 4 for regulation, 3 for technology, and 3 for leading younger generations. Conclusions. The study identified leadership skills including the ability to embrace, leverage, and stay current with technology; understand and provide a clear vision for the future; increase creativity; manage the next set of workers; motivate during a time of great change; prepare for knowledge transfer and change in workforce culture; manage regulatory expectations; expand potential utility opportunities; leverage "big data"; allow worker collaboration; and understand what drives younger generations. Recommendations. California-based electric utility leaders can remain effective by implementing key strategies identified herein. Further research could examine perspectives of additional utility leaders who lead in organizational units outside of T&D, expand the research to

Herbicide-Resistant Crops: Utilities and Limitations for Herbicide-Resistant Weed Management

PubMed Central

2010-01-01

Since 1996, genetically modified herbicide-resistant (HR) crops, particularly glyphosate-resistant (GR) crops, have transformed the tactics that corn, soybean, and cotton growers use to manage weeds. The use of GR crops continues to grow, but weeds are adapting to the common practice of using only glyphosate to control weeds. Growers using only a single mode of action to manage weeds need to change to a more diverse array of herbicidal, mechanical, and cultural practices to maintain the effectiveness of glyphosate. Unfortunately, the introduction of GR crops and the high initial efficacy of glyphosate often lead to a decline in the use of other herbicide options and less investment by industry to discover new herbicide active ingredients. With some exceptions, most growers can still manage their weed problems with currently available selective and HR crop-enabled herbicides. However, current crop management systems are in jeopardy given the pace at which weed populations are evolving glyphosate resistance. New HR crop technologies will expand the utility of currently available herbicides and enable new interim solutions for growers to manage HR weeds, but will not replace the long-term need to diversify weed management tactics and discover herbicides with new modes of action. This paper reviews the strengths and weaknesses of anticipated weed management options and the best management practices that growers need to implement in HR crops to maximize the long-term benefits of current technologies and reduce weed shifts to difficult-to-control and HR weeds. PMID:20586458

A Hierarchical Clustering Methodology for the Estimation of Toxicity

EPA Science Inventory

A Quantitative Structure Activity Relationship (QSAR) methodology based on hierarchical clustering was developed to predict toxicological endpoints. This methodology utilizes Ward's method to divide a training set into a series of structurally similar clusters. The structural sim...

Evaluative methodology for prioritizing transportation energy conservation strategies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pang, L.M.G.

An analytical methodology was developed for the purpose of prioritizing a set of transportation energy conservation (TEC) strategies within an urban environment. Steps involved in applying the methodology consist of 1) defining the goals, objectives and constraints of the given urban community, 2) identifying potential TEC strategies, 3) assessing the impact of the strategies, 4) applying the TEC evaluation model, and 5) utilizing a selection process to determine the optimal set of strategies for implementation. This research provides an overview of 21 TEC strategies, a quick-response technique for estimating energy savings, a multiattribute utility theory approach for assessing subjective impacts,more » and a computer program for making the strategy evaluations, all of which assist in expediting the execution of the entire methodology procedure. The critical element of the methodology is the strategy evaluation model which incorporates a number of desirable concepts including 1) a comprehensive accounting of all relevant impacts, 2) the application of multiobjective decision-making techniques, 3) an approach to assure compatibilty among quantitative and qualitative impact measures, 4) the inclusion of the decision maker's preferences in the evaluation procedure, and 5) the cost-effectiveness concept. Application of the methodolgy to Salt Lake City, Utah demonstrated its utility, ease of use and favorability by decision makers.« less

Highway runoff stormwater management potential (HRSMP) site characterization using NASA public domain imagery : research summary.

DOT National Transportation Integrated Search

2016-04-01

The objectives of this research were to develop and utilize GST methodologies : including remote sensing, to characterize and determine the level of performance : of stormwater management (SWM) facilities (BMPs), resulting in the reduction of : highw...

Assessment of management approaches in a public water utility: A case study of the Namibia water corporation (NAMWATER)

NASA Astrophysics Data System (ADS)

Ndokosho, Johnson; Hoko, Zvikomborero; Makurira, Hodson

More than 90% of urban water supply and sanitation services in developing countries are provided by public organizations. However, public provision of services has been inherently inefficient. As a result a number of initiatives have emerged in recent years with a common goal to improve service delivery. In Namibia, the water sector reform resulted in the creation of a public utility called the Namibia Water Corporation (NAMWATER) which is responsible for bulk water supply countrywide. Since its inception in 1998, NAMWATER has been experiencing poor financial performance. This paper presents the findings of a case study that compared the management approaches of NAMWATER to the New Public Management (NPM) paradigm. The focus of the NPM approach is for the public water sector to mirror private sector methods of management so that public utilities can accrue the benefits of effectiveness, efficiency and flexibility often associated with private sector. The study tools used were a combination of literature review, interviews and questionnaires. It was found out that NAMWATER has a high degree of autonomy in its operations, albeit government approved tariffs and sourcing of external financing. The utility reports to government annually to account for results. The utility embraces a notion of good corporate culture and adheres to sound management practices. NAMWATER demonstrated a strong market-orientation indicated by the outsourcing of non-core functions but benchmarking was poorly done. NAMWATER’s customer-orientation is poor as evidenced by the lack of customer care facilities. NAMWATER’s senior management delegated operational authority to lower management to facilitate flexibility and eliminate bottlenecks. The lower management is in turn held accountable for performance by the senior management. There are no robust methods of ensuring sufficient accountability indicated by absence of performance contracts or service level agreements. It was concluded that

Assessment of the Availability, Utilization and Management of ICT Facilities in Teaching English Language in Secondary Schools in Kaduna State, Nigeria

ERIC Educational Resources Information Center

Yusuf, Hanna Onyi; Maina, Bashir; Dare, Michael Omotayo

2013-01-01

The study investigated the availability, utilization and management of ICT facilities in teaching English language in secondary schools in Kaduna State, Nigeria. The study adopted a descriptive survey research design. A questionnaire titled "Availability, Utilization and Management of Information and Communication Technology in teaching…

Cost-effectiveness methodology for computer systems selection

NASA Technical Reports Server (NTRS)

Vallone, A.; Bajaj, K. S.

1980-01-01

A new approach to the problem of selecting a computer system design has been developed. The purpose of this methodology is to identify a system design that is capable of fulfilling system objectives in the most economical way. The methodology characterizes each system design by the cost of the system life cycle and by the system's effectiveness in reaching objectives. Cost is measured by a 'system cost index' derived from an analysis of all expenditures and possible revenues over the system life cycle. Effectiveness is measured by a 'system utility index' obtained by combining the impact that each selection factor has on the system objectives and it is assessed through a 'utility curve'. A preestablished algorithm combines cost and utility and provides a ranking of the alternative system designs from which the 'best' design is selected.

Towards a Methodology for Managing Competencies in Virtual Teams - A Systemic Approach

NASA Astrophysics Data System (ADS)

Schumacher, Marinita; Stal-Le Cardinal, Julie; Bocquet, Jean-Claude

Virtual instruments and tools are future trends in Engineering which are a response to the growing complexity of engineering tasks, the facility of communication and strong collaborations on the international market. Outsourcing, off-shoring, and the globalization of organisations’ activities have resulted in the formation of virtual product development teams. Individuals who are working in virtual teams must be equipped with diversified competencies that provide a basis for virtual team building. Thanks to the systemic approach of the functional analysis our paper responds to the need of a methodology of competence management to build virtual teams that are active in virtual design projects in the area of New Product Development (NPD).

Methodological Review of Intimate Partner Violence Prevention Research

ERIC Educational Resources Information Center

Murray, Christine E.; Graybeal, Jennifer

2007-01-01

The authors present a methodological review of empirical program evaluation research in the area of intimate partner violence prevention. The authors adapted and utilized criterion-based rating forms to standardize the evaluation of the methodological strengths and weaknesses of each study. The findings indicate that the limited amount of…

The spillover effects of Medicare managed care: Medicare Advantage and hospital utilization.

PubMed

Baicker, Katherine; Chernew, Michael E; Robbins, Jacob A

2013-12-01

More than a quarter of Medicare beneficiaries are enrolled in Medicare Advantage, which was created in large part to improve the efficiency of health care delivery by promoting competition among private managed care plans. This paper explores the spillover effects of the Medicare Advantage program on the traditional Medicare program and other patients, taking advantage of changes in Medicare Advantage payment policy to isolate exogenous increases in Medicare Advantage enrollment and trace out the effects of greater managed care penetration on hospital utilization and spending throughout the health care system. We find that when more seniors enroll in Medicare managed care, hospital costs decline for all seniors and for commercially insured younger populations. Greater managed care penetration is not associated with fewer hospitalizations, but is associated with lower costs and shorter stays per hospitalization. These spillovers are substantial - offsetting more than 10% of increased payments to Medicare Advantage plans. Copyright © 2013 Elsevier B.V. All rights reserved.

Utility of the advanced chronic kidney disease patient management tools: case studies.

PubMed

Patwardhan, Meenal B; Matchar, David B; Samsa, Gregory P; Haley, William E

2008-01-01

Appropriate management of advanced chronic kidney disease (CKD) delays or limits its progression. The Advanced CKD Patient Management Toolkit was developed using a process-improvement technique to assist patient management and address CKD-specific management issues. We pilot tested the toolkit in 2 community nephrology practices, assessed the utility of individual tools, and evaluated the impact on conformance to an advanced CKD guideline through patient chart abstraction. Tool use was distinct in the 2 sites and depended on the site champion's involvement, the extent of process reconfiguration demanded by a tool, and its perceived value. Baseline conformance varied across guideline recommendations (averaged 54%). Posttrial conformance increased in all clinical areas (averaged 59%). Valuable features of the toolkit in real-world settings were its ability to: facilitate tool selection, direct implementation efforts in response to a baseline performance audit, and allow selection of tool versions and customizing them. Our results suggest that systematically created, multifaceted, and customizable tools can promote guideline conformance.

The Spillover Effects of Medicare Managed Care: Medicare Advantage and Hospital Utilization

PubMed Central

Baicker, Katherine; Chernew, Michael; Robbins, Jacob

2013-01-01

More than a quarter of Medicare beneficiaries are enrolled in Medicare Advantage, which was created in large part to improve the efficiency of health care delivery by promoting competition among private managed care plans. This paper explores the spillover effects of the Medicare Advantage program on the traditional Medicare program and other patients, taking advantage of changes in Medicare Advantage payment policy to isolate exogenous increases in Medicare Advantage enrollment and trace out the effects of greater managed care penetration on hospital utilization and spending throughout the health care system. We find that when more seniors enroll in Medicare managed care, hospital costs decline for all seniors and for commercially insured younger populations. Greater managed care penetration is not associated with fewer hospitalizations, but is associated with lower costs and shorter stays per hospitalization. These spillovers are substantial – offsetting more than 10% of increased payments to Medicare Advantage plans. PMID:24308880

Magic from Social Networks that Talk to Management: Four Cases

ERIC Educational Resources Information Center

Sugarman, Barry

2010-01-01

Purpose: The purpose of this paper is to understand how social networks can help to produce the "magic" of extraordinary results for organizations. Design/methodology/approach: In this exploratory study four cases (from published reports) are compared in order to illustrate different management approaches to utilizing the power of networks.…

Identifying wood utilization options for ecosystem management : summary of a national research project

Treesearch

K. E. Skog; R. J. Barbour; J. E. Baumgras; A. Clark

1997-01-01

Using an ecosystem approach to forest management will change silvicultural practices, thus requiring utilization options to provide revenue and to help offset the costs of the silviculture treatments. The Forest Service, university cooperators, and several industry mills in the southern, western, and northeastern United States have been involved in a national...

Information technology security system engineering methodology

NASA Technical Reports Server (NTRS)

Childs, D.

2003-01-01

A methodology is described for system engineering security into large information technology systems under development. The methodology is an integration of a risk management process and a generic system development life cycle process. The methodology is to be used by Security System Engineers to effectively engineer and integrate information technology security into a target system as it progresses through the development life cycle. The methodology can also be used to re-engineer security into a legacy system.

An Integrative Review of Multicomponent Weight Management Interventions for Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Doherty, Alison J.; Jones, Stephanie P.; Chauhan, Umesh; Gibson, Josephine M. E.

2018-01-01

Background: Obesity is more prevalent in people with intellectual disabilities and increases the risk of developing serious medical conditions. UK guidance recommends multicomponent weight management interventions (MCIs), tailored for different population groups. Methods: An integrative review utilizing systematic review methodology was conducted…

Outpatient Utilization by Infants Auto-assigned to Medicaid Managed Care Plans

PubMed Central

Cohn, Lisa M.; Clark, Sarah J.

2013-01-01

To test the hypothesis that infants auto-assigned to a Medicaid managed care plan would have lower primary care and higher emergency department (ED) utilization compared to infants with a chosen plan. Retrospective cohort study. Medicaid administrative data were used to identify all children 0–3 months of age at enrollment in Michigan Medicaid managed care in 2005–2008 with 18-months of subsequent enrollment. Medicaid encounter and state immunization registry data were then acquired. Auto-assigned infants were compared versus chosen plan infants on: (1) well-child visits (WCVs); (2) immunizations; (3) acute office visits; and (4) ED visits. Chi squared and rank-sum tests and logistic and negative binomial regression were used in bivariate and multivariable analyses for dichotomous and count data, respectively. 18 % of infants were auto-assigned. Auto-assigned infants were less likely to meet goal number of WCVs in 18-months of managed care enrollment (32 vs. 53 %, p < 0.001) and to be up-to-date on immunizations at 12 months of age (75 vs. 85 %, p < 0.001). Auto-assigned infants had fewer acute office visits (median: 4 vs. 5, p < 0.001) but were only slightly more likely to have 2 or more ED visits (51 vs. 46 %, p < 0.001) in 18-months of enrollment. All results were significant in multivariable analyses. Auto-assigned infants were less likely to use preventive and acute primary care but only slightly more likely to use emergency care. Future work is needed to understand mechanisms of differences in utilization, but auto-assigned children may represent a target group for efforts to promote pediatric preventive care in Medicaid. PMID:23775252

Outpatient utilization by infants auto-assigned to Medicaid managed care plans.

PubMed

Zickafoose, Joseph S; Cohn, Lisa M; Clark, Sarah J

2014-04-01

To test the hypothesis that infants auto-assigned to a Medicaid managed care plan would have lower primary care and higher emergency department (ED) utilization compared to infants with a chosen plan. Retrospective cohort study. Medicaid administrative data were used to identify all children 0-3 months of age at enrollment in Michigan Medicaid managed care in 2005-2008 with 18-months of subsequent enrollment. Medicaid encounter and state immunization registry data were then acquired. Auto-assigned infants were compared versus chosen plan infants on: (1) well-child visits (WCVs); (2) immunizations; (3) acute office visits; and (4) ED visits. Chi squared and rank-sum tests and logistic and negative binomial regression were used in bivariate and multivariable analyses for dichotomous and count data, respectively. 18% of infants were auto-assigned. Auto-assigned infants were less likely to meet goal number of WCVs in 18-months of managed care enrollment (32 vs. 53%, p < 0.001) and to be up-to-date on immunizations at 12 months of age (75 vs. 85%, p < 0.001). Auto-assigned infants had fewer acute office visits (median: 4 vs. 5, p < 0.001) but were only slightly more likely to have 2 or more ED visits (51 vs. 46%, p < 0.001) in 18-months of enrollment. All results were significant in multivariable analyses. Auto-assigned infants were less likely to use preventive and acute primary care but only slightly more likely to use emergency care. Future work is needed to understand mechanisms of differences in utilization, but auto-assigned children may represent a target group for efforts to promote pediatric preventive care in Medicaid.

Management of climatic heat stress risk in construction: a review of practices, methodologies, and future research.

PubMed

Rowlinson, Steve; Yunyanjia, Andrea; Li, Baizhan; Chuanjingju, Carrie

2014-05-01

Climatic heat stress leads to accidents on construction sites brought about by a range of human factors emanating from heat induced illness, and fatigue leading to impaired capability, physical and mental. It is an occupational characteristic of construction work in many climates and the authors take the approach of re-engineering the whole safety management system rather than focusing on incremental improvement, which is current management practice in the construction industry. From a scientific viewpoint, climatic heat stress is determined by six key factors: (1) air temperature, (2) humidity, (3) radiant heat, and (4) wind speed indicating the environment, (5) metabolic heat generated by physical activities, and (6) "clothing effect" that moderates the heat exchange between the body and the environment. By making use of existing heat stress indices and heat stress management processes, heat stress risk on construction sites can be managed in three ways: (1) control of environmental heat stress exposure through use of an action-triggering threshold system, (2) control of continuous work time (CWT, referred by maximum allowable exposure duration) with mandatory work-rest regimens, and (3) enabling self-paced working through empowerment of employees. Existing heat stress practices and methodologies are critically reviewed and the authors propose a three-level methodology for an action-triggering, localized, simplified threshold system to facilitate effective decisions by frontline supervisors. The authors point out the need for "regional based" heat stress management practices that reflect unique climatic conditions, working practices and acclimatization propensity by local workers indifferent geographic regions. The authors set out the case for regional, rather than international, standards that account for this uniqueness and which are derived from site-based rather than laboratory-based research. Copyright © 2013 Elsevier Ltd. All rights reserved.

Designing a Supply Chain Management Academic Curriculum Using QFD and Benchmarking

ERIC Educational Resources Information Center

Gonzalez, Marvin E.; Quesada, Gioconda; Gourdin, Kent; Hartley, Mark

2008-01-01

Purpose: The purpose of this paper is to utilize quality function deployment (QFD), Benchmarking analyses and other innovative quality tools to develop a new customer-centered undergraduate curriculum in supply chain management (SCM). Design/methodology/approach: The researchers used potential employers as the source for data collection. Then,…

10 CFR 436.12 - Life cycle cost methodology.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Life cycle cost methodology. 436.12 Section 436.12 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.12 Life cycle cost methodology. The life cycle cost methodology...

10 CFR 436.12 - Life cycle cost methodology.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Life cycle cost methodology. 436.12 Section 436.12 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.12 Life cycle cost methodology. The life cycle cost methodology...

10 CFR 436.12 - Life cycle cost methodology.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Life cycle cost methodology. 436.12 Section 436.12 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.12 Life cycle cost methodology. The life cycle cost methodology...

10 CFR 436.12 - Life cycle cost methodology.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Life cycle cost methodology. 436.12 Section 436.12 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.12 Life cycle cost methodology. The life cycle cost methodology...

10 CFR 436.12 - Life cycle cost methodology.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Life cycle cost methodology. 436.12 Section 436.12 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.12 Life cycle cost methodology. The life cycle cost methodology...

Q methodology, risk training and quality management.

PubMed

McKeown, M; Hinks, M; Stowell-Smith, M; Mercer, D; Forster, J

1999-01-01

The results of a Q methodological study of professional understandings of the notion of risk in mental health services within the UK are discussed in relation to the relevance for staff training and quality assurance. The study attempted to access the diversity of understandings of risk issues amongst a multi-professional group of staff (n = 60) attending inter-agency risk training workshops in 1998. Q methodology is presented as both an appropriate means for such inquiry and as a novel experiential technique for training purposes. A tentative argument is advanced that the qualitative accounts generated by Q research could assist in systematic reviews of quality, complementing the singularly quantitative approaches typically represented in the audit process.

Assessment of utility side financial benefits of demand side management considering environmental impacts

NASA Astrophysics Data System (ADS)

Abeygunawardane, Saranga Kumudu

2018-02-01

Any electrical utility prefers to implement demand side management and change the shape of the demand curve in a beneficial manner. This paper aims to assess the financial gains (or losses) to the generating sector through the implementation of demand side management programs. An optimization algorithm is developed to find the optimal generation mix that minimizes the daily total generating cost. This daily total generating cost includes the daily generating cost as well as the environmental damage cost. The proposed optimization algorithm is used to find the daily total generating cost for the base case and for several demand side management programs using the data obtained from the Sri Lankan power system. Results obtained for DSM programs are compared with the results obtained for the base case to assess the financial benefits of demand side management to the generating sector.

Energy management and vehicle synthesis

NASA Astrophysics Data System (ADS)

Czysz, P.; Murthy, S. N. B.

The major drivers in the development of launch vehicles for the twenty-first century are reduction in cost of vehicles and operations, continuous reusability, mission abort capability with vehicle recovery, and readiness. One approach to the design of such vehicles is to emphasize energy management and propulsion as being the principal means of improvements given the available industrial capability and the required freedom in selecting configuration concept geometries. A methodology has been developed for the rational synthesis of vehicles based on the setting up and utilization of available data and projections, and a reference vehicle. The application of the methodology is illustrated for a single stage to orbit (SSTO) with various limits for the use of airbreathing propulsion.

Energy management and vehicle synthesis

NASA Technical Reports Server (NTRS)

Czysz, P.; Murthy, S. N. B.

1995-01-01

The major drivers in the development of launch vehicles for the twenty-first century are reduction in cost of vehicles and operations, continuous reusability, mission abort capability with vehicle recovery, and readiness. One approach to the design of such vehicles is to emphasize energy management and propulsion as being the principal means of improvements given the available industrial capability and the required freedom in selecting configuration concept geometries. A methodology has been developed for the rational synthesis of vehicles based on the setting up and utilization of available data and projections, and a reference vehicle. The application of the methodology is illustrated for a single stage to orbit (SSTO) with various limits for the use of airbreathing propulsion.

Clinical and economic evaluation of an evidence-based institutional epoetin-utilization management program.

PubMed

Buckley, Mitchell S; Kane-Gill, Sandra L; Patel, Shardool A

2013-03-01

Anemia is common in several patient populations, including those with chronic kidney disease, cancer, and HIV/AIDS, and may require treatment with erythropoietin-stimulating agents (ESAs). Given the potential risks of the ESA, epoetin, and the significant costs associated with this agent, a large teaching medical institution developed a the drug-utilization management program using evidence-based guidelines on appropriate use. This study was designed to determine the clinical and financial impact of the drug-utilization management program. This retrospective cohort study was conducted at the medical institution that implemented the program using clinical pharmacists. Patients were included if epoetin was administered during their hospital stay (evaluation period, December 1, 2010, to December 31, 2011). The rate of inappropriate epoetin prescribing and the economic impact of guideline implementation were evaluated using comparisons of data from cohorts prescribed epoetin before and after guideline implementation. Data from 796 patients were included in the analyses (pre-implementation, 496; post-implementation, 300). The proportion of patients prescribed epoetin was significantly smaller after guideline implementation (2.4% vs 1.6%; P < 0.001). The reduction in the total number of epoetin units administered was 45%. The significant reduction (25%) in inappropriate prescribing after guideline implementation was primarily attributed to a 17% decrease in epoetin use in nonspecific anemia. The reduction in inappropriate epoetin prescribing translated into a 23.8% reduction in costs (P < 0.001) associated with inappropriate epoetin use. The estimated annual cost-savings of this program was $198,352 ($16,529/mo). The implementation of a drug-utilization management program using clinical pharmacists who evaluated epoetin was associated with a decrease in inappropriate epoetin prescribing and with significant cost-savings. Copyright © 2013 Elsevier HS Journals, Inc. All

Using social media for health research: Methodological and ethical considerations for recruitment and intervention delivery.

PubMed

Arigo, Danielle; Pagoto, Sherry; Carter-Harris, Lisa; Lillie, Sarah E; Nebeker, Camille

2018-01-01

As the popularity and diversity of social media platforms increases so does their utility for health research. Using social media for recruitment into clinical studies and/or delivering health behavior interventions may increase reach to a broader audience. However, evidence supporting the efficacy of these approaches is limited, and key questions remain with respect to optimal benchmarks, intervention development and methodology, participant engagement, informed consent, privacy, and data management. Little methodological guidance is available to researchers interested in using social media for health research. In this Tutorial, we summarize the content of the 2017 Society for Behavioral Medicine Pre-Conference Course entitled 'Using Social Media for Research,' at which the authors presented their experiences with methodological and ethical issues relating to social media-enabled research recruitment and intervention delivery. We identify common pitfalls and provide recommendations for recruitment and intervention via social media. We also discuss the ethical and responsible conduct of research using social media for each of these purposes.

Using social media for health research: Methodological and ethical considerations for recruitment and intervention delivery

PubMed Central

Pagoto, Sherry; Carter-Harris, Lisa; Lillie, Sarah E; Nebeker, Camille

2018-01-01

As the popularity and diversity of social media platforms increases so does their utility for health research. Using social media for recruitment into clinical studies and/or delivering health behavior interventions may increase reach to a broader audience. However, evidence supporting the efficacy of these approaches is limited, and key questions remain with respect to optimal benchmarks, intervention development and methodology, participant engagement, informed consent, privacy, and data management. Little methodological guidance is available to researchers interested in using social media for health research. In this Tutorial, we summarize the content of the 2017 Society for Behavioral Medicine Pre-Conference Course entitled ‘Using Social Media for Research,’ at which the authors presented their experiences with methodological and ethical issues relating to social media-enabled research recruitment and intervention delivery. We identify common pitfalls and provide recommendations for recruitment and intervention via social media. We also discuss the ethical and responsible conduct of research using social media for each of these purposes. PMID:29942634

Integrating Systems Health Management with Adaptive Controls for a Utility-Scale Wind Turbine

NASA Technical Reports Server (NTRS)

Frost, Susan A.; Goebel, Kai; Trinh, Khanh V.; Balas, Mark J.; Frost, Alan M.

2011-01-01

Increasing turbine up-time and reducing maintenance costs are key technology drivers for wind turbine operators. Components within wind turbines are subject to considerable stresses due to unpredictable environmental conditions resulting from rapidly changing local dynamics. Systems health management has the aim to assess the state-of-health of components within a wind turbine, to estimate remaining life, and to aid in autonomous decision-making to minimize damage. Advanced adaptive controls can provide the mechanism to enable optimized operations that also provide the enabling technology for Systems Health Management goals. The work reported herein explores the integration of condition monitoring of wind turbine blades with contingency management and adaptive controls. Results are demonstrated using a high fidelity simulator of a utility-scale wind turbine.

Mission operations management

NASA Technical Reports Server (NTRS)

Rocco, David A.

1994-01-01

Redefining the approach and philosophy that operations management uses to define, develop, and implement space missions will be a central element in achieving high efficiency mission operations for the future. The goal of a cost effective space operations program cannot be realized if the attitudes and methodologies we currently employ to plan, develop, and manage space missions do not change. A management philosophy that is in synch with the environment in terms of budget, technology, and science objectives must be developed. Changing our basic perception of mission operations will require a shift in the way we view the mission. This requires a transition from current practices of viewing the mission as a unique end product, to a 'mission development concept' built on the visualization of the end-to-end mission. To achieve this change we must define realistic mission success criteria and develop pragmatic approaches to achieve our goals. Custom mission development for all but the largest and most unique programs is not practical in the current budget environment, and we simply do not have the resources to implement all of our planned science programs. We need to shift our management focus to allow us the opportunity make use of methodologies and approaches which are based on common building blocks that can be utilized in the space, ground, and mission unique segments of all missions.

A methodological framework to assess the carbon balance of tropical managed forests.

PubMed

Piponiot, Camille; Cabon, Antoine; Descroix, Laurent; Dourdain, Aurélie; Mazzei, Lucas; Ouliac, Benjamin; Rutishauser, Ervan; Sist, Plinio; Hérault, Bruno

2016-12-01

Managed forests are a major component of tropical landscapes. Production forests as designated by national forest services cover up to 400 million ha, i.e. half of the forested area in the humid tropics. Forest management thus plays a major role in the global carbon budget, but with a lack of unified method to estimate carbon fluxes from tropical managed forests. In this study we propose a new time- and spatially-explicit methodology to estimate the above-ground carbon budget of selective logging at regional scale. The yearly balance of a logging unit, i.e. the elementary management unit of a forest estate, is modelled by aggregating three sub-models encompassing (i) emissions from extracted wood, (ii) emissions from logging damage and deforested areas and (iii) carbon storage from post-logging recovery. Models are parametrised and uncertainties are propagated through a MCMC algorithm. As a case study, we used 38 years of National Forest Inventories in French Guiana, northeastern Amazonia, to estimate the above-ground carbon balance (i.e. the net carbon exchange with the atmosphere) of selectively logged forests. Over this period, the net carbon balance of selective logging in the French Guianan Permanent Forest Estate is estimated to be comprised between 0.12 and 1.33 Tg C, with a median value of 0.64 Tg C. Uncertainties over the model could be diminished by improving the accuracy of both logging damage and large woody necromass decay submodels. We propose an innovating carbon accounting framework relying upon basic logging statistics. This flexible tool allows carbon budget of tropical managed forests to be estimated in a wide range of tropical regions.

Identifying Thresholds for Ecosystem-Based Management

PubMed Central

Samhouri, Jameal F.; Levin, Phillip S.; Ainsworth, Cameron H.

2010-01-01

Background One of the greatest obstacles to moving ecosystem-based management (EBM) from concept to practice is the lack of a systematic approach to defining ecosystem-level decision criteria, or reference points that trigger management action. Methodology/Principal Findings To assist resource managers and policymakers in developing EBM decision criteria, we introduce a quantitative, transferable method for identifying utility thresholds. A utility threshold is the level of human-induced pressure (e.g., pollution) at which small changes produce substantial improvements toward the EBM goal of protecting an ecosystem's structural (e.g., diversity) and functional (e.g., resilience) attributes. The analytical approach is based on the detection of nonlinearities in relationships between ecosystem attributes and pressures. We illustrate the method with a hypothetical case study of (1) fishing and (2) nearshore habitat pressure using an empirically-validated marine ecosystem model for British Columbia, Canada, and derive numerical threshold values in terms of the density of two empirically-tractable indicator groups, sablefish and jellyfish. We also describe how to incorporate uncertainty into the estimation of utility thresholds and highlight their value in the context of understanding EBM trade-offs. Conclusions/Significance For any policy scenario, an understanding of utility thresholds provides insight into the amount and type of management intervention required to make significant progress toward improved ecosystem structure and function. The approach outlined in this paper can be applied in the context of single or multiple human-induced pressures, to any marine, freshwater, or terrestrial ecosystem, and should facilitate more effective management. PMID:20126647

Barriers to Innovation in Urban Wastewater Utilities: Attitudes of Managers in California.

PubMed

Kiparsky, Michael; Thompson, Barton H; Binz, Christian; Sedlak, David L; Tummers, Lars; Truffer, Bernhard

2016-06-01

In many regions of the world, urban water systems will need to transition into fundamentally different forms to address current stressors and meet impending challenges-faster innovation will need to be part of these transitions. To assess the innovation deficit in urban water organizations and to identify means for supporting innovation, we surveyed wastewater utility managers in California. Our results reveal insights about the attitudes towards innovation among decision makers, and how perceptions at the level of individual managers might create disincentives for experimentation. Although managers reported feeling relatively unhindered organizationally, they also spend less time on innovation than they feel they should. The most frequently reported barriers to innovation included cost and financing; risk and risk aversion; and regulatory compliance. Considering these results in the context of prior research on innovation systems, we conclude that collective action may be required to address underinvestment in innovation.

Barriers to Innovation in Urban Wastewater Utilities: Attitudes of Managers in California

NASA Astrophysics Data System (ADS)

Kiparsky, Michael; Thompson, Barton H.; Binz, Christian; Sedlak, David L.; Tummers, Lars; Truffer, Bernhard

2016-06-01

In many regions of the world, urban water systems will need to transition into fundamentally different forms to address current stressors and meet impending challenges—faster innovation will need to be part of these transitions. To assess the innovation deficit in urban water organizations and to identify means for supporting innovation, we surveyed wastewater utility managers in California. Our results reveal insights about the attitudes towards innovation among decision makers, and how perceptions at the level of individual managers might create disincentives for experimentation. Although managers reported feeling relatively unhindered organizationally, they also spend less time on innovation than they feel they should. The most frequently reported barriers to innovation included cost and financing; risk and risk aversion; and regulatory compliance. Considering these results in the context of prior research on innovation systems, we conclude that collective action may be required to address underinvestment in innovation.

Utilization of remotely-sensed data in the management of inland wetlands

NASA Technical Reports Server (NTRS)

Carter, V.; Smith, D. G.

1973-01-01

The author has identified the following significant results. ERTS-1 data and aerial photography are proving to be a useful tool for the inventory and management of inland wetlands. Two examples of the application of remotely-sensed data to specific wetland management needs or requirements are discussed. Studies of the Great Dismal Swamp are utilizing ERTS-1 imagery and color IR photography in: (1) study area selection; (2) field inspection; (3) vegetation mapping; (4) identification of drainage characteristics and moisture regime; (5) location of intensive study areas; and (6) detection of change. Thematic extractions of ERTS-1 data made using the United States Geological Survey's Autographic Theme Extraction System are aiding analyses of swamp hydrologic regime and providing information pertinent to quick recognition and inventory of wetlands from ERTS-1. DCP'S in south Florida wetlands provide near-real time data for water resources managers. Data relayed by satellite can be entered into models to provide predictive data and water storage information for long-term and short-term decision making.

Report: The EPA Should Assess the Utility of the Watch List as a Management Tool

EPA Pesticide Factsheets

Report #13-P-0435, September 30, 2013 . The agency runs the risk of maintaining a management tool that does not assist in tracking facilities with long-standing significant violations and has limited transparency and utility to the public.

41 CFR 109-28.5006 - Utilization.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AND DISTRIBUTION 28.50-Management of Equipment Held for Future Projects § 109-28.5006 Utilization. It... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Utilization. 109-28.5006 Section 109-28.5006 Public Contracts and Property Management Federal Property Management Regulations...

Hardware proofs using EHDM and the RSRE verification methodology

NASA Technical Reports Server (NTRS)

Butler, Ricky W.; Sjogren, Jon A.

1988-01-01

Examined is a methodology for hardware verification developed by Royal Signals and Radar Establishment (RSRE) in the context of the SRI International's Enhanced Hierarchical Design Methodology (EHDM) specification/verification system. The methodology utilizes a four-level specification hierarchy with the following levels: functional level, finite automata model, block model, and circuit level. The properties of a level are proved as theorems in the level below it. This methodology is applied to a 6-bit counter problem and is critically examined. The specifications are written in EHDM's specification language, Extended Special, and the proofs are improving both the RSRE methodology and the EHDM system.

Resource utilization for non-operative cervical radiculopathy: Management by surgeons versus non-surgeons.

PubMed

Chung, Sophie H; Bohl, Daniel D; Paul, Jonathan T; Rihn, Jeffrey A; Harrop, James S; Ghogawala, Zoher; Hilibrand, Alan S; Grauer, Jonathan N

2017-07-01

To compare the estimated resource utilization for non-operative treatment of cervical radiculopathy if managed by surgeons versus non-surgeons. A Cervical Spine Research Society-sponsored survey was administered at a national spine surgery conference to surgeons and non-surgeons, as classified above. The survey asked questions regarding resource utilization and perceived costs for the "average patient" with cervical radiculopathy managed non-operatively. Resource utilization and perceived costs were compared between surgeon and non-surgeon participants, and between private practice and academic and/or hybrid groups that combine academic and private practices. In total, 101 of the 125 conference attendees participated in the survey (return rate 80.8%, of which 60% were surgeons). Surgeon and non-surgeon estimates for duration of non-operative care did not differ (3.3 versus 4.2 months, p=0.071). Estimates also did not differ for estimated number of physical therapy visits (10.5 versus 10.5, p=0.983), cervical injections (1.4 versus 1.7, p=0.272), chiropractic visits (3.1 versus 3.7, p=0.583), or perceived days off from work (14.9 versus 16.3, p=0.816). The only difference identified was that surgeon estimates of the number of physician visits while providing non-operative care were lower than non-surgeon estimates (3.2 versus 4.0, p=0.018). In terms of estimated costs, surgeon and non-surgeon were mostly similar (only difference being that surgeon estimates for the total cost of physician visits per patient were lower than non-surgeon estimates ($382 versus $579, p=0.007). Surgeon estimates for the percent of their patients that go on to receive surgery within 6 months were higher than non-surgeon estimates (28.6% versus 18.8%, p=0.018). Similarly, surgeon estimates for the percent of their patients to go on to receive surgery within 2 years were higher than non-surgeon estimates (37.8% versus 24.8%, p=0.013). Academic/hybrid and private practice group resource

Longitudinal Research with Sexual Assault Survivors: A Methodological Review

ERIC Educational Resources Information Center

Campbell, Rebecca; Sprague, Heather Brown; Cottrill, Sara; Sullivan, Cris M.

2011-01-01

Longitudinal research designs are relatively rare in the academic literature on rape and sexual assault despite their tremendous methodological rigor and scientific utility. In the interest of promoting wider use of such methods, we conducted a methodological review of projects that have used prospective longitudinal designs to study the…

A hierarchical-multiobjective framework for risk management

NASA Technical Reports Server (NTRS)

Haimes, Yacov Y.; Li, Duan

1991-01-01

A broad hierarchical-multiobjective framework is established and utilized to methodologically address the management of risk. United into the framework are the hierarchical character of decision-making, the multiple decision-makers at separate levels within the hierarchy, the multiobjective character of large-scale systems, the quantitative/empirical aspects, and the qualitative/normative/judgmental aspects. The methodological components essentially consist of hierarchical-multiobjective coordination, risk of extreme events, and impact analysis. Examples of applications of the framework are presented. It is concluded that complex and interrelated forces require an analysis of trade-offs between engineering analysis and societal preferences, as in the hierarchical-multiobjective framework, to successfully address inherent risk.

[Methodology for construction of a panel of indicators for monitoring and evaluation of unified health system (SUS) management].

PubMed

Tamaki, Edson Mamoru; Tanaka, Oswaldo Yoshimi; Felisberto, Eronildo; Alves, Cinthia Kalyne de Almeida; Drumond Junior, Marcos; Bezerra, Luciana Caroline de Albuquerque; Calvo, Maria Cristina Marino; Miranda, Alcides Silva de

2012-04-01

This study sought to develop methodology for the construction of a Panel for the Monitoring and Evaluation of Management of the Unified Health System (SUS). The participative process used in addition to the systematization conducted made it possible to identify an effective strategy for building management tools in partnership with researchers, academic institutions and managers of the SUS. The final systematization of the Panel selected indicators for the management of the SUS in terms of Demand, Inputs, Processes, Outputs and Outcomes in order to provide a simple, versatile and useful tool for evaluation at any level of management and more transparent and easier communication with all stakeholders in decision-making. Taking the management of the SUS as the scope of these processes and practices in all normative aspects enabled dialog between systemic theories and those which consider the centrality of the social actor in the decision-making process.

77 FR 55843 - Office of Facilities Management and Program Services; Submission for OMB Review; Background...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-11

... of Facilities Management and Program Services; Submission for OMB Review; Background Investigations... collection of personal data for background investigations for child care workers accessing GSA owned and... assumptions and methodology; ways to enhance the quality, utility, and clarity of the information to be...

Reciprocal Benefits, Legacy and Risk: Applying Ellinger and Bostrom's Model of Line Manager Role Identity as Facilitators of Learning

ERIC Educational Resources Information Center

Campbell, Paul; Evans, Peter

2016-01-01

Purpose: The purpose of this paper is to explore the beliefs held by managers about their roles as facilitators of learning with their employees in a public utilities organisation. Design/methodology/approach: The research was based on Ellinger and Bostrom's (2002) study on managers' beliefs on their role as facilitators of learning in…

Effects of Home Energy Management Systems on Distribution Utilities and Feeders Under Various Market Structures: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ruth, Mark; Pratt, Annabelle; Lunacek, Monte

2015-07-17

The combination of distributed energy resources (DER) and retail tariff structures to provide benefits to both utility consumers and the utilities is poorly understood. To improve understanding, an Integrated Energy System Model (IESM) is being developed to simulate the physical and economic aspects of DER technologies, the buildings where they reside, and feeders servicing them. The IESM was used to simulate 20 houses with home energy management systems on a single feeder under a time of use tariff to estimate economic and physical impacts on both the households and the distribution utilities. HEMS reduce consumers’ electric bills by precooling housesmore » in the hours before peak electricity pricing. Household savings are greater than the reduction utility net revenue indicating that HEMS can provide a societal benefit providing tariffs are structured so that utilities remain solvent. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices and resulting in a higher peak load.« less

41 CFR 109-39.301 - Utilization guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Utilization guidelines... Management System Vehicles § 109-39.301 Utilization guidelines. DOE activities utilizing GSA IFMS motor... meeting DOE utilization guidelines or established local use objectives, as appropriate. Those vehicles not...

Energy index decomposition methodology at the plant level

NASA Astrophysics Data System (ADS)

Kumphai, Wisit

Scope and method of study. The dissertation explores the use of a high level energy intensity index as a facility-level energy performance monitoring indicator with a goal of developing a methodology for an economically based energy performance monitoring system that incorporates production information. The performance measure closely monitors energy usage, production quantity, and product mix and determines the production efficiency as a part of an ongoing process that would enable facility managers to keep track of and, in the future, be able to predict when to perform a recommissioning process. The study focuses on the use of the index decomposition methodology and explored several high level (industry, sector, and country levels) energy utilization indexes, namely, Additive Log Mean Divisia, Multiplicative Log Mean Divisia, and Additive Refined Laspeyres. One level of index decomposition is performed. The indexes are decomposed into Intensity and Product mix effects. These indexes are tested on a flow shop brick manufacturing plant model in three different climates in the United States. The indexes obtained are analyzed by fitting an ARIMA model and testing for dependency between the two decomposed indexes. Findings and conclusions. The results concluded that the Additive Refined Laspeyres index decomposition methodology is suitable to use on a flow shop, non air conditioned production environment as an energy performance monitoring indicator. It is likely that this research can be further expanded in to predicting when to perform a recommissioning process.

Thermal disposal of waste containing nanomaterials: first investigations on a methodology for risk management

NASA Astrophysics Data System (ADS)

Ounoughene, G.; LeBihan, O.; Debray, B.; Chivas-Joly, C.; Longuet, C.; Joubert, A.; Lopez-Cuesta, J.-M.; Le Coq, L.

2017-06-01

Considering the wide use and production of NMs since last two decades, these trendy nanomaterials (NMs) are expected to end up in thermal disposal and waste incineration plants (WIP). It seems relevant to assess the risks related to the thermal disposal and incineration of waste containing NMs (WCNMs). The objective of this work is to present a first approach to develop a preliminary methodology for risk management in order (1) to give insights on nanosafety of exposed operators and on potential environmental risks related to the incineration and thermal disposal of WCNMs, and (2) to eventually support decision-makers and incineration plant managers. Therefore, the main challenge is to find (a) key parameter(s) which would govern the decision related to risk management of NMs thermal disposal. On the one hand, we focused on the relevant literature studies about experimental works on incineration of NMs. On the other hand, we conducted an introductory discussion with a group of experts. The review of this literature highlights that the nano-object’s nanostructure destruction appears as a relevant indicator of the risks related to the NMs incineration. As a consequence, we defined a “temperature of nanostructure destruction” (TND) which would be the temperature from which the nanostructure will be destroyed. This parameter has been assumed to be a consistent indicator to develop a preliminary methodology. If the combustion chamber temperature is higher than the TND of the NM (or if they are close to each other), then the nanostructure will be destroyed and no risks related to NMs remain. If the TND of the NMs is higher than the combustion chamber temperature, then the nanostructure will not be destroyed and risks related to NMs have to be considered. As a result, five groups of NMs have been identified. WCNMs including carbonic NMs appear to be in good position to be destroyed safely in WIP. On the other hand, based on this criterion, there would be no

Naval Ship Maintenance: An Analysis of the Dutch Shipbuilding Industry using the Knowledge Value Added, Systems Dynamics, and Integrated Risk Management Methodologies

DTIC Science & Technology

2013-04-01

and Integrated Risk Management Methodologies 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e...supply chains, risk management with real options, and sustainability . [dnford@nps.edu] Thomas J. Housel—Housel specializes in valuing intellectual...maintenance services for the RDN. Damen Schelde has used an ILS since 2002 to manage the shipbuilding process from project initiation through the

24 CFR 904.205 - Training methodology.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DEVELOPMENT LOW RENT HOUSING HOMEOWNERSHIP OPPORTUNITIES Homeownership Counseling and Training § 904.205... training methodology. Because groups vary, there should be adaptability in the communication and learning experience. Methods to be utilized may include group presentations, small discussion groups, special classes...

Effect of case management on unmet needs and utilization of medical care and medications among HIV-infected persons.

PubMed

Katz, M H; Cunningham, W E; Fleishman, J A; Andersen, R M; Kellogg, T; Bozzette, S A; Shapiro, M F

2001-10-16

Although case management has been advocated as a method for improving the care of chronically ill persons, its effectiveness is poorly understood. To assess the effect of case managers on unmet need for supportive services and utilization of medical care and medications among HIV-infected persons. Baseline and follow-up interview of a national probability sample. Inpatient and outpatient medical facilities in the United States. 2437 HIV-infected adults representing 217 081 patients receiving medical care. Outcomes measured at follow-up were unmet need for supportive services, medical care utilization (ambulatory visits, emergency department visits, and hospitalizations), and use of HIV medication (receipt of antiretroviral therapy and prophylaxis against Pneumocystis carinii pneumonia and toxoplasmosis). At baseline, 56.5% of the sample had contact with a case manager in the previous 6 months. In multiple logistic regression analyses that adjusted for potential confounders, contact with a case manager at baseline was associated with decreased unmet need for income assistance (odds ratio [OR], 0.57 [95% CI, 0.36 to 0.91]), health insurance (OR, 0.54 [CI, 0.33 to 0.89]), home health care (OR, 0.29 [CI, 0.15 to 0.56]), and emotional counseling (OR, 0.62 [CI, 0.41 to 0.94]) at follow-up. Contact with case managers was not significantly associated with utilization of ambulatory care (OR, 0.77 [CI, 0.57 to 1.04]), hospitalization (OR, 1.13 [CI, 0.84 to 1.54]), or emergency department visits (OR, 1.30 [CI, 0.97 to 1.73]) but was associated with higher utilization of two-drug (OR, 1.58 [CI, 1.23 to 2.03]) and three-drug (OR, 1.34 [CI, 1.00 to 1.80]) antiretroviral regimens and of treatment with protease inhibitors or non-nucleoside reverse transcriptase inhibitors (OR, 1.29 [CI, 1.02 to 1.64]) at follow-up. Case management appears to be associated with fewer unmet needs and higher use of HIV medications in patients receiving HIV treatment.

Using QALYs in telehealth evaluations: a systematic review of methodology and transparency.

PubMed

Bergmo, Trine S

2014-08-03

The quality-adjusted life-year (QALY) is a recognised outcome measure in health economic evaluations. QALY incorporates individual preferences and identifies health gains by combining mortality and morbidity into one single index number. A literature review was conducted to examine and discuss the use of QALYs to measure outcomes in telehealth evaluations. Evaluations were identified via a literature search in all relevant databases. Only economic evaluations measuring both costs and QALYs using primary patient level data of two or more alternatives were included. A total of 17 economic evaluations estimating QALYs were identified. All evaluations used validated generic health related-quality of life (HRQoL) instruments to describe health states. They used accepted methods for transforming the quality scores into utility values. The methodology used varied between the evaluations. The evaluations used four different preference measures (EQ-5D, SF-6D, QWB and HUI3), and utility scores were elicited from the general population. Most studies reported the methodology used in calculating QALYs. The evaluations were less transparent in reporting utility weights at different time points and variability around utilities and QALYs. Few made adjustments for differences in baseline utilities. The QALYs gained in the reviewed evaluations varied from 0.001 to 0.118 in implying a small but positive effect of telehealth intervention on patient's health. The evaluations reported mixed cost-effectiveness results. The use of QALYs in telehealth evaluations has increased over the last few years. Different methodologies and utility measures have been used to calculate QALYs. A more harmonised methodology and utility measure is needed to ensure comparability across telehealth evaluations.

International utilization and operations

NASA Technical Reports Server (NTRS)

Goldberg, Stanley R.

1989-01-01

The international framework of the Space Station Freedom Program is described. The discussion covers the U.S. space policy, international agreements, international Station elements, overall program management structure, and utilization and operations management. Consideration is also given to Freedom's user community, Freedom's crew, pressurized payload and attached payload accommodations, utilization and operations planning, user integration, and user operations.

The past, present, and future of U.S. utility demand-side management programs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eto, J.

Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers` energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in responsemore » to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests.« less

Environmental auditing: Capabilities and management utility of recreation impact monitoring programs

USGS Publications Warehouse

Marion, J.L.

1995-01-01

A recreation impact monitoring system was developed and applied in 1984?1986 and in 1991 to all backcountry river-accessed campsites within Delaware Water Gap National Recreation Area, Pennsylvania and New Jersey. Results suggest that actions implemented by park managers in response to problems identified by the initial survey were highly effective in reducing resource degradation caused by camping. In particular, the elimination of some designated campsites and installation of anchored firegrates reduced the total area of disturbance by 50%. Firegrate installation provided a focal point that increased the concentration of camping activities, allowing peripheral areas to recover. As suggested by predictive models, additional resource degradation caused by increased camping intensities is more than offset by improvements in the condition of areas where use is eliminated. The capabilities and management utility of recreation impact monitoring programs, illustrated by the Delaware Water Gap monitoring program, are also presented and discussed.

Application of a new methodology for coastal multi-hazard-assessment & management on the state of Karnataka, India.

PubMed

Rosendahl Appelquist, Lars; Balstrøm, Thomas

2015-04-01

This paper presents the application of a new methodology for coastal multi-hazard assessment & management under a changing global climate on the state of Karnataka, India. The recently published methodology termed the Coastal Hazard Wheel (CHW) is designed for local, regional and national hazard screening in areas with limited data availability, and covers the hazards of ecosystem disruption, gradual inundation, salt water intrusion, erosion and flooding. The application makes use of published geophysical data and remote sensing information and is showcasing how the CHW framework can be applied at a scale relevant for regional planning purposes. It uses a GIS approach to develop regional and sub-regional hazard maps as well as to produce relevant hazard risk data, and includes a discussion of uncertainties, limitations and management perspectives. The hazard assessment shows that 61 percent of Karnataka's coastline has a high or very high inherent hazard of erosion, making erosion the most prevalent coastal hazard. The hazards of flooding and salt water intrusion are also relatively widespread as 39 percent of Karnataka's coastline has a high or very high inherent hazard for both of these hazard types. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Demand-Side Management and Integrated Resource Planning: Findings from a Survey of 24 Electric Utilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schweitzer, M.

1991-01-01

Integrated resource planning differs from traditional utility planning practices primarily in its increased attention to demand-side management (DSM) programs and its integration of supply- and demand-side resources into a combined resource portfolio. This report details the findings from an Oak Ridge National Laboratory (ORNL) survey of 24 electric utilities that have well-developed integrated planning processes. These utilities account for roughly one-third of total capacity, electricity generation, and DSM-program expenditures nationwide. The ORNL survey was designed to obtain descriptive data on a national sample of utilities and to test a number of hypothesized relationships between selected utility characteristics and the mixmore » of resources selected for the integrated plan, with an emphasis on the use of DSM resources and the processes by which they are chosen. The survey solicited information on each utility's current and projected resource mix, operating environment, procedures used to screen potential DSM resources, techniques used to obtain public input and to integrate supply- and demand-side options into a unified plan, and procedures used in the final selection of resources for the plan.« less

An evolving systems-based methodology for healthcare planning.

PubMed

Warwick, Jon; Bell, Gary

2007-01-01

Healthcare planning seems beset with problems at all hierarchical levels. These are caused by the 'soft' nature of many of the issues present in healthcare planning and the high levels of complexity inherent in healthcare services. There has, in recent years, been a move to utilize systems thinking ideas in an effort to gain a better understanding of the forces at work within the healthcare environment and these have had some success. This paper argues that systems-based methodologies can be further enhanced by metrication and modeling which assist in exploring the changed emergent behavior of a system resulting from management intervention. The paper describes the Holon Framework as an evolving systems-based approach that has been used to help clients understand complex systems (in the education domain) that would have application in the analysis of healthcare problems.

Methodology for Physics and Engineering of Reliable Products

NASA Technical Reports Server (NTRS)

Cornford, Steven L.; Gibbel, Mark

1996-01-01

Physics of failure approaches have gained wide spread acceptance within the electronic reliability community. These methodologies involve identifying root cause failure mechanisms, developing associated models, and utilizing these models to inprove time to market, lower development and build costs and higher reliability. The methodology outlined herein sets forth a process, based on integration of both physics and engineering principles, for achieving the same goals.

The Utility of Teleultrasound to Guide Acute Patient Management.

PubMed

Becker, Christian; Fusaro, Mario; Patel, Dhruv; Shalom, Isaac; Frishman, William H; Scurlock, Corey

Ultrasound has evolved into a core bedside tool for diagnostic and management purposes for all subsets of adult and pediatric critically-ill patients. Teleintensive care unit coverage has undergone a similar rapid expansion period throughout the United States. Round-the-clock access to ultrasound equipment is very common in today's intensive care unit, but 24/7 coverage with staff trained to acquire and interpret point-of-care ultrasound in real time is lagging behind equipment availability. Medical trainees and physician extenders require attending level supervision to ensure consistent image acquisition and accurate interpretation. Teleintensivists can extend the utility of ultrasound by supervising and guiding providers without or with only partial training in ultrasound, and also by extending direct trainee ultrasound supervision to time periods when no direct bedside attending supervisor is available, and when treatment decisions otherwise would have been made without supervision and feedback on image acquisition and interpretation. Nursing staff without ultrasound training can also be directed to perform basic ultrasound exams, which may have immediate diagnostic and/or treatment consequences, thereby overcoming access barriers in the absence of physicians or physician extenders. We discuss 4 real-life clinical scenarios in which teleintensivist supervision extended and standardized bedside ultrasound exams to guide management decisions which significantly impacted patient outcomes.

How to convince your manager to invest in an HIS preimplementation methodology for appraisal of material, process and human costs and benefits.

PubMed Central

Bossard, B.; Renard, J. M.; Capelle, P.; Paradis, P.; Beuscart, M. C.

2000-01-01

Investing in information technology has become a crucial process in hospital management today. Medical and administrative managers are faced with difficulties in measuring medical information technology costs and benefits due to the complexity of the domain. This paper proposes a preimplementation methodology for evaluating and appraising material, process and human costs and benefits. Based on the users needs and organizational process analysis, the methodology provides an evaluative set of financial and non financial indicators which can be integrated in a decision making and investment evaluation process. We describe the first results obtained after a few months of operation for the Computer-Based Patient Record (CPR) project. Its full acceptance, in spite of some difficulties, encourages us to diffuse the method for the entire project. PMID:11079851

Can a chronic disease management pulmonary rehabilitation program for COPD reduce acute rural hospital utilization?

PubMed

Rasekaba, T M; Williams, E; Hsu-Hage, B

2009-01-01

Chronic obstructive pulmonary disease (COPD) imposes a costly burden on healthcare. Pulmonary rehabilitation (PR) is the best practice to better manage COPD to improve patient outcomes and reduce acute hospital care utilization. To evaluate the impact of a once-weekly, eight-week multidisciplinary PR program as an integral part of the COPD chronic disease management (CDM) Program at Kyabram District Health Services. The study compared two cohorts of COPD patients: CDM-PR Cohort (4-8 weeks) and Opt-out Cohort (0-3 weeks) between February 2006 and March 2007. The CDM-PR Program involved multidisciplinary patient education and group exercise training. Nonparametric statistical tests were used to compare acute hospital care utilization 12 months before and after the introduction of CDM-PR. The number of patients involved in the CDM-PR Cohort was 29 (n = 29), and that in the Opt-out Cohort was 24 (n = 24). The CDM-PR Cohort showed significant reductions in cumulative acute hospital care utilization indicators (95% emergency department presentations, 95% inpatient admissions, 99% length of stay; effect sizes = 0.62-0.66, P < 0.001) 12 months after the introduction of the CDM Program; in contrast, changes in the cumulative indicators were statistically insignificant for the Opt-out Cohort (emergency department presentations decreased by 5%, inpatient admissions decreased by 12%, length of stay increased by 30%; effect size = 0.14-0.40, P > 0.05). Total costs associated with the hospital care utilization decreased from $130,000 to $7,500 for the CDM-PR Cohort and increased from $77,700 to $101,200 for the Opt-out Cohort. Participation in the CDM-PR for COPD patients can significantly reduce acute hospital care utilization and associated costs in a small rural health service.

Integrating cost information with health management support system: an enhanced methodology to assess health care quality drivers.

PubMed

Kohli, R; Tan, J K; Piontek, F A; Ziege, D E; Groot, H

1999-08-01

Changes in health care delivery, reimbursement schemes, and organizational structure have required health organizations to manage the costs of providing patient care while maintaining high levels of clinical and patient satisfaction outcomes. Today, cost information, clinical outcomes, and patient satisfaction results must become more fully integrated if strategic competitiveness and benefits are to be realized in health management decision making, especially in multi-entity organizational settings. Unfortunately, traditional administrative and financial systems are not well equipped to cater to such information needs. This article presents a framework for the acquisition, generation, analysis, and reporting of cost information with clinical outcomes and patient satisfaction in the context of evolving health management and decision-support system technology. More specifically, the article focuses on an enhanced costing methodology for determining and producing improved, integrated cost-outcomes information. Implementation issues and areas for future research in cost-information management and decision-support domains are also discussed.

Soft-Systems Methodology. Mendip Papers.

ERIC Educational Resources Information Center

Kowszun, J.

This paper provides an introduction to a particular systems-theoretical approach to problem-solving in the management of education usually referred to as soft-systems methodology (SSM), developed by Peter Checkland in the 1970s. SSM should provide a powerful tool for managers in education at any level who have a strategic role because it can be…

Optimal control, investment and utilization schemes for energy storage under uncertainty

NASA Astrophysics Data System (ADS)

Mirhosseini, Niloufar Sadat

Energy storage has the potential to offer new means for added flexibility on the electricity systems. This flexibility can be used in a number of ways, including adding value towards asset management, power quality and reliability, integration of renewable resources and energy bill savings for the end users. However, uncertainty about system states and volatility in system dynamics can complicate the question of when to invest in energy storage and how best to manage and utilize it. This work proposes models to address different problems associated with energy storage within a microgrid, including optimal control, investment, and utilization. Electric load, renewable resources output, storage technology cost and electricity day-ahead and spot prices are the factors that bring uncertainty to the problem. A number of analytical methodologies have been adopted to develop the aforementioned models. Model Predictive Control and discretized dynamic programming, along with a new decomposition algorithm are used to develop optimal control schemes for energy storage for two different levels of renewable penetration. Real option theory and Monte Carlo simulation, coupled with an optimal control approach, are used to obtain optimal incremental investment decisions, considering multiple sources of uncertainty. Two stage stochastic programming is used to develop a novel and holistic methodology, including utilization of energy storage within a microgrid, in order to optimally interact with energy market. Energy storage can contribute in terms of value generation and risk reduction for the microgrid. The integration of the models developed here are the basis for a framework which extends from long term investments in storage capacity to short term operational control (charge/discharge) of storage within a microgrid. In particular, the following practical goals are achieved: (i) optimal investment on storage capacity over time to maximize savings during normal and emergency

Inernational research in health care management: its need in the 21st century, methodological challenges, ethical issues, pitfalls, and practicalities.

PubMed

Buttigieg, Sandra C; Rathert, Cheryl; D'Aunno, Thomas A; Savage, Grant T

2015-01-01

This commentary argues in favor of international research in the 21st century. Advances in technology, science, communication, transport, and infrastructure have transformed the world into a global village. Industries have increasingly adopted globalization strategies. Likewise, the health sector is more internationalized whereby comparisons between diverse health systems, international best practices, international benchmarking, cross-border health care, and cross-cultural issues have become important subjects in the health care literature. The focus has now turned to international, collaborative, cross-national, and cross-cultural research, which is by far more demanding than domestic studies. In this commentary, we explore the methodological challenges, ethical issues, pitfalls, and practicalities within international research and offer possible solutions to address them. The commentary synthesizes contributions from four scholars in the field of health care management, who came together during the annual meeting of the Academy of Management to discuss with members of the Health Care Management Division the challenges of international research. International research is worth pursuing; however, it calls for scholarly attention to key methodological and ethical issues for its success. This commentary addresses salient issues pertaining to international research in one comprehensive account.

Shoulder-to-Shoulder Research "with" Children: Methodological and Ethical Considerations

ERIC Educational Resources Information Center

Griffin, Krista M.; Lahman, Maria K. E.; Opitz, Michael F.

2016-01-01

This paper presents a methodological study with children where two different interview methods were utilized: the "walk-around" (a form of mobile interview) and the "shoulder-to-shoulder." The paper reviews the methodological aspects of the study then provides a brief review of the history of methods employed in research with…

Cost-Utility Analysis: Sartorius Flap versus Negative Pressure Therapy for Infected Vascular Groin Graft Managment.

PubMed

Chatterjee, Abhishek; Macarios, David; Griffin, Leah; Kosowski, Tomasz; Pyfer, Bryan J; Offodile, Anaeze C; Driscoll, Daniel; Maddali, Sirish; Attwood, John

2015-11-01

Sartorius flap coverage and adjunctive negative pressure wound therapy (NPWT) have been described in managing infected vascular groin grafts with varying cost and clinical success. We performed a cost-utility analysis comparing sartorius flap with NPWT in managing an infected vascular groin graft. A literature review compiling outcomes for sartorius flap and NPWT interventions was conducted from peer-reviewed journals in MEDLINE (PubMed) and EMBASE. Utility scores were derived from expert opinion and used to estimate quality-adjusted life years (QALYs). Medicare current procedure terminology and diagnosis-related groups codes were used to assess the costs for successful graft salvage with the associated complications. Incremental cost-effectiveness was assessed at $50,000/QALY, and both univariate and probabilistic sensitivity analyses were conducted to assess robustness of the conclusions. Thirty-two studies were used pooling 384 patients (234 sartorius flaps and 150 NPWT). NPWT had better clinical outcomes (86.7% success rate, 0.9% minor complication rate, and 13.3% major complication rate) than sartorius flap (81.6% success rate, 8.0% minor complication rate, and 18.4% major complication rate). NPWT was less costly ($12,366 versus $23,516) and slightly more effective (12.06 QALY versus 12.05 QALY) compared with sartorius flap. Sensitivity analyses confirmed the robustness of the base case findings; NPWT was either cost-effective at $50,000/QALY or dominated sartorius flap in 81.6% of all probabilistic sensitivity analyses. In our cost-utility analysis, use of adjunctive NPWT, along with debridement and antibiotic treatment, for managing infected vascular groin graft wounds was found to be a more cost-effective option when compared with sartorius flaps.

Cost-Utility Analysis: Sartorius Flap versus Negative Pressure Therapy for Infected Vascular Groin Graft Managment

PubMed Central

Macarios, David; Griffin, Leah; Kosowski, Tomasz; Pyfer, Bryan J.; Offodile, Anaeze C.; Driscoll, Daniel; Maddali, Sirish; Attwood, John

2015-01-01

Background: Sartorius flap coverage and adjunctive negative pressure wound therapy (NPWT) have been described in managing infected vascular groin grafts with varying cost and clinical success. We performed a cost–utility analysis comparing sartorius flap with NPWT in managing an infected vascular groin graft. Methods: A literature review compiling outcomes for sartorius flap and NPWT interventions was conducted from peer-reviewed journals in MEDLINE (PubMed) and EMBASE. Utility scores were derived from expert opinion and used to estimate quality-adjusted life years (QALYs). Medicare current procedure terminology and diagnosis-related groups codes were used to assess the costs for successful graft salvage with the associated complications. Incremental cost-effectiveness was assessed at $50,000/QALY, and both univariate and probabilistic sensitivity analyses were conducted to assess robustness of the conclusions. Results: Thirty-two studies were used pooling 384 patients (234 sartorius flaps and 150 NPWT). NPWT had better clinical outcomes (86.7% success rate, 0.9% minor complication rate, and 13.3% major complication rate) than sartorius flap (81.6% success rate, 8.0% minor complication rate, and 18.4% major complication rate). NPWT was less costly ($12,366 versus $23,516) and slightly more effective (12.06 QALY versus 12.05 QALY) compared with sartorius flap. Sensitivity analyses confirmed the robustness of the base case findings; NPWT was either cost-effective at $50,000/QALY or dominated sartorius flap in 81.6% of all probabilistic sensitivity analyses. Conclusion: In our cost–utility analysis, use of adjunctive NPWT, along with debridement and antibiotic treatment, for managing infected vascular groin graft wounds was found to be a more cost-effective option when compared with sartorius flaps. PMID:26893991

Effects of a recovery management intervention on Chinese heroin users' community recovery through the mediation effect of enhanced service utilization

PubMed Central

Wu, F.; Fu, L.M.; Hser, Y.H.

2015-01-01

Background This study investigates whether a recovery management intervention (RMI) can improve the utilization of community drug treatment and wraparound services among heroin users in China and subsequently lead to positive recovery outcomes. Methods Secondary analysis was conducted drawing data from a randomized controlled trial; 100 heroin users with no severe mental health problems were recruited in two Shanghai districts (Hongkou and Yangpu) upon their release from compulsory rehabilitation facilities. A latent variable modeling approach was utilized to test whether the RMI influences heroin users' perceived motivation and readiness for treatment, enhances treatment and wraparound service participation, and, in turn, predicts better recovery outcomes. Results Enrollment in drug treatment and other social service utilization increased significantly as a result of RMI rather than an individual drug user's motivation and readiness for treatment. Increased service utilization thus led to more positive individual recovery outcomes. In addition to this mediation effect through service utilization, the RMI also improved participants' community recovery directly. Conclusions Findings suggest that better drug treatment enrollment, community service utilization and recovery outcomes can be potentially achieved among heroin users in China with carefully designed case management interventions. PMID:24990956

Management methodology for pressure equipment

NASA Astrophysics Data System (ADS)

Bletchly, P. J.

Pressure equipment constitutes a significant investment in capital and a major proportion of potential high-risk plant in many operations and this is particularly so in an alumina refinery. In many jurisdictions pressure equipment is also subject to statutory regulation that imposes obligations on Owners of the equipment with respect to workplace safety. Most modern technical standards and industry codes of practice employ a risk-based approach to support better decision making with respect to pressure equipment. For a management system to be effective it must demonstrate that risk is being managed within acceptable limits.

Review of LCA studies of solid waste management systems – Part II: Methodological guidance for a better practice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Laurent, Alexis, E-mail: alau@dtu.dk; Clavreul, Julie; Bernstad, Anna

Highlights: • We perform a critical review of 222 LCA studies of solid waste management systems. • We analyse the past LCA practice against the ISO standard and ILCD Handbook guidance. • Malpractices exist in many methodological aspects with large variations among studies. • Many of these aspects are important for the reliability of the results. • We provide detailed recommendations to practitioners of waste management LCAs. - Abstract: Life cycle assessment (LCA) is increasingly used in waste management to identify strategies that prevent or minimise negative impacts on ecosystems, human health or natural resources. However, the quality of themore » provided support to decision- and policy-makers is strongly dependent on a proper conduct of the LCA. How has LCA been applied until now? Are there any inconsistencies in the past practice? To answer these questions, we draw on a critical review of 222 published LCA studies of solid waste management systems. We analyse the past practice against the ISO standard requirements and the ILCD Handbook guidelines for each major step within the goal definition, scope definition, inventory analysis, impact assessment, and interpretation phases of the methodology. Results show that malpractices exist in several aspects of the LCA with large differences across studies. Examples are a frequent neglect of the goal definition, a frequent lack of transparency and precision in the definition of the scope of the study, e.g. an unclear delimitation of the system boundaries, a truncated impact coverage, difficulties in capturing influential local specificities such as representative waste compositions into the inventory, and a frequent lack of essential sensitivity and uncertainty analyses. Many of these aspects are important for the reliability of the results. For each of them, we therefore provide detailed recommendations to practitioners of waste management LCAs.« less

Psychosocial and nonclinical factors predicting hospital utilization in patients of a chronic disease management program: a prospective observational study.

PubMed

Tran, Mark W; Weiland, Tracey J; Phillips, Georgina A

2015-01-01

Psychosocial factors such as marital status (odds ratio, 3.52; 95% confidence interval, 1.43-8.69; P = .006) and nonclinical factors such as outpatient nonattendances (odds ratio, 2.52; 95% confidence interval, 1.22-5.23; P = .013) and referrals made (odds ratio, 1.20; 95% confidence interval, 1.06-1.35; P = .003) predict hospital utilization for patients in a chronic disease management program. Along with optimizing patients' clinical condition by prescribed medical guidelines and supporting patient self-management, addressing psychosocial and nonclinical issues are important in attempting to avoid hospital utilization for people with chronic illnesses.

Improving the value of costly genetic reference laboratory testing with active utilization management.

PubMed

Dickerson, Jane A; Cole, Bonnie; Conta, Jessie H; Wellner, Monica; Wallace, Stephanie E; Jack, Rhona M; Rutledge, Joe; Astion, Michael L

2014-01-01

Tests that are performed outside of the ordering institution, send-out tests, represent an area of risk to patients because of complexity associated with sending tests out. Risks related to send-out tests include increased number of handoffs, ordering the wrong or unnecessary test, specimen delays, data entry errors, preventable delays in reporting and acknowledging results, and excess financial liability. Many of the most expensive and most misunderstood tests are send-out genetic tests. To design and develop an active utilization management program to reduce the risk to patients and improve value of genetic send-out tests. Send-out test requests that met defined criteria were reviewed by a rotating team of doctoral-level consultants and a genetic counselor in a pediatric tertiary care center. Two hundred fifty-one cases were reviewed during an 8-month period. After review, nearly one-quarter of genetic test requests were modified in the downward direction, saving a total of 2% of the entire send-out bill and 19% of the test requests under management. Ultimately, these savings were passed on to patients. Implementing an active utilization strategy for expensive send-out tests can be achieved with minimal technical resources and results in improved value of testing to patients.

Adaptive optimization as a design and management methodology for coal-mining enterprise in uncertain and volatile market environment - the conceptual framework

NASA Astrophysics Data System (ADS)

Mikhalchenko, V. V.; Rubanik, Yu T.

2016-10-01

The work is devoted to the problem of cost-effective adaptation of coal mines to the volatile and uncertain market conditions. Conceptually it can be achieved through alignment of the dynamic characteristics of the coal mining system and power spectrum of market demand for coal product. In practical terms, this ensures the viability and competitiveness of coal mines. Transformation of dynamic characteristics is to be done by changing the structure of production system as well as corporate, logistics and management processes. The proposed methods and algorithms of control are aimed at the development of the theoretical foundations of adaptive optimization as basic methodology for coal mine enterprise management in conditions of high variability and uncertainty of economic and natural environment. Implementation of the proposed methodology requires a revision of the basic principles of open coal mining enterprises design.

Implementation and evaluation of a pharmacist-led hypertension management service in primary care: outcomes and methodological challenges.

PubMed

Bajorek, Beata; Lemay, Kate S; Magin, Parker; Roberts, Christopher; Krass, Ines; Armour, Carol L

2016-01-01

Suboptimal utilisation of pharmacotherapy, non-adherence to prescribed treatment, and a lack of monitoring all contribute to poor blood (BP) pressure control in patients with hypertension. The objective of this study was to evaluate the implementation of a pharmacist-led hypertension management service in terms of processes, outcomes, and methodological challenges. A prospective, controlled study was undertaken within the Australian primary care setting. Community pharmacists were recruited to one of three study groups: Group A (Control - usual care), Group B (Intervention), or Group C (Short Intervention). Pharmacists in Groups B and C delivered a service comprising screening and monitoring of BP, as well as addressing poor BP control through therapeutic adjustment and adherence strategies. Pharmacists in Group C delivered the shortened version of the service. Significant changes to key outcome measures were observed in Group C: reduction in systolic and diastolic BPs at the 3-month visit (P<0.01 and P<0.01, respectively), improvement in medication adherence scores (P=0.01), and a slight improvement in quality of life (EQ-5D-3L Index) scores (P=0.91). There were no significant changes in Group B (the full intervention), and no differences in comparison to Group A (usual care). Pharmacists fed-back that patient recruitment was a key barrier to service implementation, highlighting the methodological implications of screening. A collaborative, pharmacist-led hypertension management service can help monitor BP, improve medication adherence, and optimise therapy in a step-wise approach. However, blood pressure screening can effect behaviour change in patients, presenting methodological challenges in the evaluation of services in this context.

Implementation and evaluation of a pharmacist-led hypertension management service in primary care: outcomes and methodological challenges

PubMed Central

2016-01-01

Background: Suboptimal utilisation of pharmacotherapy, non-adherence to prescribed treatment, and a lack of monitoring all contribute to poor blood (BP) pressure control in patients with hypertension. Objective: The objective of this study was to evaluate the implementation of a pharmacist-led hypertension management service in terms of processes, outcomes, and methodological challenges. Method: A prospective, controlled study was undertaken within the Australian primary care setting. Community pharmacists were recruited to one of three study groups: Group A (Control – usual care), Group B (Intervention), or Group C (Short Intervention). Pharmacists in Groups B and C delivered a service comprising screening and monitoring of BP, as well as addressing poor BP control through therapeutic adjustment and adherence strategies. Pharmacists in Group C delivered the shortened version of the service. Results: Significant changes to key outcome measures were observed in Group C: reduction in systolic and diastolic BPs at the 3-month visit (P<0.01 and P<0.01, respectively), improvement in medication adherence scores (P=0.01), and a slight improvement in quality of life (EQ-5D-3L Index) scores (P=0.91). There were no significant changes in Group B (the full intervention), and no differences in comparison to Group A (usual care). Pharmacists fed-back that patient recruitment was a key barrier to service implementation, highlighting the methodological implications of screening. Conclusion: A collaborative, pharmacist-led hypertension management service can help monitor BP, improve medication adherence, and optimise therapy in a step-wise approach. However, blood pressure screening can effect behaviour change in patients, presenting methodological challenges in the evaluation of services in this context. PMID:27382427

The Development and Implementation of a Diversity Management Curriculum: Organizational Change through Exploration and Exploitation

ERIC Educational Resources Information Center

Danowitz, Mary Ann; Hanappi-Egger, Edeltraud; Hofmann, Roswitha

2009-01-01

Purpose: The purpose of this paper is to provide concepts and strategies to successfully introduce and implement curricular change; especially, related to incorporating diversity management into academic programs. Design/methodology/approach: Utilizing documents and accounts from two agents involved in the change process and an outside observer,…

Variability in blood and blood component utilization as assessed by an anesthesia information management system.

PubMed

Frank, Steven M; Savage, Will J; Rothschild, Jim A; Rivers, Richard J; Ness, Paul M; Paul, Sharon L; Ulatowski, John A

2012-07-01

Data can be collected for various purposes with anesthesia information management systems. The authors describe methods for using data acquired from an anesthesia information management system to assess intraoperative utilization of blood and blood components. Over an 18-month period, data were collected on 48,086 surgical patients at a tertiary care academic medical center. All data were acquired with an automated anesthesia recordkeeping system. Detailed reports were generated for blood and blood component utilization according to surgical service and surgical procedure, and for individual surgeons and anesthesiologists. Transfusion hemoglobin trigger and target concentrations were compared among surgical services and procedures, and between individual medical providers. For all patients given erythrocytes, the mean transfusion hemoglobin trigger was 8.4 ± 1.5, and the target was 10.2 ± 1.5 g/dl. Variation was significant among surgical services (trigger range: 7.5 ± 1.2-9.5 ± 1.1, P = 0.0001; target range: 9.1 ± 1.2-11.3 ± 1.4 g/dl, P = 0.002), surgeons (trigger range: 7.2 ± 0.7-9.8 ± 1.0, P = 0.001; target range: 8.8 ± 0.9-11.8 ± 1.3 g/dl, P = 0.001), and anesthesiologists (trigger range: 7.2 ± 0.8-9.6 ± 1.2, P = 0.001; target range: 9.0 ± 0.9-11.7 ± 1.3 g/dl, P = 0.0004). The use of erythrocyte salvage, fresh frozen plasma, and platelets varied threefold to fourfold among individual surgeons compared with their peers performing the same surgical procedure. The use of data acquired from an anesthesia information management system allowed a detailed analysis of blood component utilization, which revealed significant variation among surgical services and surgical procedures, and among individual anesthesiologists and surgeons compared with their peers. Incorporating these methods of data acquisition and analysis into a blood management program could reduce unnecessary transfusions, an outcome that may increase patient safety and reduce costs.

Focused Group Interviews as an Innovative Quanti-Qualitative Methodology (QQM): Integrating Quantitative Elements into a Qualitative Methodology

ERIC Educational Resources Information Center

Grim, Brian J.; Harmon, Alison H.; Gromis, Judy C.

2006-01-01

There is a sharp divide between quantitative and qualitative methodologies in the social sciences. We investigate an innovative way to bridge this gap that incorporates quantitative techniques into a qualitative method, the "quanti-qualitative method" (QQM). Specifically, our research utilized small survey questionnaires and experiment-like…

Does performance evaluation help public managers? A Balanced Scorecard approach in urban waste services.

PubMed

Guimarães, Bernardo; Simões, Pedro; Marques, Rui Cunha

2010-12-01

The urban waste market has evolved significantly in the past decades, which among other changes, has led to the creation of new utilities and new business models. However, very few things have changed for the users. Urban waste collection remains mainly under the responsibility of local authorities and the charges paid by the users in most countries are very low compared to the provision costs. This situation forces the injection of public money into the system, encouraging the 'quiet-life' within the utilities and, therefore, inefficiency. The present study intends to analyze the potential for the application of the Balanced Scorecard (BSc) methodology into the waste utilities. After a comprehensive revision of the urban waste sector in Portugal, the methodology of BSc and its application in local public services is described and discussed. Focusing on implementation rather than on strategy, a set of performance indicators is proposed to be utilized in the different management models of waste utilities in Portugal: the municipalities, semi-autonomous utilities, municipal companies and mixed companies. This implementation is then exemplified through four case studies, one for each type of utility. This paper provides a flexible framework proposal to be applied to waste utilities operating both in Portugal and abroad. Copyright © 2010 Elsevier Ltd. All rights reserved.

Generalized Cartographic and Simultaneous Representation of Utility Networks for Decision-Support Systems and Crisis Management in Urban Environments

NASA Astrophysics Data System (ADS)

Becker, T.; König, G.

2015-10-01

Cartographic visualizations of crises are used to create a Common Operational Picture (COP) and enforce Situational Awareness by presenting relevant information to the involved actors. As nearly all crises affect geospatial entities, geo-data representations have to support location-specific analysis throughout the decision-making process. Meaningful cartographic presentation is needed for coordinating the activities of crisis manager in a highly dynamic situation, since operators' attention span and their spatial memories are limiting factors during the perception and interpretation process. Situational Awareness of operators in conjunction with a COP are key aspects in decision-making process and essential for making well thought-out and appropriate decisions. Considering utility networks as one of the most complex and particularly frequent required systems in urban environment, meaningful cartographic presentation of multiple utility networks with respect to disaster management do not exist. Therefore, an optimized visualization of utility infrastructure for emergency response procedures is proposed. The article will describe a conceptual approach on how to simplify, aggregate, and visualize multiple utility networks and their components to meet the requirements of the decision-making process and to support Situational Awareness.

Clinical Utility of Viral Load in Management of Cytomegalovirus Infection after Solid Organ Transplantation

PubMed Central

2013-01-01

SUMMARY The negative impact of cytomegalovirus (CMV) infection on transplant outcomes warrants efforts toward improving its prevention, diagnosis, and treatment. During the last 2 decades, significant breakthroughs in diagnostic virology have facilitated remarkable improvements in CMV disease management. During this period, CMV nucleic acid amplification testing (NAT) evolved to become one of the most commonly performed tests in clinical virology laboratories. NAT provides a means for rapid and sensitive diagnosis of CMV infection in transplant recipients. Viral quantification also introduced several principles of CMV disease management. Specifically, viral load has been utilized (i) for prognostication of CMV disease, (ii) to guide preemptive therapy, (iii) to assess the efficacy of antiviral treatment, (iv) to guide the duration of treatment, and (v) to indicate the risk of clinical relapse or antiviral drug resistance. However, there remain important limitations that require further optimization, including the interassay variability in viral load reporting, which has limited the generation of standardized viral load thresholds for various clinical indications. The recent introduction of an international reference standard should advance the major goal of uniform viral load reporting and interpretation. However, it has also become apparent that other aspects of NAT should be standardized, including sample selection, nucleic acid extraction, amplification, detection, and calibration, among others. This review article synthesizes the vast amount of information on CMV NAT and provides a timely review of the clinical utility of viral load testing in the management of CMV in solid organ transplant recipients. Current limitations are highlighted, and avenues for further research are suggested to optimize the clinical application of NAT in the management of CMV after transplantation. PMID:24092851

Comparative Review of the Treatment Methodologies of Carotid Stenosis

PubMed Central

Bae, Coney; Szuchmacher, Mauricio; Chang, John B.

2015-01-01

The treatment of carotid stenosis entails three methodologies, namely, medical management, carotid angioplasty and stenting (CAS), as well as carotid endarterectomy (CEA). The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and European Carotid Surgery Trial (ECST) have shown that symptomatic carotid stenosis greater than 70% is best treated with CEA. In asymptomatic patients with carotid stenosis greater than 60%, CEA was more beneficial than treatment with aspirin alone according to the Asymptomatic Carotid Atherosclerosis (ACAS) and Asymptomatic Carotid Stenosis Trial (ACST) trials. When CAS is compared with CEA, the CREST resulted in similar rates of ipsilateral stroke and death rates regardless of symptoms. However, CAS not only increased adverse effects in women, it also amplified stroke rates and death in elderly patients compared with CEA. CAS can maximize its utility in treating focal restenosis after CEA and patients with overwhelming cardiac risk or prior neck irradiation. When performing CEA, using a patch was equated to a more durable result than primary closure, whereas eversion technique is a new methodology deserving a spotlight. Comparing the three major treatment strategies of carotid stenosis has intrinsic drawbacks, as most trials are outdated and they vary in their premises, definitions, and study designs. With the newly codified best medical management including antiplatelet therapies with aspirin and clopidogrel, statin, antihypertensive agents, strict diabetes control, smoking cessation, and life style change, the current trials may demonstrate that asymptomatic carotid stenosis is best treated with best medical therapy. The ongoing trials will illuminate and reshape the treatment paradigm for symptomatic and asymptomatic carotid stenosis. PMID:26417191

Prevalence of postpartum depression and interventions utilized for its management.

PubMed

Anokye, Reindolf; Acheampong, Enoch; Budu-Ainooson, Amy; Obeng, Edmund Isaac; Akwasi, Adjei Gyimah

2018-01-01

Postpartum depression is a mood disorder that affects approximately 10-15% of adult mothers yearly. This study sought to determine the prevalence of postpartum depression and interventions utilized for its management in a Health facility in Ghana. A descriptive cross-sectional study design using a quantitative approach was used for the study. The study population included mothers and healthcare workers. Simple random sampling technique was used to select 257 mothers, while a convenience sampling technique was used to select 56 health workers for the study. A Patient Health Questionnaire was used to screen for depression and a structured questionnaire comprising closed-ended questions was used to collect primary data on the interventions for the management of postpartum depression. Data were analyzed using statistical software SPSS version 16.0. Postpartum depression was prevalent among 7% of all mothers selected. The severity ranged from minimal depression to severe depression. Psychosocial support proved to be the most effective intervention ( p  = 0.001) that has been used by the healthcare workers to reduce depressive symptoms. Postpartum depression is prevalent among mothers although at a lower rate and psychosocial support has been the most effective intervention in its management. Postpartum depression may affect socialization behaviors in children and the mother, and it may lead to thoughts of failure leading to deeper depression. Frequent screening exercises for postpartum depression should be organized by authorities of the hospitals in conjunction with the Ministry of Health.

Availability and utilization of opioids for pain management: global issues.

PubMed

Manjiani, Deepak; Paul, D Baby; Kunnumpurath, Sreekumar; Kaye, Alan David; Vadivelu, Nalini

2014-01-01

Pain can significantly influence an individual's health status and can have serious negative consequences: poor nutrition, decreased appetite, abnormal sleep patterns, fatigue, and impairment of daily living activities. Pain can cause psychological impairment and decrease healing and recovery from injuries and illness. A hallmark of many chronic conditions, pain affects more patients' lives than diabetes mellitus, heart disease, and cancer combined. However, many chronic sufferers do not have access to effective pain management for a variety of reasons, including limited access, restrictions, and personal and cultural biases. This review summarizes issues of access, distribution, and cultural bias with regard to opioid agents and seeks to clarify the challenges related to opioid delivery. The considerable negative physical and mental consequences of chronic pain are discussed for the general and palliative care population. Opioids are an effective treatment for various intractable painful conditions, but problems in global opioid access for safe and rational use in pain management contribute to unnecessary suffering. These problems persist despite increased understanding in recent years of the pathophysiology of pain. Comprehensive guidelines for goal-directed and patient-friendly chronic opiate therapy will potentially enhance the outlook for future chronic pain management. The improvement of pain education in undergraduate and postgraduate training will benefit patients and clinicians. The promise of new medications, along with the utilization of multimodal approaches, has the potential to provide effective pain relief to future generations of sufferers.

Availability and Utilization of Opioids for Pain Management: Global Issues

PubMed Central

Manjiani, Deepak; Paul, D. Baby; Kunnumpurath, Sreekumar; Kaye, Alan David; Vadivelu, Nalini

2014-01-01

Background Pain can significantly influence an individual's health status and can have serious negative consequences: poor nutrition, decreased appetite, abnormal sleep patterns, fatigue, and impairment of daily living activities. Pain can cause psychological impairment and decrease healing and recovery from injuries and illness. A hallmark of many chronic conditions, pain affects more patients' lives than diabetes mellitus, heart disease, and cancer combined. However, many chronic sufferers do not have access to effective pain management for a variety of reasons, including limited access, restrictions, and personal and cultural biases. Methods This review summarizes issues of access, distribution, and cultural bias with regard to opioid agents and seeks to clarify the challenges related to opioid delivery. The considerable negative physical and mental consequences of chronic pain are discussed for the general and palliative care population. Results Opioids are an effective treatment for various intractable painful conditions, but problems in global opioid access for safe and rational use in pain management contribute to unnecessary suffering. These problems persist despite increased understanding in recent years of the pathophysiology of pain. Conclusions Comprehensive guidelines for goal-directed and patient-friendly chronic opiate therapy will potentially enhance the outlook for future chronic pain management. The improvement of pain education in undergraduate and postgraduate training will benefit patients and clinicians. The promise of new medications, along with the utilization of multimodal approaches, has the potential to provide effective pain relief to future generations of sufferers. PMID:24940131

Developing a personalised self-management system for post stroke rehabilitation; utilising a user-centred design methodology.

PubMed

Mawson, Susan; Nasr, Nasrin; Parker, Jack; Zheng, Huiru; Davies, Richard; Mountain, Gail

2014-11-01

To develop and evaluate an information and communication technology (ICT) solution for a post-stroke Personalised Self-Managed Rehabilitation System (PSMrS). The PSMrS translates current models of stroke rehabilitation and theories underpinning self-management and self-efficacy into an ICT-based system for home-based post-stroke rehabilitation. The interdisciplinary research team applied a hybrid of health and social sciences research methods and user-centred design methods. This included a series of home visits, focus groups, in-depth interviews, cultural probes and technology biographies. The iterative development of both the content of the PSMrS and the interactive interfaces between the system and the user incorporates current models of post-stroke rehabilitation and addresses the factors that promote self-managed behaviour and self-efficacy such as mastery, verbal persuasion and physiological feedback. The methodological approach has ensured that the interactive technology has been driven by the needs of the stroke survivors and their carers in the context of their journey to both recovery and adaptation. Underpinned by theories of motor relearning, neuroplasticity, self-management and behaviour change, the PSMrS developed in this study has resulted in a personalised system for self-managed rehabilitation, which has the potential to change motor behaviour and promote the achievement of life goals for stroke survivors.

Cost-effectiveness in the management of Dupuytren's contracture. A Canadian cost-utility analysis of current and future management strategies.

PubMed

Baltzer, H; Binhammer, P A

2013-08-01

In Canada, Dupuytren's contracture is managed with partial fasciectomy or percutaneous needle aponeurotomy (PNA). Injectable collagenase will soon be available. The optimal management of Dupuytren's contracture is controversial and trade-offs exist between the different methods. Using a cost-utility analysis approach, our aim was to identify the most cost-effective form of treatment for managing Dupuytren's contracture it and the threshold at which collagenase is cost-effective. We developed an expected-value decision analysis model for Dupuytren's contracture affecting a single finger, comparing the cost-effectiveness of fasciectomy, aponeurotomy and collagenase from a societal perspective. Cost-effectiveness, one-way sensitivity and variability analyses were performed using standard thresholds for cost effective treatment ($50 000 to $100 000/QALY gained). Percutaneous needle aponeurotomy was the preferred strategy for managing contractures affecting a single finger. The cost-effectiveness of primary aponeurotomy improved when repeated to treat recurrence. Fasciectomy was not cost-effective. Collagenase was cost-effective relative to and preferred over aponeurotomy at $875 and $470 per course of treatment, respectively. In summary, our model supports the trend towards non-surgical interventions for managing Dupuytren's contracture affecting a single finger. Injectable collagenase will only be feasible in our publicly funded healthcare system if it costs significantly less than current United States pricing.

Situational Methodology as Multifaceted Pedagogical Tool of Influence on the Formation of Socio-Ethical Values of Future Managers-Economists in Higher Schools of Ukraine and Germany

ERIC Educational Resources Information Center

Sikaliuk, Anzhela

2014-01-01

The role and importance of situational methodology as one of the pedagogical tools of influence on the formation of socio-ethical values of future managers in higher schools of Ukraine and Germany have been theoretically substantiated. The possibilities of situational methodology influence on the formation of socio-ethical values of…

Utilizing sensory prediction errors for movement intention decoding: A new methodology

PubMed Central

Nakamura, Keigo; Ando, Hideyuki

2018-01-01

We propose a new methodology for decoding movement intentions of humans. This methodology is motivated by the well-documented ability of the brain to predict sensory outcomes of self-generated and imagined actions using so-called forward models. We propose to subliminally stimulate the sensory modality corresponding to a user’s intended movement, and decode a user’s movement intention from his electroencephalography (EEG), by decoding for prediction errors—whether the sensory prediction corresponding to a user’s intended movement matches the subliminal sensory stimulation we induce. We tested our proposal in a binary wheelchair turning task in which users thought of turning their wheelchair either left or right. We stimulated their vestibular system subliminally, toward either the left or the right direction, using a galvanic vestibular stimulator and show that the decoding for prediction errors from the EEG can radically improve movement intention decoding performance. We observed an 87.2% median single-trial decoding accuracy across tested participants, with zero user training, within 96 ms of the stimulation, and with no additional cognitive load on the users because the stimulation was subliminal. PMID:29750195

Lessons learned from new construction utility demand side management programs and their implications for implementing building energy codes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wise, B.K.; Hughes, K.R.; Danko, S.L.

1994-07-01

This report was prepared for the US Department of Energy (DOE) Office of Codes and Standards by the Pacific Northwest Laboratory (PNL) through its Building Energy Standards Program (BESP). The purpose of this task was to identify demand-side management (DSM) strategies for new construction that utilities have adopted or developed to promote energy-efficient design and construction. PNL conducted a survey of utilities and used the information gathered to extrapolate lessons learned and to identify evolving trends in utility new-construction DSM programs. The ultimate goal of the task is to identify opportunities where states might work collaboratively with utilities to promotemore » the adoption, implementation, and enforcement of energy-efficient building energy codes.« less

Assessing the effect of increased managed care on hospitals.

PubMed

Mowll, C A

1998-01-01

This study uses a new relative risk methodology developed by the author to assess and compare certain performance indicators to determine a hospital's relative degree of financial vulnerability, based on its location, to the effects of increased managed care market penetration. The study also compares nine financial measures to determine whether hospital in states with a high degree of managed-care market penetration experience lower levels of profitability, liquidity, debt service, and overall viability than hospitals in low managed care states. A Managed Care Relative Financial Risk Assessment methodology composed of nine measures of hospital financial and utilization performance is used to develop a high managed care state Composite Index and to determine the Relative Financial Risk and the Overall Risk Ratio for hospitals in a particular state. Additionally, financial performance of hospitals in the five highest managed care states is compared to hospitals in the five lowest states. While data from Colorado and Massachusetts indicates that hospital profitability diminishes as the level of managed care market penetration increases, the overall study results indicate that hospitals in high managed care states demonstrate a better cash position and higher profitability than hospitals in low managed care states. Hospitals in high managed care states are, however, more heavily indebted in relation to equity and have a weaker debt service coverage capacity. Moreover, the overall financial health and viability of hospitals in high managed care states is superior to that of hospitals in low managed care states.

Design methodology of Dutch banknotes

NASA Astrophysics Data System (ADS)

de Heij, Hans A. M.

2000-04-01

Since the introduction of a design methodology for Dutch banknotes, the quality of Dutch paper currency has improved in more than one way. The methodology is question provides for (i) a design policy, which helps fix clear objectives; (ii) design management, to ensure a smooth cooperation between the graphic designer, printer, papermaker an central bank, (iii) a program of requirements, a banknote development guideline for all parties involved. This systematic approach enables an objective selection of design proposals, including security features. Furthermore, the project manager obtains regular feedback from the public by conducting market surveys. Each new design of a Netherlands Guilder banknote issued by the Nederlandsche Bank of the past 50 years has been an improvement on its predecessor in terms of value recognition, security and durability.

Effects of a recovery management intervention on Chinese heroin users' community recovery through the mediation effect of enhanced service utilization.

PubMed

Wu, F; Fu, L M; Hser, Y H

2015-09-01

This study investigates whether a recovery management intervention (RMI) can improve the utilization of community drug treatment and wraparound services among heroin users in China and subsequently lead to positive recovery outcomes. Secondary analysis was conducted drawing data from a randomized controlled trial; 100 heroin users with no severe mental health problems were recruited in two Shanghai districts (Hongkou and Yangpu) upon their release from compulsory rehabilitation facilities. A latent variable modeling approach was utilized to test whether the RMI influences heroin users' perceived motivation and readiness for treatment, enhances treatment and wraparound service participation, and, in turn, predicts better recovery outcomes. Enrollment in drug treatment and other social service utilization increased significantly as a result of RMI rather than an individual drug user's motivation and readiness for treatment. Increased service utilization thus led to more positive individual recovery outcomes. In addition to this mediation effect through service utilization, the RMI also improved participants' community recovery directly. Findings suggest that better drug treatment enrollment, community service utilization and recovery outcomes can be potentially achieved among heroin users in China with carefully designed case management interventions. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Root Source Analysis/ValuStream[Trade Mark] - A Methodology for Identifying and Managing Risks

NASA Technical Reports Server (NTRS)

Brown, Richard Lee

2008-01-01

Root Source Analysis (RoSA) is a systems engineering methodology that has been developed at NASA over the past five years. It is designed to reduce costs, schedule, and technical risks by systematically examining critical assumptions and the state of the knowledge needed to bring to fruition the products that satisfy mission-driven requirements, as defined for each element of the Work (or Product) Breakdown Structure (WBS or PBS). This methodology is sometimes referred to as the ValuStream method, as inherent in the process is the linking and prioritizing of uncertainties arising from knowledge shortfalls directly to the customer's mission driven requirements. RoSA and ValuStream are synonymous terms. RoSA is not simply an alternate or improved method for identifying risks. It represents a paradigm shift. The emphasis is placed on identifying very specific knowledge shortfalls and assumptions that are the root sources of the risk (the why), rather than on assessing the WBS product(s) themselves (the what). In so doing RoSA looks forward to anticipate, identify, and prioritize knowledge shortfalls and assumptions that are likely to create significant uncertainties/ risks (as compared to Root Cause Analysis, which is most often used to look back to discover what was not known, or was assumed, that caused the failure). Experience indicates that RoSA, with its primary focus on assumptions and the state of the underlying knowledge needed to define, design, build, verify, and operate the products, can identify critical risks that historically have been missed by the usual approaches (i.e., design review process and classical risk identification methods). Further, the methodology answers four critical questions for decision makers and risk managers: 1. What s been included? 2. What's been left out? 3. How has it been validated? 4. Has the real source of the uncertainty/ risk been identified, i.e., is the perceived problem the real problem? Users of the RoSA methodology

Longitudinal analysis on utilization of medical document management system in a hospital with EPR implementation.

PubMed

Kuwata, Shigeki; Yamada, Hitomi; Park, Keunsik

2011-01-01

Document management systems (DMS) have widespread in major hospitals in Japan as a platform to digitize the paper-based records being out of coverage by EPR. This study aimed to examine longitudinal trends of actual use of DMS in a hospital in which EPR had been in operation, which would be conducive to planning the further information management system in the hospital. Degrees of utilization of electronic documents and templates with DMS were analyzed based on data extracted from a university-affiliated hospital with EPR. As a result, it was found that the number of electronic documents as well as scanned documents circulating at the hospital tended to increase. The result indicated that replacement of paper-based documents with electronic documents did not occur. Therefore it was anticipated that the need for DMS would continue to increase in the hospital. The methods used this study to analyze the trend of DMS utilization would be applicable to other hospitals with with a variety of DMS implementation, such as electronic storage by scanning documents or paper preservation that is compatible with EPR.

Optimizing airport capacity utilization in air traffic flow management subject to constraints at arrival and departure fixes

DOT National Transportation Integrated Search

1997-09-01

This paper formulates a new approach for improvement : of air traffic flow management at airports, which leads to : more efficient utilization of existing airport capacity to alleviate : the consequences of congestion. A new model is presented, : whi...

Interpolation of extensive routine water pollution monitoring datasets: methodology and discussion of implications for aquifer management.

PubMed

Yuval, Yuval; Rimon, Yaara; Graber, Ellen R; Furman, Alex

2014-08-01

A large fraction of the fresh water available for human use is stored in groundwater aquifers. Since human activities such as mining, agriculture, industry and urbanisation often result in incursion of various pollutants to groundwater, routine monitoring of water quality is an indispensable component of judicious aquifer management. Unfortunately, groundwater pollution monitoring is expensive and usually cannot cover an aquifer with the spatial resolution necessary for making adequate management decisions. Interpolation of monitoring data is thus an important tool for supplementing monitoring observations. However, interpolating routine groundwater pollution data poses a special problem due to the nature of the observations. The data from a producing aquifer usually includes many zero pollution concentration values from the clean parts of the aquifer but may span a wide range of values (up to a few orders of magnitude) in the polluted areas. This manuscript presents a methodology that can cope with such datasets and use them to produce maps that present the pollution plumes but also delineates the clean areas that are fit for production. A method for assessing the quality of mapping in a way which is suitable to the data's dynamic range of values is also presented. A local variant of inverse distance weighting is employed to interpolate the data. Inclusion zones around the interpolation points ensure that only relevant observations contribute to each interpolated concentration. Using inclusion zones improves the accuracy of the mapping but results in interpolation grid points which are not assigned a value. The inherent trade-off between the interpolation accuracy and coverage is demonstrated using both circular and elliptical inclusion zones. A leave-one-out cross testing is used to assess and compare the performance of the interpolations. The methodology is demonstrated using groundwater pollution monitoring data from the coastal aquifer along the Israeli

Dose-response effects for disease management programs on hospital utilization in Illinois Medicaid.

PubMed

Berg, Gregory D; Donnelly, Shawn; Miller, Mary; Medina, Wendie; Warnick, Kathleen

2012-12-01

The objective of this study is to estimate a dose-response impact of disease management contacts on inpatient admissions. Multivariate regression analysis of panel data was used to test the hypothesis that increased disease management contacts lower the odds of an inpatient admission. Subjects were 40,452 members of Illinois' noninstitutionalized Medicaid-only aged, blind, or disabled population diagnosed with asthma, coronary artery disease, chronic obstructive pulmonary disease, diabetes, and/or heart failure. All members are also in the state's Illinois Health Connect program, a medical home strategy in place for most of the 2.4 million Illinois Medicaid beneficiaries. The statistical measure is the odds ratio, which is a measure of association between the monthly inpatient admission indicator and the number of contacts (doses) a member has had for each particular disease management intervention. Statistically significant contacts are between 8 and 12 for heart failure, between 4 and 12 contacts for diabetes, and between 8 and 13 contacts for asthma. Total inpatient savings during the study period is estimated to be $12.4 million. This study shows the dose-response pattern of inpatient utilization improvements through the number of disease management contacts.

The need for a comprehensive expert system development methodology

NASA Technical Reports Server (NTRS)

Baumert, John; Critchfield, Anna; Leavitt, Karen

1988-01-01

In a traditional software development environment, the introduction of standardized approaches has led to higher quality, maintainable products on the technical side and greater visibility into the status of the effort on the management side. This study examined expert system development to determine whether it differed enough from traditional systems to warrant a reevaluation of current software development methodologies. Its purpose was to identify areas of similarity with traditional software development and areas requiring tailoring to the unique needs of expert systems. A second purpose was to determine whether existing expert system development methodologies meet the needs of expert system development, management, and maintenance personnel. The study consisted of a literature search and personal interviews. It was determined that existing methodologies and approaches to developing expert systems are not comprehensive nor are they easily applied, especially to cradle to grave system development. As a result, requirements were derived for an expert system development methodology and an initial annotated outline derived for such a methodology.

Improving hospital bed occupancy and resource utilization through queuing modeling and evolutionary computation.

PubMed

Belciug, Smaranda; Gorunescu, Florin

2015-02-01

Scarce healthcare resources require carefully made policies ensuring optimal bed allocation, quality healthcare service, and adequate financial support. This paper proposes a complex analysis of the resource allocation in a hospital department by integrating in the same framework a queuing system, a compartmental model, and an evolutionary-based optimization. The queuing system shapes the flow of patients through the hospital, the compartmental model offers a feasible structure of the hospital department in accordance to the queuing characteristics, and the evolutionary paradigm provides the means to optimize the bed-occupancy management and the resource utilization using a genetic algorithm approach. The paper also focuses on a "What-if analysis" providing a flexible tool to explore the effects on the outcomes of the queuing system and resource utilization through systematic changes in the input parameters. The methodology was illustrated using a simulation based on real data collected from a geriatric department of a hospital from London, UK. In addition, the paper explores the possibility of adapting the methodology to different medical departments (surgery, stroke, and mental illness). Moreover, the paper also focuses on the practical use of the model from the healthcare point of view, by presenting a simulated application. Copyright © 2014 Elsevier Inc. All rights reserved.

Personality Assessment of Global Talent: Conceptual and Methodological Issues

ERIC Educational Resources Information Center

van de Vijver, Fons J. R.

2008-01-01

The recruitment of managers who will operate in a culturally heterogeneous context (as expatriate managers, managers in a global company, or managers of a multicultural workforce) is increasingly important in an age of globalization. This article describes conceptual and methodological issues in the assessment of such managers, notably in the…

Air Quality Management Alternatives: United States Air Force Firefighter Training Facilities

DTIC Science & Technology

1988-01-01

Pollution at LAX, JFK , and ORD," Impact of Aircraft Emissions on Air Quality in the Vicinity of Airports , Volume II, FAA-EE-80-09B, Federal...developed and applied . This method enabled fire prevention, and environmental management experts and professionals to provide data, opinions, and to...methodology utilizing questionnaires, interviews, and site visits is developed and applied . This method enabled fire prevention, and environmental

Management of Malignant Pleural Effusion: A Cost-Utility Analysis.

PubMed

Shafiq, Majid; Frick, Kevin D; Lee, Hans; Yarmus, Lonny; Feller-Kopman, David J

2015-07-01

Malignant pleural effusion (MPE) is associated with a significant impact on health-related quality of life. Palliative interventions abound, with varying costs and degrees of invasiveness. We examined the relative cost-utility of 5 therapeutic alternatives for MPE among adults. Original studies investigating the management of MPE were extensively researched, and the most robust and current data particularly those from the TIME2 trial were chosen to estimate event probabilities. Medicare data were used for cost estimation. Utility estimates were adapted from 2 original studies and kept consistent with prior estimations. The decision tree model was based on clinical guidelines and authors' consensus opinion. Primary outcome of interest was the incremental cost-effectiveness ratio for each intervention over a less effective alternative over an analytical horizon of 6 months. Given the paucity of data on rapid pleurodesis protocol, a sensitivity analysis was conducted to address the uncertainty surrounding its efficacy in terms of achieving long-term pleurodesis. Except for repeated thoracentesis (RT; least effective), all interventions had similar effectiveness. Tunneled pleural catheter was the most cost-effective option with an incremental cost-effectiveness ratio of $45,747 per QALY gained over RT, assuming a willingness-to-pay threshold of $100,000/QALY. Multivariate sensitivity analysis showed that rapid pleurodesis protocol remained cost-ineffective even with an estimated probability of lasting pleurodesis up to 85%. Tunneled pleural catheter is the most cost-effective therapeutic alternative to RT. This, together with its relative convenience (requiring neither hospitalization nor thoracoscopic procedural skills), makes it an intervention of choice for MPE.

A risk assessment methodology for critical transportation infrastructure.

DOT National Transportation Integrated Search

2002-01-01

Infrastructure protection typifies a problem of risk assessment and management in a large-scale system. This study offers a methodological framework to identify, prioritize, assess, and manage risks. It includes the following major considerations: (1...

A comparison of results of empirical studies of supplementary search techniques and recommendations in review methodology handbooks: a methodological review.

PubMed

Cooper, Chris; Booth, Andrew; Britten, Nicky; Garside, Ruth

2017-11-28

The purpose and contribution of supplementary search methods in systematic reviews is increasingly acknowledged. Numerous studies have demonstrated their potential in identifying studies or study data that would have been missed by bibliographic database searching alone. What is less certain is how supplementary search methods actually work, how they are applied, and the consequent advantages, disadvantages and resource implications of each search method. The aim of this study is to compare current practice in using supplementary search methods with methodological guidance. Four methodological handbooks in informing systematic review practice in the UK were read and audited to establish current methodological guidance. Studies evaluating the use of supplementary search methods were identified by searching five bibliographic databases. Studies were included if they (1) reported practical application of a supplementary search method (descriptive) or (2) examined the utility of a supplementary search method (analytical) or (3) identified/explored factors that impact on the utility of a supplementary method, when applied in practice. Thirty-five studies were included in this review in addition to the four methodological handbooks. Studies were published between 1989 and 2016, and dates of publication of the handbooks ranged from 1994 to 2014. Five supplementary search methods were reviewed: contacting study authors, citation chasing, handsearching, searching trial registers and web searching. There is reasonable consistency between recommended best practice (handbooks) and current practice (methodological studies) as it relates to the application of supplementary search methods. The methodological studies provide useful information on the effectiveness of the supplementary search methods, often seeking to evaluate aspects of the method to improve effectiveness or efficiency. In this way, the studies advance the understanding of the supplementary search methods. Further

AHP for Risk Management Based on Expected Utility Theory

NASA Astrophysics Data System (ADS)

Azuma, Rumiko; Miyagi, Hayao

This paper presents a model of decision-making considering the risk assessment. The conventional evaluation in AHP is considered to be a kind of utility. When dealing with the risk, however, it is necessary to consider the probability of damage. In order to take risk into decision-making problem, we construct AHP based on expected utility. The risk is considered as a related element of criterion rather than criterion itself. The expected utility is integrated, considering that satisfaction is positive utility and damage by risk is negative utility. Then, evaluation in AHP is executed using the expected utility.

42 CFR 484.230 - Methodology used for the calculation of the low-utilization payment adjustment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Methodology used for the calculation of the low... Prospective Payment System for Home Health Agencies § 484.230 Methodology used for the calculation of the low... amount is determined by using cost data set forth in § 484.210(a) and adjusting by the appropriate wage...

Cost-utility of a disease management program for patients with asthma.

PubMed

Steuten, Lotte; Palmer, Stephen; Vrijhoef, Bert; van Merode, Frits; Spreeuwenberg, Cor; Severens, Hans

2007-01-01

The long-term cost-utility of a disease management program (DMP) for adults with asthma was assessed compared to usual care. A DMP for patients with asthma has been developed and implemented in the region of Maastricht (The Netherlands). By integrating care, the program aims to continuously improve quality of care within existing budgets. A clinical trial was performed over a period of 15 months to collect data on costs and effects of the program and usual care. These data were used to inform a probabilistic decision-analytic model to estimate the 5-year impact of the program beyond follow-up. A societal perspective was adopted, with outcomes assessed in terms of costs per quality-adjusted life-year (QALY). The DMP is associated with a gain in QALYs compared to usual care (2.7+/-.2 versus 3.4+/-.8), at lower costs (3,302+/-314 euro versus 2,973+/-304 euro), thus leading to dominance. The probability that disease management is the more cost-effective strategy is 76 percent at a societal willingness to pay (WTP) for an additional QALY of 0 euro, reaching 95 percent probability at a WTP of 1,000 euro per additional QALY. Organizing health care according to the principles of disease management for adults with asthma has a high probability of being cost-effective and is associated with a gain in QALYs at lower costs.

Basic principles, methodology, and applications of remote sensing in agriculture

NASA Technical Reports Server (NTRS)

Moreira, M. A. (Principal Investigator); Deassuncao, G. V.

1984-01-01

The basic principles of remote sensing applied to agriculture and the methods used in data analysis are described. Emphasis is placed on the importance of developing a methodology that may help crop forecast, basic concepts of spectral signatures of vegetation, the methodology of the LANDSAT data utilization in agriculture, and the remote sensing program application of INPE (Institute for Space Research) in agriculture.

Association of Early Outpatient Rehabilitation With Health Service Utilization in Managing Medicare Beneficiaries With Nontraumatic Knee Pain: Retrospective Cohort Study.

PubMed

Stevans, Joel M; Fitzgerald, G Kelley; Piva, Sara R; Schneider, Michael

2017-06-01

Nontraumatic knee pain (NTKP) is highly prevalent in adults 65 years of age and older. Evidence-based guidelines recommend early use of rehabilitation; however, there is limited information comparing differences in health care utilization when rehabilitation is included in the management of NTKP. To describe the overall health care utilization associated with the management of NTKP; estimate the proportion of people who receive outpatient rehabilitation services; and evaluate the timing of outpatient rehabilitation and its association with other health care utilization. Rretrospective cohort study was conducted using a random 10% sample of 2009-2010 Medicare claims. The sample included 52,504 beneficiaries presenting within the ambulatory setting for management of NTKP. Exposure to outpatient rehabilitative services following the NTKP index ambulatory visit was defined as 1) no rehabilitation; 2) early rehabilitation (1-15 days); 3) intermediate rehabilitation (16-120 days); and 4) late rehabilitation (>120 days). Logistic regression models were fit to analyze the association of rehabilitation timing with narcotic analgesic use, utilization of nonsurgical invasive procedure, and knee surgery during a 12-month follow-up period. Only 11.1% of beneficiaries were exposed to outpatient rehabilitation services. The likelihood of using narcotics, nonsurgical invasive procedures, or surgery was significantly less (adjusted odds ratios; 0.67, 0.50, 0.58, respectively) for those who received early rehabilitation when compared to no rehabilitation. The exposure-outcome relationships were reversed in the intermediate and late rehabilitation cohorts. This was an observational study, and residual confounding could affect the observed relationships. Therefore, definitive conclusions regarding the causal effect of rehabilitation exposure and reduced utilization of more aggressive interventions cannot be determined at this time. Early referral for outpatient rehabilitation may

Kidney transplant patients' attitudes towards self-management support: A Q-methodological study.

PubMed

Grijpma, J W; Tielen, M; van Staa, A L; Maasdam, L; van Gelder, T; Berger, S P; Busschbach, J J; Betjes, M G H; Weimar, W; Massey, E K

2016-05-01

Kidney transplant recipients face many self-management challenges. We aimed to identify profiles of attitudes towards self-management support (SMS) shortly after kidney transplantation. Profiles were generated using Q-methodology: In face-to-face interviews participants rank-ordered opinion statements on aspects of SMS according to agreement. Socio-demographic and medical characteristics were assessed using a questionnaire. By-person factor analysis was used to analyze the rankings and qualitative data was used to support choice of profiles. The resulting factors represent clusters of patients with similar attitudes towards SMS. Forty-three patients (mean age=56; 77% male) participated. Four profiles were identified: (A) transplant-focused and obedient; (B) holistic and collaborative; (C) life-focused and self-determined; and (D) was bipolar. The positive pole (D+) minimalizing and disengaged and the negative pole (D-) coping-focused and needy represent opposing viewpoints within the same profile. Socio-demographic and medical characteristics were not related to profile membership. Each profile represents a specific attitude on post-transplant life, responsibility for health and decision-making, SMS needs, and preferences for SMS. Patients vary in their attitude, needs and preferences for SMS indicating the necessity of providing personalized support after kidney transplantation. Health professionals should explore patients' SMS needs and adapt support accordingly. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

An ontological case base engineering methodology for diabetes management.

PubMed

El-Sappagh, Shaker H; El-Masri, Samir; Elmogy, Mohammed; Riad, A M; Saddik, Basema

2014-08-01

Ontology engineering covers issues related to ontology development and use. In Case Based Reasoning (CBR) system, ontology plays two main roles; the first as case base and the second as domain ontology. However, the ontology engineering literature does not provide adequate guidance on how to build, evaluate, and maintain ontologies. This paper proposes an ontology engineering methodology to generate case bases in the medical domain. It mainly focuses on the research of case representation in the form of ontology to support the case semantic retrieval and enhance all knowledge intensive CBR processes. A case study on diabetes diagnosis case base will be provided to evaluate the proposed methodology.

Spare parts management for nuclear power generation facilities

NASA Astrophysics Data System (ADS)

Scala, Natalie Michele

With deregulation, utilities in the power sector face a much more urgent imperative to emphasize cost efficiencies as compared to the days of regulation. One major opportunity for cost savings is through reductions in spare parts inventories. Most utilities are accustomed to carrying large volumes of expensive, relatively slow-moving parts because of a high degree of risk-averseness. This attitude towards risk is rooted in the days of regulation. Under regulation, companies recovered capital inventory costs by incorporating them into the base rate charged to their customers. In a deregulated environment, cost recovery is no longer guaranteed. Companies must therefore reexamine their risk profile and develop policies for spare parts inventory that are appropriate for a competitive business environment. This research studies the spare parts inventory management problem in the context of electric utilities, with a focus on nuclear power. It addresses three issues related to this problem: criticality, risk, and policy. With respect to criticality and risk, a methodology is presented that incorporates the use of influence diagrams and the Analytic Hierarchy Process (AHP). A new method is developed for group aggregation in the AHP when Saaty and Vargas' (2007) dispersion test fails and decision makers are unwilling or unable to revise their judgments. With respect to policy, a quantitative model that ranks the importance of keeping a part in inventory and recommends a corresponding stocking policy through the use of numerical simulation is developed. This methodology and its corresponding models will enable utilities that have transitioned from a regulated to a deregulated environment become more competitive in their operations while maintaining safety and reliability standards. Furthermore, the methodology developed is general enough so that other utility plants, especially those in the nuclear sector, will be able to use this approach. In addition to regulated

Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

PubMed

Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

2011-04-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

Preparing Addiction Specialists to Include Case Management and Vocational Rehabilitation Services in the Treatment Model for Problem Gamblers

ERIC Educational Resources Information Center

Glenn, Margaret K.; Diaz, Sebastian R.; Hawley, Carolyn

2009-01-01

Professionals in the field of addictions view problems associated with recovery management across multiple domains. This exploratory study utilized concept mapping and pattern matching methodology to conceptualize the resulting 7 domains of concern for treatment and aftercare of problem and pathological gamblers. The information can be used by…

Developing purchasing strategy: a case study of a District Health Authority using soft systems methodology.

PubMed

Brown, A D

1997-02-01

This paper examines the attempt by a District Health Authority (DHA) to create structures (called Purchasing Strategy Groups or PSGs) to facilitate the effective development of its purchasing strategy. The paper is based on a case study design conducted using Soft Systems Methodology (SSM). The research contribution the paper makes is twofold. First, it analyses some of the fundamental management-related difficulties that a DHA can experience when attempting to come to terms with its role and responsibilities in the 1990s. Second, it provides a discussion and evaluation of the utility of SSM for qualitative research in the National Health Service (NHS) in the UK.

Assessment of a French scenario with the INPRO methodology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vasile, A.; Fiorini, G.L.; Cazalet, J.

2006-07-01

This paper presents the French contribution to the Joint Study of the IAEA International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO). It concerns the application of the INPRO methodology to a French scenario, on the transition from present LWRs to EPRs in a first phase and to 4. generation fast reactors in a second phase during the 21. century. The scenario also considers the renewal of the present fuel cycle facilities by the third and the fourth generation ones. Present practice of plutonium recycling in PWR is replaced by the middle of the century by a global recyclingmore » of actinides, uranium, plutonium and minor actinides in fast reactors. The status and the evolution of the INPRO criteria and the corresponding indicators during the studied period are analyzed for each of the six considered areas: economics, safety, environment, waste management, proliferation resistance and infrastructure. Improvements on economic and safety are expected for both the EPR and the 4. generation systems having these improvements among their basic goals. The use of fast reactors and global recycling of actinides leads to a significant improvement on environment indicators and in particular on the natural resources utilization. The envisaged waste management policy results in significant reductions on mass, thermal loads and radiotoxicity of the final waste which only contains fission products. The use of fuels that do not relay on enriched uranium and separated plutonium increases the proliferation resistance characteristics of the future fuel cycle. The paper summarizes also some recommendations on the data, codes and methods used to support the continuous improvement of the INPRO methodology and help future assessors. (authors)« less

Integrated Baseline System (IBS) Version 2.0: Utilities Guide

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burford, M.J.; Downing, T.R.; Williams, J.R.

1994-03-01

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool being developed under the direction of the US Army Nuclear and Chemical Agency. This Utilities Guide explains how you can use the IBS utility programs to manage and manipulate various kinds of IBS data. These programs include utilities for creating, editing, and displaying maps and other data that are referenced to geographic location. The intended audience for this document are chiefly data managers but also system managers and some emergency management planners and analysts.

Electronic Handbooks Simplify Process Management

NASA Technical Reports Server (NTRS)

2012-01-01

Getting a multitude of people to work together to manage processes across many organizations for example, flight projects, research, technologies, or data centers and others is not an easy task. Just ask Dr. Barry E. Jacobs, a research computer scientist at Goddard Space Flight Center. He helped NASA develop a process management solution that provided documenting tools for process developers and participants to help them quickly learn, adapt, test, and teach their views. Some of these tools included editable files for subprocess descriptions, document descriptions, role guidelines, manager worksheets, and references. First utilized for NASA's Headquarters Directives Management process, the approach led to the invention of a concept called the Electronic Handbook (EHB). This EHB concept was successfully applied to NASA's Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs, among other NASA programs. Several Federal agencies showed interest in the concept, so Jacobs and his team visited these agencies to show them how their specific processes could be managed by the methodology, as well as to create mockup versions of the EHBs.

Agile methodology selection criteria: IT start-up case study

NASA Astrophysics Data System (ADS)

Micic, Lj

2017-05-01

Project management in modern IT companies is often based on agile methodologies which have several advantages compared to traditional methodologies such is waterfall. Having in mind that clients sometimes change project during development it is crucial for an IT company to choose carefully which methodology is going to implement and is it going to be mostly based on one or is it going got be combination of several. There are several modern and often used methodologies but among those Scrum, Kanban and XP programming are usually the most common. Sometimes companies use mostly tools and procedures from one but quite often they use some of the combination of those methodologies. Having in mind that those methodologies are just a framework they allow companies to adapt it for their specific projects as well as for other limitations. These methodologies are in limited usage Bosnia but more and more IT companies are starting to use agile methodologies because it is practice and common not just for their clients abroad but also starting to be the only option in order to deliver quality product on time. However it is always challenging which methodology or combination of several companies should implement and how to connect it to its own project, organizational framework and HR management. This paper presents one case study based on local IT start up and delivers solution based on theoretical framework and practical limitations that case company has.

Designing management strategies for carbon dioxide storage and utilization under uncertainty using inexact modelling

NASA Astrophysics Data System (ADS)

Wang, Yu; Fan, Jie; Xu, Ye; Sun, Wei; Chen, Dong

2017-06-01

Effective application of carbon capture, utilization and storage (CCUS) systems could help to alleviate the influence of climate change by reducing carbon dioxide (CO2) emissions. The research objective of this study is to develop an equilibrium chance-constrained programming model with bi-random variables (ECCP model) for supporting the CCUS management system under random circumstances. The major advantage of the ECCP model is that it tackles random variables as bi-random variables with a normal distribution, where the mean values follow a normal distribution. This could avoid irrational assumptions and oversimplifications in the process of parameter design and enrich the theory of stochastic optimization. The ECCP model is solved by an equilibrium change-constrained programming algorithm, which provides convenience for decision makers to rank the solution set using the natural order of real numbers. The ECCP model is applied to a CCUS management problem, and the solutions could be useful in helping managers to design and generate rational CO2-allocation patterns under complexities and uncertainties.

Methodology to explore emergent behaviours of the interactions between water resources and ecosystem under a pluralistic approach

NASA Astrophysics Data System (ADS)

García-Santos, Glenda; Madruga de Brito, Mariana; Höllermann, Britta; Taft, Linda; Almoradie, Adrian; Evers, Mariele

2018-06-01

Understanding the interactions between water resources and its social dimensions is crucial for an effective and sustainable water management. The identification of sensitive control variables and feedback loops of a specific human-hydro-scape can enhance the knowledge about the potential factors and/or agents leading to the current water resources and ecosystems situation, which in turn supports the decision-making process of desirable futures. Our study presents the utility of a system dynamics modeling approach for water management and decision-making for the case of a forest ecosystem under risk of wildfires. We use the pluralistic water research concept to explore different scenarios and simulate the emergent behaviour of water interception and net precipitation after a wildfire in a forest ecosystem. Through a case study, we illustrate the applicability of this new methodology.

An inexpensive, interdisciplinary, methodology to conduct an impact study of homeless persons on hospital based services.

PubMed

Parker, R David; Regier, Michael; Brown, Zachary; Davis, Stephen

2015-02-01

Homelessness is a primary concern for community health. Scientific literature on homelessness is wide ranging and diverse. One opportunity to add to existing literature is the development and testing of affordable, easily implemented methods for measuring the impact of homeless on the healthcare system. Such methodological approaches rely on the strengths in a multidisciplinary approach, including providers, both healthcare and homeless services and applied clinical researchers. This paper is a proof of concept for a methodology which is easily adaptable nationwide, given the mandated implementation of homeless management information systems in the United States and other countries; medical billing systems by hospitals; and research methods of researchers. Adaptation is independent of geographic region, budget restraints, specific agency skill sets, and many other factors that impact the application of a consistent methodological science based approach to assess and address homelessness. We conducted a secondary data analysis merging data from homeless utilization and hospital case based data. These data detailed care utilization among homeless persons in a small, Appalachian city in the United States. In our sample of 269 persons who received at least one hospital based service and one homeless service between July 1, 2012 and June 30, 2013, the total billed costs were $5,979,463 with 10 people costing more than one-third ($1,957,469) of the total. Those persons were primarily men, living in an emergency shelter, with pre-existing disabling conditions. We theorize that targeted services, including Housing First, would be an effective intervention. This is proposed in a future study.

Utilization of Skills in the Application of the Management Process (NS 239): Competency-Based Course Syllabus.

ERIC Educational Resources Information Center

Green, Elizabeth G.; And Others

"Utilization of Skills in the Application of the Management Process" (NS 239) is an associate degree nursing course offered at Chattanooga State Technical Community College to prepare students to assume the role of planner and coordinator of patient care. The course focuses on competencies related to the care of patients with deviations of the…

NNP-LANL Utilities - Condition Assessment and Project Approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stewart, Grant Lorenz

2017-11-21

This report is a presentation on LANL Utilities & Transportation Asset Management; Utility Assets Overview; Condition Assessment; Utilities Project Nominations & Ranking; and Utilities Project Execution.

Cost and resource utilization in cervical cancer management: a real-world retrospective cost analysis.

PubMed

Cromwell, I; Ferreira, Z; Smith, L; van der Hoek, K; Ogilvie, G; Coldman, A; Peacock, S J

2016-02-01

We set out to assess the health care resource utilization and cost of cervical cancer from the perspective of a single-payer health care system. Retrospective observational data for women diagnosed with cervical cancer in British Columbia between 2004 and 2009 were analyzed to calculate patient-level resource utilization patterns from diagnosis to death or 5-year discharge. Domains of resource use within the scope of this cost analysis were chemotherapy, radiotherapy, and brachytherapy administered by the BC Cancer Agency; resource utilization related to hospitalization and outpatient visits as recorded by the B.C. Ministry of Health; medically required services billed under the B.C. Medical Services Plan; and prescriptions dispensed under British Columbia's health insurance programs. Unit costs were applied to radiotherapy and brachytherapy, producing per-patient costs. The mean cost per case of treating cervical cancer in British Columbia was $19,153 (standard error: $3,484). Inpatient hospitalizations, at 35%, represented the largest proportion of the total cost (95% confidence interval: 32.9% to 36.9%). Costs were compared for subgroups of the total cohort. As health care systems change the way they manage, screen for, and prevent cervical cancer, cost-effectiveness evaluations of the overall approach will require up-to-date data for resource utilization and costs. We provide information suitable for such a purpose and also identify factors that influence costs.

Management and utilization of poultry wastes.

PubMed

Williams, C M; Barker, J C; Sims, J T

1999-01-01

Waste by-products such as excreta or bedding material that are generated by the worldwide annual production of more than 40 million metric tons (t) of poultry meat and 600 billion eggs are generally land applied as the final step of a producer's waste management strategy. Under proper land application conditions, the nutrients and organisms in poultry wastes pose little environmental threat. Environmental contamination occurs when land application of poultry wastes is in excess of crop utilization potential, or is done under poor management conditions causing nutrient loss from environmental factors such as soil erosion or surface runoff during rainfall. Environmental parameters of concern are N, P, and certain metals (Cu and Zn in particular), as well as pathogenic microorganisms that may be contained in poultry waste. The biochemical cycle of N is very dynamic, and N contained in poultry waste may either be removed by crop harvest, leave the animal production facility, waste treatment lagoon, or application field as a gas (NH3, NO, NO2, N2O, or N2), or, due to its mobility in soil, be transported in organic or inorganic N forms in the liquid state via surface runoff or leaching into groundwater. Elevated concentrations of NO3-N in groundwater used for human consumption is a health risk to infants that are susceptible to methemoglobinemia. An environmental impact resulting from elevated NO3-N is eutrophication of surface waters. Ammonia loss from poultry waste is an environmental concern because of volatilized wet and dry deposits of NH3 into nitrogen-sensitive ecosystems. Phosphorus in poultry wastes may contribute to environmental degradation by accelerating the process of eutrophication. Unlike N, P is very immobile in soil and must first be transported to a surface water environment to have an environmental impact. It is generally accepted, however, that this nutrient affects receiving waters via transport in eroding soil as sediment-bound P or in surface

The Burn Wound Exudate – an under-utilized resource

PubMed Central

Widgerow, Alan D; King, Kassandra; Tussardi, Ilaria Tocco; Banyard, Derek A.; Chiang, Ryan; Awad, Antony; Afzel, Hassan; Bhatnager, Shweta; Melkumyan, Satenik; Wirth, Garrett; Evans, Gregory R.D

2014-01-01

Introduction The burn wound exudate represents the burn tissue microenvironment. Extracting information from the exudate relating to cellular components, signaling mediators and protein content can provide much needed data relating to the local tissue damage, depth of the wound and probable systemic complications. This review examines the scientific data extracted from burn wound exudates over the years and proposes new investigations that will provide useful information from this underutilized resource. Method A literature review was conducted using the electronic database PubMed to search for literature pertaining to burn wound or blister fluid analysis. Key words included burn exudate, blister fluid, wound exudate, cytokine burn fluid, subeschar fluid, cytokine burns, serum cytokines. 32 relevant article were examined and 29 selected as relevant to the review. 3 papers were discarded due to questionable methodology or conclusions. The reports were assessed for their affect on management decisions and diagnostics. Furthermore, traditional blood level analysis of these mediators was made to compare the accuracy of blood versus exudate in burn wound management. Extrapolations are made for new possibilities of burn wound exudate analysis. Results Studies pertaining to burn wound exudate, subeschar fluid and blister fluid analyses may have contributed to burn wound management decisions particularly related to escharectomies and early burn wound excision. In addition, information from these studies have the potential to impact on areas such as healing, scarring, burn wound conversion and burn wound depth analysis. Conclusion Burn wound exudate analysis has proven useful in burn wound management decisions. It appears to offer a far more accurate reflection of the burn wound pathophysiology than the traditional blood/serum investigations undertaken in the past. New approaches to diagnostics and treatment efficacy assessment are possible utilizing data from this fluid

Review of utility values for economic modeling in type 2 diabetes.

PubMed

Beaudet, Amélie; Clegg, John; Thuresson, Per-Olof; Lloyd, Adam; McEwan, Phil

2014-06-01

Economic analysis in type 2 diabetes mellitus (T2DM) requires an assessment of the effect of a wide range of complications. The objective of this article was to identify a set of utility values consistent with the National Institute for Health and Care Excellence (NICE) reference case and to critically discuss and illustrate challenges in creating such a utility set. A systematic literature review was conducted to identify studies reporting utility values for relevant complications. The methodology of each study was assessed for consistency with the NICE reference case. A suggested set of utility values applicable to modeling was derived, giving preference to studies reporting multiple complications and correcting for comorbidity. The review considered 21 relevant diabetes complications. A total of 16,574 articles were identified; after screening, 61 articles were assessed for methodological quality. Nineteen articles met NICE criteria, reporting utility values for 20 of 21 relevant complications. For renal transplant, because no articles meeting NICE criteria were identified, two articles using other methodologies were included. Index value estimates for T2DM without complication ranged from 0.711 to 0.940. Utility decrement associated with complications ranged from 0.014 (minor hypoglycemia) to 0.28 (amputation). Limitations associated with the selection of a utility value for use in economic modeling included variability in patient recruitment, heterogeneity in statistical analysis, large variability around some point estimates, and lack of recent data. A reference set of utility values for T2DM and its complications in line with NICE requirements was identified. This research illustrates the challenges associated with systematically selecting utility data for economic evaluations. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

How to assess solid waste management in armed conflicts? A new methodology applied to the Gaza Strip, Palestine.

PubMed

Caniato, Marco; Vaccari, Mentore

2014-09-01

We have developed a new methodology for assessing solid waste management in a situation of armed conflict. This methodology is composed of six phases with specific activities, and suggested methods and tools. The collection, haulage, and disposal of waste in low- and middle-income countries is so complicated and expensive task for municipalities, owing to several challenges involved, that some waste is left in illegal dumps. Armed conflicts bring further constraints, such as instability, the sudden increase in violence, and difficulty in supplying equipment and spare parts: planning is very difficult and several projects aimed at improving the situation have failed. The methodology was validated in the Gaza Strip, where the geopolitical situation heavily affects natural resources. We collected information in a holistic way, crosschecked, and discussed it with local experts, practitioners, and authorities. We estimated that in 2011 only 1300 tonne day(-1) were transported to the three disposal sites, out of a production exceeding 1700. Recycling was very limited, while the composting capacity was 3.5 tonnes day(-1), but increasing. We carefully assessed system elements and their interaction. We identified the challenges, and developed possible solutions to increase system effectiveness and robustness. The case study demonstrated that our methodology is flexible and adaptable to the context, thus it could be applied in other areas to improve the humanitarian response in similar situations. © The Author(s) 2014.

Secondary Science Homework and Instructional Methodologies: An Investigation of the Alignment of Homework Assignments and Teachers' Self-Professed Instructional Methodology

ERIC Educational Resources Information Center

Lucas, Paul M.

2009-01-01

This study utilized a mixed-method design in order to investigate the alignment of secondary science teachers' instructional methodologies and their homework designs. Surveys were distributed to educators from a Center for Ocean Sciences Excellence Education (COSEE) database. Coding rubrics were developed to categorize the participants' responses…

A PDA study management tool (SMT) utilizing wireless broadband and full DICOM viewing capability

NASA Astrophysics Data System (ADS)

Documet, Jorge; Liu, Brent; Zhou, Zheng; Huang, H. K.; Documet, Luis

2007-03-01

During the last 4 years IPI (Image Processing and Informatics) Laboratory has been developing a web-based Study Management Tool (SMT) application that allows Radiologists, Film librarians and PACS-related (Picture Archiving and Communication System) users to dynamically and remotely perform Query/Retrieve operations in a PACS network. The users utilizing a regular PDA (Personal Digital Assistant) can remotely query a PACS archive to distribute any study to an existing DICOM (Digital Imaging and Communications in Medicine) node. This application which has proven to be convenient to manage the Study Workflow [1, 2] has been extended to include a DICOM viewing capability in the PDA. With this new feature, users can take a quick view of DICOM images providing them mobility and convenience at the same time. In addition, we are extending this application to Metropolitan-Area Wireless Broadband Networks. This feature requires Smart Phones that are capable of working as a PDA and have access to Broadband Wireless Services. With the extended application to wireless broadband technology and the preview of DICOM images, the Study Management Tool becomes an even more powerful tool for clinical workflow management.

Impact of Primary Care Intensive Management on High-Risk Veterans' Costs and Utilization: A Randomized Quality Improvement Trial.

PubMed

Yoon, Jean; Chang, Evelyn; Rubenstein, Lisa V; Park, Angel; Zulman, Donna M; Stockdale, Susan; Ong, Michael K; Atkins, David; Schectman, Gordon; Asch, Steven M

2018-06-05

Primary care models that offer comprehensive, accessible care to all patients may provide insufficient resources to meet the needs of patients with complex conditions who have the greatest risk for hospitalization. To assess whether augmenting usual primary care with team-based intensive management lowers utilization and costs for high-risk patients. Randomized quality improvement trial. (ClinicalTrials.gov: NCT03100526). 5 U.S. Department of Veterans Affairs (VA) medical centers. Primary care patients at high risk for hospitalization who had a recent acute care episode. Locally tailored intensive management programs providing care coordination, goals assessment, health coaching, medication reconciliation, and home visits through an interdisciplinary team, including a physician or nurse practitioner, a nurse, and psychosocial experts. Utilization and costs (including intensive management program expenses) 12 months before and after randomization. 2210 patients were randomly assigned, 1105 to intensive management and 1105 to usual care. Patients had a mean age of 63 years and an average of 7 chronic conditions; 90% were men. Of the patients assigned to intensive management, 487 (44%) received intensive outpatient care (that is, ≥3 encounters in person or by telephone) and 204 (18%) received limited intervention. From the pre- to postrandomization periods, mean inpatient costs decreased more for the intensive management than the usual care group (-$2164 [95% CI, -$7916 to $3587]). Outpatient costs increased more for the intensive management than the usual care group ($2636 [CI, $524 to $4748]), driven by greater use of primary care, home care, telephone care, and telehealth. Mean total costs were similar in the 2 groups before and after randomization. Sites took up to several months to contact eligible patients, limiting the time between treatment and outcome assessment. Only VA costs were assessed. High-risk patients with access to an intensive management program

Information System Design Methodology Based on PERT/CPM Networking and Optimization Techniques.

ERIC Educational Resources Information Center

Bose, Anindya

The dissertation attempts to demonstrate that the program evaluation and review technique (PERT)/Critical Path Method (CPM) or some modified version thereof can be developed into an information system design methodology. The methodology utilizes PERT/CPM which isolates the basic functional units of a system and sets them in a dynamic time/cost…

Development of an integrated utilities billing management system for the Navy Public Works Center San Diego, California

DOE Office of Scientific and Technical Information (OSTI.GOV)

Monsabert, S. de; Lemmer, H.; Dinwiddie, D.

1995-10-01

In the past, most buildings, structures, and ship visits were not metered, and flat estimates were calculated based on various estimating techniques. The decomposition process was further complicated by the fact that many of the meters monitor consumption values only and do not provide demand or time of use data. This method of billing provides no incentives to the PWC customers to implement energy conservation programs, including load shedding, Energy Monitoring and Control Systems (EMCS), building shell improvements, low flow toilets and shower heads, efficient lighting systems, or other energy savings alternatives. Similarly, the method had no means of adjustmentmore » for seasonal or climatic variations outside of the norm. As an alternative to flat estimates, the Customized Utility Billing Integrated Control (CUBIC) system and the Graphical Data Input System (GDIS) were developed to better manage the data to the major claimant area users based on utilities usage factors, building size, weather data, and hours of operation. GDIS is a graphical database that assists PWC engineers in the development and maintenance of single-line utility diagrams of the facilities and meters. It functions as a drawing associate system and is written in AutoLISP for AutoCAD version 12. GDIS interprets the drawings and provides the facility-to-meter and meter-to-meter hierarchy data that are used by the CUBIC to allocate the billings. This paper reviews the design, development and implementation aspects of CUBIC/GDIS and discusses the benefits of this improved utilities management system.« less

Utility of Functional Hemodynamics and Echocardiography to Aid Diagnosis and Management of Shock.

PubMed

McGee, William T; Raghunathan, Karthik; Adler, Adam C

2015-12-01

The utility of functional hemodynamics and bedside ultrasonography is increasingly recognized as advantageous for both improved diagnosis and management of shock states. In contrast to conventional "static" measures, "dynamic" hemodynamic measures and bedside imaging modalities enhance pathophysiology-based comprehensive understanding of shock states and the response to therapy. The current editions of major textbooks in the primary specialties--in which clinicians routinely encounter patients in shock--including surgery, anesthesia, emergency medicine, and internal medicine continue to incorporate traditional (conventional) descriptions of shock that use well-described (but potentially misleading) intravascular pressures to classify shock states. Reliance on such intravascular pressure measurements is not as helpful as newer "dynamic" functional measures including ultrasonography to both better assess volume responsiveness and biventricular cardiac function. This review thus emphasizes the application of current functional hemodynamics and ultrasonography to the diagnosis and management of shock as a contrast to conventional "static" pressure-based measures.

Implications of workforce and financing changes for primary care practice utilization, revenue, and cost: a generalizable mathematical model for practice management.

PubMed

Basu, Sanjay; Landon, Bruce E; Song, Zirui; Bitton, Asaf; Phillips, Russell S

2015-02-01

Primary care practice transformations require tools for policymakers and practice managers to understand the financial implications of workforce and reimbursement changes. To create a simulation model to understand how practice utilization, revenues, and expenses may change in the context of workforce and financing changes. We created a simulation model estimating clinic-level utilization, revenues, and expenses using user-specified or public input data detailing practice staffing levels, salaries and overhead expenditures, patient characteristics, clinic workload, and reimbursements. We assessed whether the model could accurately estimate clinic utilization, revenues, and expenses across the nation using labor compensation, medical expenditure, and reimbursements databases, as well as cost and revenue data from independent practices of varying size. We demonstrated the model's utility in a simulation of how utilization, revenue, and expenses would change after hiring a nurse practitioner (NP) compared with hiring a part-time physician. Modeled practice utilization and revenue closely matched independent national utilization and reimbursement data, disaggregated by patient age, sex, race/ethnicity, insurance status, and ICD diagnostic group; the model was able to estimate independent revenue and cost estimates, with highest accuracy among larger practices. A demonstration analysis revealed that hiring an NP to work independently with a subset of patients diagnosed with diabetes or hypertension could increase net revenues, if NP visits involve limited MD consultation or if NP reimbursement rates increase. A model of utilization, revenue, and expenses in primary care practices may help policymakers and managers understand the implications of workforce and financing changes.

Strategies in disability management. Corporate disability management programs implemented at the work site.

PubMed

Kalina, C M

1999-10-30

Managers are challenged to demonstrate all programs as economically essential to the business, generating an appreciable return on investment. Further challenge exists to blend and integrate clinical and business objectives in program development. Disability management programs must be viewed as economically essential to the financial success of the business to assure management support for clinical interventions and return-to-work strategies essential for a successful program. This paper discusses a disability management program integrating clinical and business goals and objectives in return-to-work strategies to effect positive clinical, social-cultural, and business results. Clinical, educational, social, and economic challenges in the development, implementation, and continued management of a disability program at a large corporation with multiple global work sites are defined. Continued discussion addresses the effective clinical interventions and educational strategies utilized successfully within the workplace environment in response to each defined challenge. A multiple disciplinary team approach, clinical and business outcome measures, and quality assurance indicators are discussed as major program components. This article discusses a successful program approach focusing on business process and methodology. These parameters are used to link resources to strategy, developing a product for implementing and managing a program demonstrating economic value added through effective clinical medical case management.

41 CFR 109-38.5103 - Motor vehicle utilization standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Motor vehicle... AVIATION, TRANSPORTATION, AND MOTOR VEHICLES 38-MOTOR EQUIPMENT MANAGEMENT 38.51-Utilization of Motor Equipment § 109-38.5103 Motor vehicle utilization standards. (a) The following average utilization standards...

Using scan statistics for congenital anomalies surveillance: the EUROCAT methodology.

PubMed

Teljeur, Conor; Kelly, Alan; Loane, Maria; Densem, James; Dolk, Helen

2015-11-01

Scan statistics have been used extensively to identify temporal clusters of health events. We describe the temporal cluster detection methodology adopted by the EUROCAT (European Surveillance of Congenital Anomalies) monitoring system. Since 2001, EUROCAT has implemented variable window width scan statistic for detecting unusual temporal aggregations of congenital anomaly cases. The scan windows are based on numbers of cases rather than being defined by time. The methodology is imbedded in the EUROCAT Central Database for annual application to centrally held registry data. The methodology was incrementally adapted to improve the utility and to address statistical issues. Simulation exercises were used to determine the power of the methodology to identify periods of raised risk (of 1-18 months). In order to operationalize the scan methodology, a number of adaptations were needed, including: estimating date of conception as unit of time; deciding the maximum length (in time) and recency of clusters of interest; reporting of multiple and overlapping significant clusters; replacing the Monte Carlo simulation with a lookup table to reduce computation time; and placing a threshold on underlying population change and estimating the false positive rate by simulation. Exploration of power found that raised risk periods lasting 1 month are unlikely to be detected except when the relative risk and case counts are high. The variable window width scan statistic is a useful tool for the surveillance of congenital anomalies. Numerous adaptations have improved the utility of the original methodology in the context of temporal cluster detection in congenital anomalies.

Barriers and Opportunities to Broader Adoption of Integrated Demand Side Management at Electric Utilities: A Scoping Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Potter, Jennifer; Stuart, Elizabeth; Cappers, P

Integrated demand-side management (IDSM) is a strategic approach to designing and delivering a portfolio of demand side management (DSM) programs to customers. IDSM typically delivers customer centric strategies with the goal of increasing the amount of DSM in the field, but doing so in a way that integrates various measures and technologies to improve their collective performance and/or penetration. Specifically, IDSM can be defined as the integrated or coordinated delivery of three or more of: (1) energy efficiency (EE), (2) demand response (DR), (3) distributed generation (DG), (4) storage, (5) electric vehicle (EV) technologies, and (6) time-based rate programs tomore » residential and commercial electric utility customers. The electric industry’s limited experience deploying IDSM to date suggests that significant barriers may exist. A Berkeley Lab report “Barriers and Opportunities to Broader Adoption of Integrated Demand Side Management at Electric Utilities: A Scoping Study” explores recent electric utility experience with IDSM to provide an assessment of the barriers and potential benefits perceived or experienced by program administrators in their attempts to implement integrated programs. The research draws on surveys and interviews with eleven staff from a sample of eight DSM program administrators and program implementers who were currently implementing or had previously attempted to implement an IDSM program or initiative. Respondents provided their perspectives on drivers for IDSM and barriers to broader deployment. They also reported on actions they had undertaken to promote expanded delivery of IDSM and provided their assessments of the most important under-tapped opportunities for expanding IDSM efforts, both for program administrator and regulatory organizations.« less

New Methodology for Estimating Fuel Economy by Vehicle Class

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chin, Shih-Miao; Dabbs, Kathryn; Hwang, Ho-Ling

2011-01-01

Office of Highway Policy Information to develop a new methodology to generate annual estimates of average fuel efficiency and number of motor vehicles registered by vehicle class for Table VM-1 of the Highway Statistics annual publication. This paper describes the new methodology developed under this effort and compares the results of the existing manual method and the new systematic approach. The methodology developed under this study takes a two-step approach. First, the preliminary fuel efficiency rates are estimated based on vehicle stock models for different classes of vehicles. Then, a reconciliation model is used to adjust the initial fuel consumptionmore » rates from the vehicle stock models and match the VMT information for each vehicle class and the reported total fuel consumption. This reconciliation model utilizes a systematic approach that produces documentable and reproducible results. The basic framework utilizes a mathematical programming formulation to minimize the deviations between the fuel economy estimates published in the previous year s Highway Statistics and the results from the vehicle stock models, subject to the constraint that fuel consumptions for different vehicle classes must sum to the total fuel consumption estimate published in Table MF-21 of the current year Highway Statistics. The results generated from this new approach provide a smoother time series for the fuel economies by vehicle class. It also utilizes the most up-to-date and best available data with sound econometric models to generate MPG estimates by vehicle class.« less

41 CFR 101-39.301 - Utilization guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Utilization guidelines... § 101-39.301 Utilization guidelines. An agency must be able to justify a full-time vehicle assignment. The following guidelines may be employed by an agency requesting GSA Interagency Fleet Management...

Utilization of geotextile tube for sandy and muddy coastal management: a review.

PubMed

Lee, Siew Cheng; Hashim, Roslan; Motamedi, Shervin; Song, Ki-Il

2014-01-01

Threats to beaches have accelerated the coastal destruction. In recent decades, geotextile tubes were used around the world to prevent coastal erosion, to encourage beach nourishment, and to assist mangrove rehabilitation. However, the applications of geotextile tube in sandy and muddy coasts have different concerns as the geological settings are different. Applications of geotextile tubes in sandy beaches were mainly to prevent coastline from further erosion and to nourish the beach. However, for the muddy coasts, mangrove rehabilitation and conservation were additional concerns in coastal management schemes. The mangrove forests are natural barriers which can be found on the muddy coasts of many tropical countries. In this paper, the viability of geotextile tubes in sandy and muddy beaches was analysed. The advantages and disadvantages of the utilization of geotextile tubes in coastal management were discussed based on the experiences from the tropical countries such as Mexico, Malaysia, and Thailand. From the case studies, impressive improvements in coastal restoration after installation of geotextile tubes were shown. Based on the discussion, several recommendations to improve the application of geotextile tubes were suggested in this paper.

Utilization and management of maternal and child health funds in rural Nepal.

PubMed

Morrison, Joanna; Thapa, Rita; Sen, Aman; Neupane, Rishi; Borghi, Jo; Tumbahangphe, Kirti Man; Osrin, David; Manandhar, Dharma; Costello, Anthony

2010-01-01

Maternal and neonatal mortality rates are highest in the poorest countries, and financial barriers impede access to health care. Community loan funds can increase access to cash in rural areas, thereby reducing delays in care seeking. As part of a participatory intervention in rural Nepal, community women's groups initiated and managed local funds. We explore the factors affecting utilization and management of these funds and the role of the funds in the success of the women's group intervention. We conducted a qualitative study using focus group discussions, group interviews and unstructured observations. Funds may increase access to care for members of trusted 'insider' families adjudged as able to repay loans. Sustainability and sufficiency of funds was a concern but funds increased women's independence and enabled timely care seeking. Conversely, the perceived necessity to contribute may have deterred poorer women. While funds were integral to group success and increased women's autonomy, they may not be the most effective way of supporting the poorest, as the risk pool is too small to allow for repayment default.

Utilization of Parenteral Morphine by Application of ATC/DDD Methodology: Retrospective Study in the Referral Teaching Hospital.

PubMed

Dragojevic-Simic, Viktorija; Rancic, Nemanja; Stamenkovic, Dusica; Simic, Radoje

2017-01-01

Few studies analyzed the pattern of opioid analgesic utilization in hospital settings. The aim of this study was to determine the consumption pattern of parenteral morphine in patients hospitalized in the Serbian referral teaching hospital and to correlate it with utilization at the national and international level. In retrospective study, the required data were extracted from medical records of surgical patients who received parenteral morphine in the 5-year period, from 2011 to 2015. We used the Anatomical Therapeutic Chemical Classification/Defined Daily Doses (DDD) international system for consumption evaluation. While the number of performed surgical procedures in our hospital steadily increased from 2011 to 2015, the number of inpatient bed-days decreased from 2012. However, the consumption of parenteral morphine varied and was not more than 0.867 DDD/100 bed-days in the observed period. Based on the available data, parenteral morphine consumption in our hospital was lower compared with international data. The low level of morphine use in the hospital was in accordance with national data, and compared with other countries, morphine consumption applied for medical indications in Serbia was low. Adequate legal provision to ensure the availability of opioids, better education and training of medical personnel, as well as multidisciplinary approach should enable more rational and individual pain management in the future, not only within the hospitals.

Integrated corridor management analysis, modeling and simulation (AMS) methodology.

DOT National Transportation Integrated Search

2008-03-01

This AMS Methodologies Document provides a discussion of potential ICM analytical approaches for the assessment of generic corridor operations. The AMS framework described in this report identifies strategies and procedures for tailoring AMS general ...

A negotiation methodology and its application to cogeneration planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, S.M.; Liu, C.C.; Luu, S.

Power system planning has become a complex process in utilities today. This paper presents a methodology for integrated planning with multiple objectives. The methodology uses a graphical representation (Goal-Decision Network) to capture the planning knowledge. The planning process is viewed as a negotiation process that applies three negotiation operators to search for beneficial decisions in a GDN. Also, the negotiation framework is applied to the problem of planning for cogeneration interconnection. The simulation results are presented to illustrate the cogeneration planning process.

Bacterial exopolymer utilization by a harpacticoid copepod: A methodology and results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Decho, A.W.; Moriarty, D.J.W.

1990-07-01

Exopolymer mucus secretions of bacteria and diatoms are potential foods for benthic animals. These secretions are coincidently ingested by animals during consumption of microbial cells and sediments. The utilization of microbial secretions was investigated with exopolymer derived from a marine bacterium (pseudomonas sp.) from seagrass beds and a harpacticoid copepod Laophonte sp. from the same habitat. A new technique was developed to examine ingestion, absorption, and absorption efficiencies of these bacterial secretions by consumers. Exopolymer mucus (from the bacterium in stationary phase) was labeled with {sup 14}C, collected, purified, and bound onto bacterium-sized beads. The exopolymer slime coating mimicked themore » coatings associated with many marine bacteria. Results from feeding experiments where the coated beads were mixed with sediment demonstrated that the mucus-exopolymer secretions of bacteria were ingested and utilized by Laophonte sp. Absorption efficiencies, determined directly, were > 80% in the presence of other food resources, indicating that exopolymer is potentially a highly labile C resource for this animal.« less

The Development of a Checklist to Enhance Methodological Quality in Intervention Programs.

PubMed

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Sánchez-Martín, Milagrosa

2016-01-01

The methodological quality of primary studies is an important issue when performing meta-analyses or systematic reviews. Nevertheless, there are no clear criteria for how methodological quality should be analyzed. Controversies emerge when considering the various theoretical and empirical definitions, especially in relation to three interrelated problems: the lack of representativeness, utility, and feasibility. In this article, we (a) systematize and summarize the available literature about methodological quality in primary studies; (b) propose a specific, parsimonious, 12-items checklist to empirically define the methodological quality of primary studies based on a content validity study; and (c) present an inter-coder reliability study for the resulting 12-items. This paper provides a precise and rigorous description of the development of this checklist, highlighting the clearly specified criteria for the inclusion of items and a substantial inter-coder agreement in the different items. Rather than simply proposing another checklist, however, it then argues that the list constitutes an assessment tool with respect to the representativeness, utility, and feasibility of the most frequent methodological quality items in the literature, one that provides practitioners and researchers with clear criteria for choosing items that may be adequate to their needs. We propose individual methodological features as indicators of quality, arguing that these need to be taken into account when designing, implementing, or evaluating an intervention program. This enhances methodological quality of intervention programs and fosters the cumulative knowledge based on meta-analyses of these interventions. Future development of the checklist is discussed.

41 CFR 109-38.5102 - Utilization controls and practices.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Utilization controls and..., TRANSPORTATION, AND MOTOR VEHICLES 38-MOTOR EQUIPMENT MANAGEMENT 38.51-Utilization of Motor Equipment § 109-38.5102 Utilization controls and practices. Controls and practices to be used by DOE organizations and...

A dynamic systems engineering methodology research study. Phase 2: Evaluating methodologies, tools, and techniques for applicability to NASA's systems projects

NASA Technical Reports Server (NTRS)

Paul, Arthur S.; Gill, Tepper L.; Maclin, Arlene P.

1989-01-01

A study of NASA's Systems Management Policy (SMP) concluded that the primary methodology being used by the Mission Operations and Data Systems Directorate and its subordinate, the Networks Division, is very effective. Still some unmet needs were identified. This study involved evaluating methodologies, tools, and techniques with the potential for resolving the previously identified deficiencies. Six preselected methodologies being used by other organizations with similar development problems were studied. The study revealed a wide range of significant differences in structure. Each system had some strengths but none will satisfy all of the needs of the Networks Division. Areas for improvement of the methodology being used by the Networks Division are listed with recommendations for specific action.

Employing Earned Value Management in Government Research and Design - Lessons Learned from the Trenches

NASA Technical Reports Server (NTRS)

Simon, Tom

2009-01-01

To effectively manage a project, the project manager must have a plan, understand the current conditions, and be able to take action to correct the course when challenges arise. Research and design projects face technical, schedule, and budget challenges that make it difficult to utilize project management tools developed for projects based on previously demonstrated technologies. Projects developing new technologies by their inherent nature are trying something new and thus have little to no data to support estimates for schedule and cost, let alone the technical outcome. Projects with a vision for the outcome but little confidence in the exact tasks to accomplish in order to achieve the vision incur cost and schedule penalties when conceptual solutions require unexpected iterations or even a reinvention of the plan. This presentation will share the project management methodology and tools developed through trial and error for a NASA research and design project combining industry, academia, and NASA inhouse work in which Earned Value Management principles were employed but adapted for the reality of the government financial system and the reality of challenging technology development. The priorities of the presented methodology are flexibility, accountability, and simplicity to give the manager tools to help deliver to the customer while not using up valuable time and resources on extensive planning and analysis. This presentation will share the methodology, tools, and work through failed and successful examples from the three years of process evolution.

A methodology to support the development of 4-year pavement management plan.

DOT National Transportation Integrated Search

2014-07-01

A methodology for forming and prioritizing pavement maintenance and rehabilitation (M&R) projects was developed. : The Texas Department of Transportation (TxDOT) can use this methodology to generate defensible and cost-effective : 4-year pavement man...

Increasing accuracy in the assessment of motion sickness: A construct methodology

NASA Technical Reports Server (NTRS)

Stout, Cynthia S.; Cowings, Patricia S.

1993-01-01

The purpose is to introduce a new methodology that should improve the accuracy of the assessment of motion sickness. This construct methodology utilizes both subjective reports of motion sickness and objective measures of physiological correlates to assess motion sickness. Current techniques and methods used in the framework of a construct methodology are inadequate. Current assessment techniques for diagnosing motion sickness and space motion sickness are reviewed, and attention is called to the problems with the current methods. Further, principles of psychophysiology that when applied will probably resolve some of these problems are described in detail.

Simple Linux Utility for Resource Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jette, M.

2009-09-09

SLURM is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for large and small computer clusters. As a cluster resource manager, SLURM has three key functions. First, it allocates exclusive and/or non exclusive access to resources (compute nodes) to users for some duration of time so they can perform work. Second, it provides a framework for starting, executing, and monitoring work (normally a parallel job) on the set of allciated nodes. Finally, it arbitrates conflicting requests for resouces by managing a queue of pending work.

Agricultural management legacy affects microbial energetics, resource utilization and active bacterial community membership during 13C-glucose consumption

NASA Astrophysics Data System (ADS)

Helgason, B. L.; Levy-Booth, D.; Arcand, M. M.

2017-12-01

Over the long-term, differences in soil management can result in fundamental changes in biogeochemical cycling. The Alternative Cropping Systems (ACS) Study at Scott, SK, Canada (est. 1994) compares organic (ORG) vs. conventionally (CON) managed crop rotations in a loamy Typic Borall. Nitrogen (N) and phosphorus (P) deficiency in the ORG systems have limited crop growth and thus plant carbon (C) inputs for over two decades, ultimately resulting in a C deficiency which has further altered biogeochemical cycling. We conducted a short-term microcosm experiment using 13C-glucose stable isotope probing (SIP) of DNA to test whether ORG soils have greater microbial C use efficiency due to long term resource limitation. Glucose-utilizing populations were dominated by Proteobacteria and Actinobacteria, with differing species-level identities and physiological capacities between CON and ORG systems. Of the 13C-utilizing taxa, relative abundance of Proteobacteria was greater in CON while Actinobacteria (and notably Firmicutes) were more dominant in ORG soils. Using isothermal calorimetry, we measured a thermodynamic efficiency (ηeff) of 0.68, which was not significantly different between soils indicating that the metabolic cost of glucose utilization was similar in CON and ORG soils. In spite of this, differential abundance analysis of 13C-labelled OTUs revealed that ORG soils had distinct active bacterial populations that were positively correlated with ηeff, ηsoil (glucose energy retained in soil) and primed soil organic matter (pSOM). In contrast, differentially abundant OTUs in the CON soils were negatively correlated with measures of thermodynamic efficiency but positively correlated with glucose-derived heat and CO2 production as well as NO3- and PO4- availability. ORG bacterial communities may co-metabolize other resources (N and P) from SOM to meet their metabolic requirements during glucose utilization, while the active bacteria in the CON soils could access these

Project management practices in engineering university

NASA Astrophysics Data System (ADS)

Sirazitdinova, Y.; Dulzon, A.; Mueller, B.

2015-10-01

The article presents the analysis of usage of project management methodology in Tomsk Polytechnic University, in particular the experience with the course Project management which started 15 years ago. The article presents the discussion around advantages of project management methodology for engineering education and administration of the university in general and the problems impeding extensive implementation of this methodology in teaching, research and management in the university.

EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

PubMed

DeFraia, Gary S

2013-01-01

Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

A hierarchical clustering methodology for the estimation of toxicity.

PubMed

Martin, Todd M; Harten, Paul; Venkatapathy, Raghuraman; Das, Shashikala; Young, Douglas M

2008-01-01

ABSTRACT A quantitative structure-activity relationship (QSAR) methodology based on hierarchical clustering was developed to predict toxicological endpoints. This methodology utilizes Ward's method to divide a training set into a series of structurally similar clusters. The structural similarity is defined in terms of 2-D physicochemical descriptors (such as connectivity and E-state indices). A genetic algorithm-based technique is used to generate statistically valid QSAR models for each cluster (using the pool of descriptors described above). The toxicity for a given query compound is estimated using the weighted average of the predictions from the closest cluster from each step in the hierarchical clustering assuming that the compound is within the domain of applicability of the cluster. The hierarchical clustering methodology was tested using a Tetrahymena pyriformis acute toxicity data set containing 644 chemicals in the training set and with two prediction sets containing 339 and 110 chemicals. The results from the hierarchical clustering methodology were compared to the results from several different QSAR methodologies.

The Challenges of Managing Transnational Education Partnerships: The Views of "Home-Based" Managers vs "In-Country" Managers

ERIC Educational Resources Information Center

Healey, Nigel Martin

2018-01-01

Purpose: The purpose of this paper is to investigate the challenges of managing transnational education (TNE) partnerships from the perspective of the home university managers. Design/methodology/approach: The study adopts a qualitative, "insider researcher" methodology. It uses a sample set of eight mangers who operate from the home…

From Physician to Consumer: The Effectiveness of Strategies to Manage Health Care Utilization

PubMed Central

Flynn, Kathryn E.; Smith, Maureen A.; Davis, Margaret K.

2006-01-01

Many strategies are commonly used to influence physician behavior in managed care organizations. This review examines the effectiveness of three mechanisms to influence physician behavior: financial incentives directed at providers or patients, policies/procedures for managing care, and the selection/education of both providers and patients. We reach three conclusions. First, all health care systems use financial incentives, but these mechanisms are shifting away from financial incentives directed at the physician to those directed at the consumer. Second, heavily procedural strategies such as utilization review and gatekeeping show some evidence of effectiveness but are highly unpopular due to their restrictions on physician and patient choice. Third, a future system built on consumer choice is contradicted by mechanisms that rely solely on narrow networks of providers or the education of physicians. If patients become the new locus of decision-making in health care, provider-focused mechanisms to influence physician behavior will not disappear but are likely to decline in importance. PMID:12508705

Case manager-reported utilization of support group, substance use and mental health services among HIV-positive women in New York City.

PubMed

Kupprat, Sandra A; Dayton, Alex; Guschlbauer, Andrea; Halkitis, Perry N

2009-07-01

A retrospective, longitudinal analysis of case management and medical charts was used to evaluate utilization of support group, mental health, and substance abuse treatment services among HIV-positive women in New York City. Analyses of 4134 case management and supportive service transactions revealed that 70% utilized support groups over the two-year study period. In contrast, only 35% utilized mental health services (therapy) and of those identified as using substances, only 48% utilized substance abuse treatment services. Considering the high prevalence of mental illness (63%, n=29) and substance use (54%, n=25) in the sample, the low utilization rates highlight unmet needs for service. Significant differences were found in utilization of mental health and substance abuse treatment services, with those who received services at a medical model agency (integrated care) being more likely to receive both types of treatment. In contrast, participants attending support groups in non-medical model agencies (77.8%, n=7) were significantly more likely to be retained in group (i.e., attend 11 or more sessions) than those at medical model agencies (39.1%, n=9). Based on the higher utilization rates of support groups among seropositive women, perhaps these groups could be a vehicle for establishing rapport between mental health professionals and group members to bridge the utilization gap and reduce the stigma associated with therapy and substance abuse treatment services. These findings both taut the success and highlight weaknesses regarding accessing mental health and substance abuse care, and support group retention. Sharing of information regarding recruitment and retention efforts between agencies of different modalities would be beneficial and also could identify service niches that capitalize on their subsequent strengths.

IMSF: Infinite Methodology Set Framework

NASA Astrophysics Data System (ADS)

Ota, Martin; Jelínek, Ivan

Software development is usually an integration task in enterprise environment - few software applications work autonomously now. It is usually a collaboration of heterogeneous and unstable teams. One serious problem is lack of resources, a popular result being outsourcing, ‘body shopping’, and indirectly team and team member fluctuation. Outsourced sub-deliveries easily become black boxes with no clear development method used, which has a negative impact on supportability. Such environments then often face the problems of quality assurance and enterprise know-how management. The used methodology is one of the key factors. Each methodology was created as a generalization of a number of solved projects, and each methodology is thus more or less connected with a set of task types. When the task type is not suitable, it causes problems that usually result in an undocumented ad-hoc solution. This was the motivation behind formalizing a simple process for collaborative software engineering. Infinite Methodology Set Framework (IMSF) defines the ICT business process of adaptive use of methods for classified types of tasks. The article introduces IMSF and briefly comments its meta-model.

Characterizing wood-plastic composites via data-driven methodologies

Treesearch

John G. Michopoulos; John C. Hermanson; Robert Badaliance

2007-01-01

The recent increase of wood-plastic composite materials in various application areas has underlined the need for an efficient and robust methodology to characterize their nonlinear anisotropic constitutive behavior. In addition, the multiplicity of various loading conditions in structures utilizing these materials further increases the need for a characterization...

Integrated payload and mission planning, phase 3. Volume 4: Optimum utilization of Spacelab racks and pallets

NASA Technical Reports Server (NTRS)

Logston, R. G.; Budris, G. D.

1977-01-01

The methodology to optimize the utilization of Spacelab racks and pallets and to apply this methodology to the early STS Spacelab missions was developed. A review was made of Spacelab Program requirements and flow plans, generic flow plans for racks and pallets were examined, and the principal optimization criteria and methodology were established. Interactions between schedule, inventory, and key optimization factors; schedule and cost sensitivity to optional approaches; and the development of tradeoff methodology were addressed. This methodology was then applied to early spacelab missions (1980-1982). Rack and pallet requirements and duty cycles were defined, a utilization assessment was made, and several trade studies performed involving varying degrees of Level IV integration, inventory level, and shared versus dedicated Spacelab racks and pallets.

Knowledge Management Implementation and the Tools Utilized in Healthcare for Evidence-Based Decision Making: A Systematic Review.

PubMed

Shahmoradi, Leila; Safadari, Reza; Jimma, Worku

2017-09-01

Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: "Healthcare and Knowledge Management"; "Knowledge Management Tools in Healthcare" and "Community of Practices in healthcare". It was found that utilization of knowledge management in healthcare is encouraging. There exist numbers of opportunities for knowledge management implementation, though there are some barriers as well. Some of the opportunities that can transform healthcare are advances in health information and communication technology, clinical decision support systems, electronic health record systems, communities of practice and advanced care planning. Providing the right knowledge at the right time, i.e., at the point of decision making by implementing knowledge management in healthcare is paramount. To do so, it is very important to use appropriate tools for knowledge management and user-friendly system because it can significantly improve the quality and safety of care provided for patients both at hospital and home settings.

Integration of infrared thermography into various maintenance methodologies

NASA Astrophysics Data System (ADS)

Morgan, William T.

1993-04-01

Maintenance methodologies are in developmental stages throughout the world as global competitiveness drives all industries to improve operational efficiencies. Rapid progress in technical advancements has added an additional strain on maintenance organizations to progressively change. Accompanying needs for advanced training and documentation is the demand for utilization of various analytical instruments and quantitative methods. Infrared thermography is one of the primary elements of engineered approaches to maintenance. Current maintenance methodologies can be divided into six categories; Routine ('Breakdown'), Preventive, Predictive, Proactive, Reliability-Based, and Total Productive (TPM) maintenance. Each of these methodologies have distinctive approaches to achieving improved operational efficiencies. Popular though is that infrared thermography is a Predictive maintenance tool. While this is true, it is also true that it can be effectively integrated into each of the maintenance methodologies for achieving desired results. The six maintenance strategies will be defined. Infrared applications integrated into each will be composed in tabular form.

Methodological issues associated with preclinical drug development and increased placebo effects in schizophrenia clinical trials.

PubMed

Brown, Matt A; Bishnoi, Ram J; Dholakia, Sara; Velligan, Dawn I

2016-01-20

Recent failures to detect efficacy in clinical trials investigating pharmacological treatments for schizophrenia raise concerns regarding the potential contribution of methodological shortcomings to this research. This review provides an examination of two key methodological issues currently suspected of playing a role in hampering schizophrenia drug development; 1) limitations on the translational utility of preclinical development models, and 2) methodological challenges posed by increased placebo effects. Recommendations for strategies to address these methodological issues are addressed.

Development and Attestation of Gamma-Ray Measurement Methodologies for use by Rostekhnadzor Inspectors in the Russian Federation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jeff Sanders

2006-09-01

Development and attestation of gamma-ray non-destructive assay measurement methodologies for use by inspectors of the Russian Federal Service for Environmental, Technological, and Nuclear Oversight (Rostekhnadzor, formerly Gosatomnadzor or GAN), as well as for use by Russian nuclear facilities, has been completed. Specifically, a methodology utilizing the gamma-ray multi group analysis (MGA) method for determining plutonium isotopic composition has been developed, while existing methodologies to determining uranium enrichment and isotopic composition have been revised to make them more appropriate to the material types and conditions present in nuclear facilities in the Russian Federation. This paper will discuss the development and revisionmore » of these methodologies, the metrological characteristics of the final methodologies, as well as the limitations and concerns specific to the utilization of these analysis methods in the Russian Federation.« less

Remote sensing of Qatar nearshore habitats with perspectives for coastal management.

PubMed

Warren, Christopher; Dupont, Jennifer; Abdel-Moati, Mohamed; Hobeichi, Sanaa; Palandro, David; Purkis, Sam

2016-04-30

A framework is proposed for utilizing remote sensing and ground-truthing field data to map benthic habitats in the State of Qatar, with potential application across the Arabian Gulf. Ideally the methodology can be applied to optimize the efficiency and effectiveness of mapping the nearshore environment to identify sensitive habitats, monitor for change, and assist in management decisions. The framework is applied to a case study for northeastern Qatar with a key focus on identifying high sensitivity coral habitat. The study helps confirm the presence of known coral and provides detail on a region in the area of interest where corals have not been previously mapped. Challenges for the remote sensing methodology associated with natural heterogeneity of the physical and biological environment are addressed. Recommendations on the application of this approach to coastal environmental risk assessment and management planning are discussed as well as future opportunities for improvement of the framework. Copyright © 2015 Elsevier Ltd. All rights reserved.

Full cost accounting in the analysis of separated waste collection efficiency: A methodological proposal.

PubMed

D'Onza, Giuseppe; Greco, Giulio; Allegrini, Marco

2016-02-01

Recycling implies additional costs for separated municipal solid waste (MSW) collection. The aim of the present study is to propose and implement a management tool - the full cost accounting (FCA) method - to calculate the full collection costs of different types of waste. Our analysis aims for a better understanding of the difficulties of putting FCA into practice in the MSW sector. We propose a FCA methodology that uses standard cost and actual quantities to calculate the collection costs of separate and undifferentiated waste. Our methodology allows cost efficiency analysis and benchmarking, overcoming problems related to firm-specific accounting choices, earnings management policies and purchase policies. Our methodology allows benchmarking and variance analysis that can be used to identify the causes of off-standards performance and guide managers to deploy resources more efficiently. Our methodology can be implemented by companies lacking a sophisticated management accounting system. Copyright © 2015 Elsevier Ltd. All rights reserved.

A methodology to identify stranded generation facilities and estimate stranded costs for Louisiana's electric utility industry

NASA Astrophysics Data System (ADS)

Cope, Robert Frank, III

1998-12-01

The electric utility industry in the United States is currently experiencing a new and different type of growing pain. It is the pain of having to restructure itself into a competitive business. Many industry experts are trying to explain how the nation as a whole, as well as individual states, will implement restructuring and handle its numerous "transition problems." One significant transition problem for federal and state regulators rests with determining a utility's stranded costs. Stranded generation facilities are assets which would be uneconomic in a competitive environment or costs for assets whose regulated book value is greater than market value. At issue is the methodology which will be used to estimate stranded costs. The two primary methods are known as "Top-Down" and "Bottom-Up." The "Top-Down" approach simply determines the present value of the losses in revenue as the market price for electricity changes over a period of time into the future. The problem with this approach is that it does not take into account technical issues associated with the generation and wheeling of electricity. The "Bottom-Up" approach computes the present value of specific strandable generation facilities and compares the resulting valuations with their historical costs. It is regarded as a detailed and difficult, but more precise, approach to identifying stranded assets and their associated costs. This dissertation develops a "Bottom-Up" quantitative, optimization-based approach to electric power wheeling within the state of Louisiana. It optimally evaluates all production capabilities and coordinates the movement of bulk power through transmission interconnections of competing companies in and around the state. Sensitivity analysis to this approach is performed by varying seasonal consumer demand, electric power imports, and transmission inter-connection cost parameters. Generation facility economic dispatch and transmission interconnection bulk power transfers, specific

Utility Energy Services Contracts: Enabling Documents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas, Karen; Vasquez, Deb

The Federal Energy Management Program's 'Utility Energy Service Contracts: Enabling Documents' provide legislative information and materials that clarify the authority for federal agencies to enter into utility energy service contracts, or UESCs.

Methodology for designing accelerated aging tests for predicting life of photovoltaic arrays

NASA Technical Reports Server (NTRS)

Gaines, G. B.; Thomas, R. E.; Derringer, G. C.; Kistler, C. W.; Bigg, D. M.; Carmichael, D. C.

1977-01-01

A methodology for designing aging tests in which life prediction was paramount was developed. The methodology builds upon experience with regard to aging behavior in those material classes which are expected to be utilized as encapsulant elements, viz., glasses and polymers, and upon experience with the design of aging tests. The experiences were reviewed, and results are discussed in detail.

An analysis of the factors influencing demand-side management activity in the electric utility industry

NASA Astrophysics Data System (ADS)

Bock, Mark Joseph

Demand-side management (DSM), defined as the "planning, implementation, and monitoring of utility activities designed to encourage consumers to modify their pattern of electricity usage, including the timing and level of electricity demand," is a relatively new concept in the U.S. electric power industry. Nevertheless, in twenty years since it was first introduced, utility expenditures on DSM programs, as well as the number of such programs, have grown rapidly. At first glance, it may seem peculiar that a firm would actively attempt to reduce demand for its primary product. There are two primary explanations as to why a utility might pursue DSM: regulatory mandate, and self-interest. The purpose of this dissertation is to determine the impact these influences have on the amount of DSM undertaken by utilities. This research is important for two reasons. First, it provides insight into whether DSM will continue to exist as competition becomes more prevalent in the industry. Secondly, it is important because no one has taken a comprehensive look at firm-level DSM activity on an industry-wide basis. The primary data set used in this dissertation is the U.S. Department of Energy's Annual Electric Utility Report, Form EIA-861, which represents the most comprehensive data set available for analyzing DSM activity in the U.S. There are four measures of DSM activity in this data set: (1) utility expenditures on DSM programs; (2) energy savings by DSM program participants; and (3) the actual and (4) the potential reductions in peak load resulting from utility DSM measures. Each is used as the dependent variable in an econometric analysis where independent variables include various utility characteristics, regulatory characteristics, and service territory and customer characteristics. In general, the results from the econometric analysis suggest that in 1993, DSM activity was primarily the result of regulatory pressure. All of the evidence suggests that if DSM continues to

A perspective on laboratory utilization management from Canada.

PubMed

Naugler, Christopher

2014-01-01

Utilization, particularly in chemistry and molecular testing, is growing rapidly in Canada at a time when laboratory budgets are shrinking. Canadian laboratories face particular challenges as the prevailing funding model limits the scope for new revenue generation. Aggressive and coordinated interventions to reduce over-utilization will be necessary to ensure the long-term viability of the current system. © 2013.

An effective utilization management strategy by dual approach of influencing physician ordering and gate keeping.

PubMed

Elnenaei, Manal O; Campbell, Samuel G; Thoni, Andrea J; Lou, Amy; Crocker, Bryan D; Nassar, Bassam A

2016-02-01

There is increasing recognition of the importance of appropriate laboratory test utilization. We investigate the effect of a multifaceted educational approach that includes physician feedback on individual test ordering, in conjunction with targeted restriction, on the utilization of selected laboratory tests. Scientific evidence was compiled on the usefulness and limitations of tests suspected of being over utilized in our laboratories. A variety of approaches were used to deliver education on each of the targeted tests, with greater focus on primary care physicians (PCPs). Feedback on requesting behavior of these tests was also communicated to the latter group which included an educational component. Laboratory based restriction of testing was also exercised, including the unbundling of our electrolyte panel. PCP requesting patterns for the selected tests were found to be markedly skewed. The interventions implemented over the study period resulted in a substantial 51% reduction in overall ordering of five of the targeted tests equating to an annual marginal cost saving of $60,124. Unbundling of the electrolyte panel resulted in marginal cost savings that equated annually to $42,500 on chloride and $48,000 on total CO2. A multifaceted educational approach combined with feedback on utilization and laboratory driven gate-keeping significantly reduced the number of laboratory tests suspected of being redundant or unjustifiably requested. Laboratory professionals are well positioned to manage demand on laboratory tests by utilizing evidence base in developing specific test ordering directives and gate-keeping rules. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Population-based medical and disease management: an evaluation of cost and quality.

PubMed

Wise, Christopher G; Bahl, Vinita; Mitchell, Rita; West, Brady T; Carli, Thomas

2006-02-01

Reports by the Institute of Medicine and the Health Care Financing Administration have emphasized that the integration of medical care delivery, evidence-based medicine, and chronic care disease management may play a significant role in improving the quality of care and reducing medical care costs. The specific aim of this project is to assess the impact of an integrated set of care coordination tools and chronic disease management interventions on utilization, cost, and quality of care for a population of beneficiaries who have complementary health coverage through a plan designed to apply proactive medical and disease management processes. The utilization of health care services by the study population was compared to another population from the same geographic service area and covered by a traditional fee-for-service indemnity insurance plan that provided few medical or disease management services. Evaluation of the difference in utilization was based on the difference in the cost per-member-per-month (PMPM) in a 1-year measurement period, after adjusting for differences in fee schedules, case-mix and healthcare benefit design. After adjustments for both case-mix and benefit differences, the study group is $63 PMPM less costly than the comparison population for all members. Cost differences are largest in the 55-64 and 65 and above age groups. The study group is $115 PMPM lower than the comparison population for the age category of 65 years and older, after adjustments for case-mix and benefits. Health Plan Employer and Data Information Set (HEDIS)-based quality outcomes are near the 90th percentile for most indications. The cost outcomes of a population served by proactive, population-based disease management and complex care management, compared to an unmanaged population, demonstrates the potential of coordinated medical and disease management programs. Further studies utilizing appropriate methodologies would be beneficial.

41 CFR 109-38.5104 - Other motor equipment utilization standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Other motor equipment... AVIATION, TRANSPORTATION, AND MOTOR VEHICLES 38-MOTOR EQUIPMENT MANAGEMENT 38.51-Utilization of Motor Equipment § 109-38.5104 Other motor equipment utilization standards. No utilization standards are...

41 CFR 109-38.5104 - Other motor equipment utilization standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Other motor equipment... AVIATION, TRANSPORTATION, AND MOTOR VEHICLES 38-MOTOR EQUIPMENT MANAGEMENT 38.51-Utilization of Motor Equipment § 109-38.5104 Other motor equipment utilization standards. No utilization standards are...

Trends in health care resource utilization and pharmacological management of COPD in Taiwan from 2004 to 2010.

PubMed

Tsai, Ying-Huang; Yang, Tsung-Ming; Lin, Chieh-Mo; Huang, Shu-Yi; Wen, Yu-Wen

2017-01-01

COPD has attracted widespread attention worldwide. The prevalence of COPD in Taiwan has been reported, but little is known about trends in health care resource utilization and pharmacologic management in COPD treatment. The objective of this article was to study trends in health care resource utilization, pharmacologic management, and medical costs of COPD treatment in Taiwan. Reimbursement claims in the Taiwan National Health Insurance System from 2004 to 2010 were collected. The disease burden of COPD, including health care resource utilization and medical costs, was evaluated. The pharmacy cost of COPD increased from 2004 to 2010 due to the increased utilization of long-acting muscarinic antagonist (LAMA) and fixed-dose combination of long-acting β2-agonist and inhaled corticosteroid (LABA/ICS), whereas the cost of all other COPD-related medications decreased. The average outpatient department (OPD) cost per patient increased 29.3% from 1,070 USD in 2004 to 1,383 USD in 2010. The highest average total medical cost per patient was 3,434 USD in 2005, and it decreased 12.4% to 3,008 USD in 2010. There was no significant difference in the average number of OPD visits and emergency department visits per patient. The highest average number of hospital admissions was 0.81 in 2005, and it decreased to 0.65 in 2010. The average number of intensive care unit (ICU) admissions decreased from 0.52 in 2005 to 0.31 in 2010. From 2004 to 2010, the average total medical cost per patient of COPD was slightly decreased because of the decreased average number of hospital admissions and ICU admissions. The costs of both LAMA and LABA/ICS increased, while the cost for all other COPD-related medications decreased. These findings suggest that the increased utilization of LAMA and LABA/ICS may have contributed to the decreased average number of hospital admissions and ICU admissions in COPD patients from 2004 to 2010.

The Development of a Checklist to Enhance Methodological Quality in Intervention Programs

PubMed Central

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Sánchez-Martín, Milagrosa

2016-01-01

The methodological quality of primary studies is an important issue when performing meta-analyses or systematic reviews. Nevertheless, there are no clear criteria for how methodological quality should be analyzed. Controversies emerge when considering the various theoretical and empirical definitions, especially in relation to three interrelated problems: the lack of representativeness, utility, and feasibility. In this article, we (a) systematize and summarize the available literature about methodological quality in primary studies; (b) propose a specific, parsimonious, 12-items checklist to empirically define the methodological quality of primary studies based on a content validity study; and (c) present an inter-coder reliability study for the resulting 12-items. This paper provides a precise and rigorous description of the development of this checklist, highlighting the clearly specified criteria for the inclusion of items and a substantial inter-coder agreement in the different items. Rather than simply proposing another checklist, however, it then argues that the list constitutes an assessment tool with respect to the representativeness, utility, and feasibility of the most frequent methodological quality items in the literature, one that provides practitioners and researchers with clear criteria for choosing items that may be adequate to their needs. We propose individual methodological features as indicators of quality, arguing that these need to be taken into account when designing, implementing, or evaluating an intervention program. This enhances methodological quality of intervention programs and fosters the cumulative knowledge based on meta-analyses of these interventions. Future development of the checklist is discussed. PMID:27917143

A STUDY ON THE HIERARCHY OF MANAGEMENT ELEMENTS

NASA Astrophysics Data System (ADS)

Suzuki, Nobuyuki; Watanabe, Tadashi

Compared to the late 20th century, the Japanese construction industry has drastically changed its business methodology, outlook and approach in response to global issues and the incredible advances in technology. Such influences, non-exhaustively include the; WTO Government procurement agreement, updating conditions of tendering and contracting, client demands for cost reduction and the rapid penetration of ICT (Information and Communication Technology) into modern society. These days, the significance of controlling Quality, Cost and Time (the so-called QCT) has been recognized as an eternal-triangle by almost all countries, Government organizations and the private sector. However, as the construction industry is exposed to , and influenced by, more and more internal and external dynamic factors, continued reliance on managing and controlling QCT elements on their own is no longer adequate in meeting the growing demands and expectations, and as such control of additional management elements is now essential to avoid problems, or minimize their potential impacts should they occur. This paper utilizes the results of a survey carried out amongst construction managers and consultants in Japan and overseas to develop a spatial network that defines the interaction of management factors as a weighted graphical model. The calculated closeness centrality index of the developed management network model is adopted to identify the initialelement hierarchy, which is then further analyzed using the minimum distance of independent relationships of management elements (Warshall-Floyd algorism methodology), to identify the optimum potential hierarchy for effective construction management. A key result of the analysis is the significance of "Human Resource" in the construction industry management element hierarchy alongside the traditional QCT elements.

Cost-utility Analysis of Supported Self-management with Motiva-tional Interviewing for Patients with Psoriasis.

PubMed

Larsen, Marie H; Wahl, Astrid K; Krogstad, Anne-Lene; Aas, Eline

2016-06-15

There are few studies evaluating the cost-effectiveness of self-management interventions for patients with psoriasis. Motivational interviewing (MI) as a telephone follow-up after climate-heliotherapy was effective on several clinical parameters, but its cost-effectiveness is unknown. A cost-utility analysis was conducted alongside a randomized controlled trial (RCT) comparing MI with usual care. A total of 169 Norwegian patients were included. A within-trial analysis compared the costs and quality-adjusted life years (QALYs). Utilities were measured with the 15D instrument, supplemented with Dermatological Life Quality Index (DLQI). A time-integrated summary score defined the clinical effects. QALYs were adjusted for baseline differences. MI provided equivalent quality of life and utility (15D: -0.0022 QALYs (95% Cl -0.02, 0.01), p = 0.77, and DLQI: -0.62 QALYs (95%CI -0.65, 0.41), p = 0.24, at lower costs €-1103 (-2293, 87), p = 0.058, compared with treatment-as-usual. The MI intervention was thus cost-effective. This result was more evident when using the DLQI as outcome measure compared with 15D.

Utilization of Geotextile Tube for Sandy and Muddy Coastal Management: A Review

PubMed Central

Lee, Siew Cheng; Hashim, Roslan; Motamedi, Shervin; Song, Ki-Il

2014-01-01

Threats to beaches have accelerated the coastal destruction. In recent decades, geotextile tubes were used around the world to prevent coastal erosion, to encourage beach nourishment, and to assist mangrove rehabilitation. However, the applications of geotextile tube in sandy and muddy coasts have different concerns as the geological settings are different. Applications of geotextile tubes in sandy beaches were mainly to prevent coastline from further erosion and to nourish the beach. However, for the muddy coasts, mangrove rehabilitation and conservation were additional concerns in coastal management schemes. The mangrove forests are natural barriers which can be found on the muddy coasts of many tropical countries. In this paper, the viability of geotextile tubes in sandy and muddy beaches was analysed. The advantages and disadvantages of the utilization of geotextile tubes in coastal management were discussed based on the experiences from the tropical countries such as Mexico, Malaysia, and Thailand. From the case studies, impressive improvements in coastal restoration after installation of geotextile tubes were shown. Based on the discussion, several recommendations to improve the application of geotextile tubes were suggested in this paper. PMID:24955408

Impact of disease management on health care utilization: evidence from the "Florida: A Healthy State (FAHS)" Medicaid Program.

PubMed

Afifi, Abdelmonem A; Morisky, Donald E; Kominski, Gerald F; Kotlerman, Jenny B

2007-06-01

To examine the impact of disease management on utilization of selected health care services. Prospective observational population-based study comparing Florida Medicaid patients who elected to participate in disease management (DM, N=15,275) with a usual-care (UC, N=32,034) group who elected not to participate in the program. Patients had at least one of four chronic diseases (diabetes, asthma, congestive heart failure, and hypertension) and all received standard health care. DM participants received supplementary telephone health counseling by a managed care specialist. The data for this paper were collected between October 2001 and October 2004. Annual rates of inpatient hospital stays, inpatient days, emergency room (ER) visits, and outpatient (OP) visits, during and post intervention, were used as outcomes. Age, race, gender, comorbidities, severity indicators, geographic location and pre-intervention utilization were used as covariates. Compared to UC patients, DM patients had lower adjusted post intervention annualized rates of hospitalizations ranging from 0.07 to 0.38 stays, lower rates of hospital days ranging from 0.40 to 2.54 days, and lower rates of ER visits ranging from 0.10 to 0.91 visits per DM enrollee in all four chronic conditions. Most results were statistically significant at the 5% level, except for hypertension patients, where they were suggestive, though not significant. Disease management is effective in reducing potentially avoidable inpatient hospital stays and ER visits among patients with chronic illness.

Interpolation of extensive routine water pollution monitoring datasets: methodology and discussion of implications for aquifer management

NASA Astrophysics Data System (ADS)

Yuval; Rimon, Y.; Graber, E. R.; Furman, A.

2013-07-01

A large fraction of the fresh water available for human use is stored in groundwater aquifers. Since human activities such as mining, agriculture, industry and urbanization often result in incursion of various pollutants to groundwater, routine monitoring of water quality is an indispensable component of judicious aquifer management. Unfortunately, groundwater pollution monitoring is expensive and usually cannot cover an aquifer with the spatial resolution necessary for making adequate management decisions. Interpolation of monitoring data between points is thus an important tool for supplementing measured data. However, interpolating routine groundwater pollution data poses a special problem due to the nature of the observations. The data from a producing aquifer usually includes many zero pollution concentration values from the clean parts of the aquifer but may span a wide range (up to a few orders of magnitude) of values in the polluted areas. This manuscript presents a methodology that can cope with such datasets and use them to produce maps that present the pollution plumes but also delineates the clean areas that are fit for production. A method for assessing the quality of mapping in a way which is suitable to the data's dynamic range of values is also presented. Local variant of inverse distance weighting is employed to interpolate the data. Inclusion zones around the interpolation points ensure that only relevant observations contribute to each interpolated concentration. Using inclusion zones improves the accuracy of the mapping but results in interpolation grid points which are not assigned a value. That inherent trade-off between the interpolation accuracy and coverage is demonstrated using both circular and elliptical inclusion zones. A leave-one-out cross testing is used to assess and compare the performance of the interpolations. The methodology is demonstrated using groundwater pollution monitoring data from the Coastal aquifer along the Israeli

Workplace bullying among managers: a multifactorial perspective and understanding.

PubMed

Ariza-Montes, J Antonio; Muniz R, Noel M; Leal-Rodríguez, Antonio L; Leal-Millán, Antonio G

2014-03-04

The aim of this paper is to study certain factors that may be determinant in the emergence of workplace bullying among managers-employees with a recognized and privileged position to exercise power-adopting the individual perspective of the subject, the bullied manager. Individual, organizational, and contextual factors integrate the developed global model, and the methodology utilized to accomplish our research objectives is based on the binary logistic regression model. A sample population of 661 managers was obtained from the micro data file of the 5th European Working Conditions Survey-2010 (European Foundation for the Improvement of Living and Working Conditions) and utilized to conduct the present research. The results indicate that the chance for a manager to refer to him/herself as bullied increases among women that hold managerial positions and live with children under 15 at home, and among subjects that work at night, on a shift system, suffering from work stress, enjoying little satisfaction from their working conditions, and not perceiving opportunities for promotions in their organizations. The present work summarizes an array of outcomes and proposes, within the usual course of events, that workplace bullying could be reduced if job demands were limited and job resources were increased. The implications of these findings could assist directors/general directors in facilitating, to some extent, good social relationships among managers.

Redesigning service delivery for hypertensive patients: a methodological guideline to improve the management of chronic diseases.

PubMed

Ippolito, Adelaide; Cannavacciuolo, Lorella; Ponsiglione, Cristina; De Luca, Nicola; Iaccarino, Guido; Illario, Maddalena

2014-04-01

Best care is not necessarily the most expensive, but the most appropriate, and prevention is the most powerful tool to promote health. A novel approach might envision the reduction of hospital admittance (thus meeting a requirement from long term condition patients: they would rather not being hospitalized!) and the enforcement of peripheral (both on the territory and at home) assistance. In this direction, experiences of reshaping new service deliveries towards an integrated disease management, namely clinical pathways, can be observed in Europe and in different parts of the world. Aim of this paper is to provide a methodological guideline to support the management in planning clinical pathways, also outlining the main barriers limiting the process. In particular, we present the results of planning a clinical pathway at the Centre for Hypertension of the Federico II University Hospital (Naples, Italy). The case study showed that the introduction of a similar service impacts on the organisation of the structure. An analysis of organizational processes "as are" and the re-design of processes "to be" are necessary to integrate the clinical pathway into the actual activities.

Bringing Classroom Utilization Reporting Up-to-Date. AIR Forum 1982 Paper.

ERIC Educational Resources Information Center

Smith, John D.

The purpose, audience, methodology, and statistics of classroom utilization reports used at the University of Colorado, Boulder, are examined with a view toward an evolving report on a schedule of classes. Utilization reports from the past decade are examined in terms of information attributes discussed by Kleijnen (1980). A computer-generated…

Hydro-environmental management of groundwater resources: A fuzzy-based multi-objective compromise approach

NASA Astrophysics Data System (ADS)

Alizadeh, Mohammad Reza; Nikoo, Mohammad Reza; Rakhshandehroo, Gholam Reza

2017-08-01

Sustainable management of water resources necessitates close attention to social, economic and environmental aspects such as water quality and quantity concerns and potential conflicts. This study presents a new fuzzy-based multi-objective compromise methodology to determine the socio-optimal and sustainable policies for hydro-environmental management of groundwater resources, which simultaneously considers the conflicts and negotiation of involved stakeholders, uncertainties in decision makers' preferences, existing uncertainties in the groundwater parameters and groundwater quality and quantity issues. The fuzzy multi-objective simulation-optimization model is developed based on qualitative and quantitative groundwater simulation model (MODFLOW and MT3D), multi-objective optimization model (NSGA-II), Monte Carlo analysis and Fuzzy Transformation Method (FTM). Best compromise solutions (best management policies) on trade-off curves are determined using four different Fuzzy Social Choice (FSC) methods. Finally, a unanimity fallback bargaining method is utilized to suggest the most preferred FSC method. Kavar-Maharloo aquifer system in Fars, Iran, as a typical multi-stakeholder multi-objective real-world problem is considered to verify the proposed methodology. Results showed an effective performance of the framework for determining the most sustainable allocation policy in groundwater resource management.

Individual determinants of research utilization: a systematic review.

PubMed

Estabrooks, Carole A; Floyd, Judith A; Scott-Findlay, Shannon; O'Leary, Katherine A; Gushta, Matthew

2003-09-01

In order to design interventions that increase research use in nursing, it is necessary to have an understanding of what influences research use. To report findings on a systematic review of studies that examine individual characteristics of nurses and how they influence the utilization of research. A survey of published articles in English that examine the influence of individual factors on the research utilization behaviour of nurses, without restriction of the study design, from selected computerized databases and hand searches. Articles had to measure one or more individual determinants of research utilization, measure the dependent variable (research utilization), and evaluate the relationship between the dependent and independent variables. The studies also had to indicate the direction of the relationship between the independent and dependent variables, report a P-value and the statistic used, and indicate the magnitude of the relationship. Six categories of potential individual determinants were identified: beliefs and attitudes, involvement in research activities, information seeking, professional characteristics, education and other socio-economic factors. Research design, sampling, measurement, and statistical analysis were examined to evaluate methodological quality. Methodological problems surfaced in all of the studies and, apart from attitude to research, there was little to suggest that any potential individual determinant influences research use. Important conceptual and measurement issues with regard to research utilization could be better addressed if research in the area were undertaken longitudinally by multi-disciplinary teams of researchers.

18 CFR 301.7 - Average System Cost methodology functionalization.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SYSTEM COST METHODOLOGY FOR SALES FROM UTILITIES TO BONNEVILLE POWER ADMINISTRATION UNDER NORTHWEST POWER... functionalization under its Direct Analysis assigns costs, revenues, debits or credits based upon the actual and/or...) Functionalization methods. (1) Direct analysis, if allowed or required by Table 1, assigns costs, revenues, debits...

From on High: Utilizing Multi-Temporal Atmospheric and Synthetic Aperture Radar Satellites for Land Management Decisions

NASA Astrophysics Data System (ADS)

Hall, M.

2016-12-01

The Black Rock Field Office (BRFO) of the Bureau of Land Management manages nearly 2 million acres of public land in NW Nevada. Approximately 1.2 million acres area a National Conservation Area (NCA), and over 700,000 acres are formally designated Wilderness Areas. While imagery from Landsat and MODIS assist in monitoring and making land management decisions, multi-temporal data from atmospheric monitoring and synthetic aperture radar (SAR) satellites are also utilized. The Burning Man Festival since 2007 creates a temporary city of 50,000 to 70,000 people in the NCA. Public concern is being expressed over the event's physical and greenhouse gas footprints. Sub-set L2 and L3 CO2 data were obtained from the ACOS, AQUA (AIRS platform) and OCO-2 satellites. These data sets cover both daily and monthly CO2 concentrations between 2007 and 2015. Each data set was analyzed separately using Bayesian time series methods. While there were statistically significant changes in the CO2concentration in a calendar year, none of the increases coincided with the Burning Man Festival. The ALOS-PALSAR and Sentinel-1 SAR data archives have also been utilized. Interferograms, false-color composites (FCC) of coherence images, and FCC of the processed backscattered images are all useful in monitoring surface changes. Case study summaries will illustrate the seasonal changes at critical riparian areas in the NCA; the post-event recovery of the Burning Man Festival footprint; dune formation on the Black Rock playa, and landscape changes associated with open-pit mining in the BRFO.

EAES recommendations on methodology of innovation management in endoscopic surgery.

PubMed

Neugebauer, Edmund A M; Becker, Monika; Buess, Gerhard F; Cuschieri, Alfred; Dauben, Hans-Peter; Fingerhut, Abe; Fuchs, Karl H; Habermalz, Brigitte; Lantsberg, Leonid; Morino, Mario; Reiter-Theil, Stella; Soskuty, Gabriela; Wayand, Wolfgang; Welsch, Thilo

2010-07-01

Under the mandate of the European Association for Endoscopic Surgery (EAES) a guideline on methodology of innovation management in endoscopic surgery has been developed. The primary focus of this guideline is patient safety, efficacy, and effectiveness. An international expert panel was invited to develop recommendations for the assessment and introduction of surgical innovations. A consensus development conference (CDC) took place in May 2009 using the method of a nominal group process (NGP). The recommendations were presented at the annual EAES congress in Prague, Czech Republic, on June 18th, 2009 for discussion and further input. After further Delphi processes between the experts, the final recommendations were agreed upon. The development and implementation of innovations in surgery are addressed in five sections: (1) definition of an innovation, (2) preclinical and (3) clinical scientific development, (4) scientific approval, and (5) implementation along with monitoring. Within the present guideline each of the sections and several steps are defined, and several recommendations based on available evidence have been agreed within each category. A comprehensive workflow of the different steps is given in an algorithm. In addition, issues of health technology assessment (HTA) serving to estimate efficiency followed by ethical directives are given. Innovations into clinical practice should be introduced with the highest possible grade of safety for the patient (nil nocere: do no harm). The recommendations can contribute to the attainment of this objective without preventing future promising diagnostic and therapeutic innovations in the field of surgery and allied techniques.

T-4G Methodology: Undergraduate Pilot Training T-37 Phase.

ERIC Educational Resources Information Center

Woodruff, Robert R.; And Others

The report's brief introduction describes the application of T-4G methodology to the T-37 instrument phase of undergraduate pilot training. The methodology is characterized by instruction in trainers, proficiency advancement, a highly structured syllabus, the training manager concept, early exposure to instrument training, and hands-on training.…

A modified utilization gauge for western range grasses

Treesearch

Earl F. Aldon; Richard E. Francis

1984-01-01

Accurate, low cost measurements of forage utilization by livestock are essential in range management and the evaluation of grazing systems. However, because of difficulty in making these measurements, visual estimates often are substituted for measured values. To help land managers better determine use, range utilization calculating charts (Crafts 1938, NRCAB 1962)...

Healthcare utilization and costs in persons with insomnia in a managed care population.

PubMed

Anderson, Louise H; Whitebird, Robin R; Schultz, Jennifer; McEvoy, Charlene E; Kreitzer, Mary Jo; Gross, Cynthia R

2014-05-01

To better understand the direct costs of insomnia. Our study aimed to compare healthcare costs and utilization of patients diagnosed with insomnia who received care in a managed care organization with a set of matched controls. Our observational, retrospective cohort study compared 7647 adults with an insomnia diagnosis with an equally sized matched cohort of health plan members without an insomnia diagnosis between 2003 and 2006. We also compared a subset of patients diagnosed with and treated for insomnia with those diagnosed with insomnia but not treated. A large Midwestern health plan with more than 600,000 members. Multivariate analysis was used to estimate the association between insomnia diagnosis and costs, controlling for covariates, in the baseline and follow-up periods. Although we cannot conclude a causal relationship between insomnia and healthcare costs, our analysis found that insomnia diagnosis was associated with 26% higher costs in the baseline and 46% in the 12 months after diagnosis. When comorbidities were recognized, the insomnia cohort had 80% higher costs, on average, than the matched control cohort. These outcomes suggest the need to look beyond the direct cost of insomnia to how its interaction with comorbid conditions drives healthcare cost and utilization.

Utilizing the Design Charrette for Teaching Sustainability

ERIC Educational Resources Information Center

Walker, Jason B.; Seymour, Michael W.

2008-01-01

Purpose: This paper aims to investigate the design charrette as a method for teaching sustainability. Design/methodology/approach: The paper utilizes a student-based design charrette for the Mississippi Gulf Coast comprising a framework for teaching sustainability. An assessment of the charrette's role in promoting sustainability in higher…

Risk management for drinking water safety in low and middle income countries - cultural influences on water safety plan (WSP) implementation in urban water utilities.

PubMed

Omar, Yahya Y; Parker, Alison; Smith, Jennifer A; Pollard, Simon J T

2017-01-15

We investigated cultural influences on the implementation of water safety plans (WSPs) using case studies from WSP pilots in India, Uganda and Jamaica. A comprehensive thematic analysis of semi-structured interviews (n=150 utility customers, n=32 WSP 'implementers' and n=9 WSP 'promoters'), field observations and related documents revealed 12 cultural themes, offered as 'enabling', 'limiting', or 'neutral', that influence WSP implementation in urban water utilities to varying extents. Aspects such as a 'deliver first, safety later' mind set; supply system knowledge management and storage practices; and non-compliance are deemed influential. Emergent themes of cultural influence (ET1 to ET12) are discussed by reference to the risk management, development studies and institutional culture literatures; by reference to their positive, negative or neutral influence on WSP implementation. The results have implications for the utility endorsement of WSPs, for the impact of organisational cultures on WSP implementation; for the scale-up of pilot studies; and they support repeated calls from practitioner communities for cultural attentiveness during WSP design. Findings on organisational cultures mirror those from utilities in higher income nations implementing WSPs - leadership, advocacy among promoters and customers (not just implementers) and purposeful knowledge management are critical to WSP success. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Hospital administrative characteristics and volunteer resource management practices.