Managing Demand and Capacity Using Multi-Sector Planning and Flexible Airspace: Human-in-the-Loop Evaluation of NextGen

NASA Technical Reports Server (NTRS)

Lee, Paul U.; Smith, Nancy M.; Prevot, Thomas; Homola, Jeffrey R.

2010-01-01

When demand for an airspace sector exceeds capacity, the balance can be re-established by reducing the demand, increasing the capacity, or both. The Multi-Sector Planner (MSP) concept has been proposed to better manage traffic demand by modifying trajectories across multiple sectors. A complementary approach to MSP, called Flexible Airspace Management (FAM), reconfigures the airspace such that capacity can be reallocated dynamically to balance the traffic demand across multiple sectors, resulting in fewer traffic management initiatives. The two concepts have been evaluated with a series of human-in-the-loop simulations at the Airspace Operations Laboratory to examine and refine the roles of the human operators in these concepts, as well as their tools and procedural requirements. So far MSP and FAM functions have been evaluated individually but the integration of the two functions is desirable since there are significant overlaps in their goals, geographic/temporal scope of the problem space, and the implementation timeframe. Ongoing research is planned to refine the humans roles in the integrated concept.

National Airspace System : free flight tools show promise, but implementation challenges remain

DOT National Transportation Integrated Search

2001-08-31

To help meet growing demand for air travel, the Federal Aviation Administration (FAA), in collaboration with the aviation community, is implementing a new approach for air traffic management known as free flight. By using a set of new automated techn...

Managing demand for laboratory tests: a laboratory toolkit.

PubMed

Fryer, Anthony A; Smellie, W Stuart A

2013-01-01

Healthcare budgets worldwide are facing increasing pressure to reduce costs and improve efficiency, while maintaining quality. Laboratory testing has not escaped this pressure, particularly since pathology investigations cost the National Health Service £2.5 billion per year. Indeed, the Carter Review, a UK Department of Health-commissioned review of pathology services in England, estimated that 20% of this could be saved by improving pathology services, despite an average annual increase of 8%-10% in workload. One area of increasing importance is managing the demands for pathology tests and reducing inappropriate requesting. The Carter Review estimated that 25% of pathology tests were unnecessary, representing a huge potential waste. Certainly, the large variability in levels of requesting between general practitioners suggests that inappropriate requesting is widespread. Unlocking the key to this variation and implementing measures to reduce inappropriate requesting would have major implications for patients and healthcare resources alike. This article reviews the approaches to demand management. Specifically, it aims to (a) define demand management and inappropriate requesting, (b) assess the drivers for demand management, (c) examine the various approaches used, illustrating the potential of electronic requesting and (d) provide a wider context. It will cover issues, such as educational approaches, information technology opportunities and challenges, vetting, duplicate request identification and management, the role of key performance indicators, profile composition and assessment of downstream impact of inappropriate requesting. Currently, many laboratories are exploring demand management using a plethora of disparate approaches. Hence, this review seeks to provide a 'toolkit' with the view to allowing laboratories to develop a standardised demand management strategy.

Integrated management of water resources demand and supply in irrigated agriculture from plot to regional scale

NASA Astrophysics Data System (ADS)

Schütze, Niels; Wagner, Michael

2016-05-01

Growing water scarcity in agriculture is an increasing problem in future in many regions of the world. Recent trends of weather extremes in Saxony, Germany also enhance drought risks for agricultural production. In addition, signals of longer and more intense drought conditions during the vegetation period can be found in future regional climate scenarios for Saxony. However, those climate predictions are associated with high uncertainty and therefore, e.g. stochastic methods are required to analyze the impact of changing climate patterns on future crop water requirements and water availability. For assessing irrigation as a measure to increase agricultural water security a generalized stochastic approach for a spatial distributed estimation of future irrigation water demand is proposed, which ensures safe yields and a high water productivity at the same time. The developed concept of stochastic crop water production functions (SCWPF) can serve as a central decision support tool for both, (i) a cost benefit analysis of farm irrigation modernization on a local scale and (ii) a regional water demand management using a multi-scale approach for modeling and implementation. The new approach is applied using the example of a case study in Saxony, which is dealing with the sustainable management of future irrigation water demands and its implementation.

Community and District Empowerment for Scale-up (CODES): a complex district-level management intervention to improve child survival in Uganda: study protocol for a randomized controlled trial.

PubMed

Waiswa, Peter; O'Connell, Thomas; Bagenda, Danstan; Mullachery, Pricila; Mpanga, Flavia; Henriksson, Dorcus Kiwanuka; Katahoire, Anne Ruhweza; Ssegujja, Eric; Mbonye, Anthony K; Peterson, Stefan Swartling

2016-03-11

Innovative and sustainable strategies to strengthen districts and other sub-national health systems and management are urgently required to reduce child mortality. Although highly effective evidence-based and affordable child survival interventions are well-known, at the district level, lack of data, motivation, analytic and planning capacity often impedes prioritization and management weaknesses impede implementation. The Community and District Empowerment for Scale-up (CODES) project is a complex management intervention designed to test whether districts when empowered with data and management tools can prioritize and implement evidence-based child survival interventions equitably. The CODES strategy combines management, diagnostic, and evaluation tools to identify and analyze the causes of bottlenecks to implementation, build capacity of district management teams to implement context-specific solutions, and to foster community monitoring and social accountability to increase demand for services. CODES combines UNICEF tools designed to systematize priority setting, allocation of resources and problem solving with Community dialogues based on Citizen Report Cards and U-Reports used to engage and empower communities in monitoring health service provision and to demand for quality services. Implementation and all data collection will be by the districts teams or local Community-based Organizations who will be supported by two local implementing partners. The study will be evaluated as a cluster randomized trial with eight intervention and eight comparison districts over a period of 3 years. Evaluation will focus on differences in uptake of child survival interventions and will follow an intention-to-treat analysis. We will also document and analyze experiences in implementation including changes in management practices. By increasing the District Health Management Teams' capacity to prioritize and implement context-specific solutions, and empowering communities to become active partners in service delivery, coverage of child survival interventions will increase. Lessons learned on strengthening district-level managerial capacities and mechanisms for community monitoring may have implications, not only in Uganda but also in other similar settings, especially with regard to accelerating effective coverage of key child survival interventions using locally available resources. ISRCTN15705788 , Date of registration; 24 July 2015.

The case for implementing activity based costing.

PubMed

Monge, Paul H; Bolinger-Perez, Nicole; Boysen, Kent

2012-01-01

ABC identifies profitable volumes to give managers information to better manage volumes. Managers must balance the demand for service while maintaining a reasonable profit margin. Disparate systems work extremely well for their intended purposes, but they do not communicate with one another. The strength of the data they hold individually may be leveraged when implementing ABC methodology. Mayo Clinic in Rochester, Minnesota implemented a pilot of ABC to evaluate CT services where there is a high volume, multiple service location for cost comparison, variety of patient acuity and service mix, and large capital investments.The goal was to reveal the actual cost of CT services at the procedural level.

A Water Demand Management Strategy For The Namibian Tourism Sector

NASA Astrophysics Data System (ADS)

Schachtschneider, K.; Winter, K.

The arid conditions of Namibia are forcing its decision-makers to resort to new wa- ter resource management approaches, including Water Demand Management (WDM). When Namibia achieved its independence from South Africa 1990, a new opportunity arose to rewrite certain restrictive laws and policies in order to bring about redress, development and transformation. The new Water Policy is one example in which the mindset is changed from a supply to a demand oriented water management ap- proach. Legal support for WDM within the new Water Act is a critical component that will support the implementation of WDM in all economic sectors, such as agri- culture, mining and tourism. It is argued that an appropriate WDM strategy should be designed specifically for each sector, once the typical water use patterns in a sec- tor are understood and key water resource managers at all levels are identified. The Namibian tourism sector is geographically dispersed and control over its operations is compounded by the fact that it is frequently located in extremely remote areas that are arid and ecologically sensitive. In general, WDM is rarely practised, because it is not yet supported by law and there are currently no institutional arrangements to con- trol water use in this geographically dispersed industrial sector through which WDM could be enforced either through metering and/or payments. Managers of tourist en- terprises undertake most of the water management themselves, and have been identi- fied as being crucial to the implementation of WDM strategies. A study of six tourist facilities determined the willingness and motivation of these managers to undertake various WDM initiatives. The study identified three factors which appear to influence the actions of managers, namely external controls, economics and company ethics. It is recommended that a tourism sector WDM strategy should focus on these three factors in order to transform the WDM aims and objectives on the policy level into practical implementation at the tourist facility level.

Alternative silvicultural practices in Appalachian forest ecosystems: implications for species diversity, ecosystem resilience, and commercial timber production

Treesearch

Thomas R. Fox; Carola A. Haas; David W. Smith; David L. Loftis; Shepard M. Zedaker; Robert H. Jones; A.L. Hammett

2007-01-01

Increasing demands for timber and non-timber forest products often conflict with demands to maintain biodiversity and ecosystem processes. To examine tradeoffs between these goals, we implemented six alternative management systems using a stand-level, replicated experiment. The treatments included four silvicultural regeneration methods designed to sustain timber...

Challenges in Implementing Wellness Approaches in Childhood Disability Services: Views from the Field

ERIC Educational Resources Information Center

Breen, Lauren; Wildy, Helen; Saggers, Sherry

2011-01-01

Despite increasing demand for wellness approaches from disability advocates and consumer groups, they are not implemented routinely in childhood disability services. Interviews were conducted with 23 allied health therapists and managers working within four Australian childhood disability services. They described attempts to embed wellness…

Saving Energy. Managing School Facilities, Guide 3.

ERIC Educational Resources Information Center

Department for Education and Employment, London (England). Architects and Building Branch.

This guide offers information on how schools can implement an energy saving action plan to reduce their energy costs. Various low-cost energy-saving measures are recommended covering heating levels and heating systems, electricity demand reduction and lighting, ventilation, hot water usage, and swimming pool energy management. Additional…

[Management of the risks associated with allergens in school canteens in Barcelona (Spain)].

PubMed

Caballé-Gavaldà, Laura; García-Cid, Ester; Fontcuberta-Famadas, Mireia; Balfagón-Marzal, Pere; Durán-Neira, Julia

2014-01-01

To determine demand for special meals and their types for students with food allergies or intolerances (FAI) in school canteens in Barcelona (Spain) during the 2011-12 school year, and to ascertain the degree of implementation of self-assessment plans and preventive measures for the management of allergens, and the relationships between the application of such measures and other variables. A descriptive study was performed of a representative sample of schools (n=129). The dependent variables collected data on the schools and students, the level of demand for special meals, and the implementation of preventive measures. Independent variables consisted of canteen management, the number of users, and whether self-assessment plans were implemented. For those schools that prepared meals (n=92), an index was calculated from the questions on preventive measures. Student t-tests were used to compare the means of the indices with stratification by the independent variables. A total of 89% of schools served special meals for students with FAI (1,507 special meals per day, 5% of all meals) and 65% had no allergen control plan. The mean of the indices was 11.6 out of 17. Externally managed canteens, with more users and with self-assessment plans, implemented more preventive measures for allergen management (p<0.05). A high proportion of schools report carrying out preventive measures in the process of preparing and serving special meals. Those with self-assessment plans have better preventive practices. To manage this food-related risk, food hygiene inspection services should promote the implementation of allergen control plans in school canteens. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

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

Global Access Programs: A Collaborative Approach for Effective Implementation and Management.

PubMed

Ainge, Debra; Aitken, Suzanne; Corbett, Mark; De-Keyzer, David

Global access programs (GAPs) provide access to medicinal products for patients with serious medical conditions and no commercially available treatment options. Providing early access to medicines can be challenging for a pharmaceutical company. The demand for a GAP often occurs at a time when other activities are the prime focus, such as delivery of pivotal clinical trials or gaining of marketing authorization. Furthermore, the skills, experience, and infrastructure necessary to implement and manage a successful GAP vary significantly from those required for regular clinical trial execution, and the regulatory environment presents its own challenges, with regulations often poorly defined and with considerable inter-country variation. This article considers the triggers for early access requests and examines the need for companies to develop a global strategy for GAPs in order to respond appropriately to requests for early access. It also provides a comprehensive overview of the processes for GAP set-up, implementation, management, and closure, along with the considerations affecting the type and scope of GAP, such as demand, regulatory feasibility, license status of the product, drug pricing structure, company strategy, costs, and product supply. Also discussed is the need for appropriate personnel to implement and manage the GAP, and when to consider collaboration with an external GAP provider. In summary, GAPs require careful and efficient planning and management, from set-up to closure. Well-run GAPs provide an ethical and regulatory-compliant pathway for access of new treatments to patients with serious conditions and an unmet medical need.

Perceptions of Barriers and Facilitators During Implementation of a Complex Model of Group Prenatal Care in Six Urban Sites

PubMed Central

Novick, Gina; Womack, Julie A.; Lewis, Jessica; Stasko, Emily C.; Rising, Sharon S.; Sadler, Lois S.; Cunningham, Shayna C.; Tobin, Jonathan N.; Ickovics, Jeannette R.

2016-01-01

Group prenatal care improves perinatal outcomes, but implementing this complex model places substantial demands on settings designed for individual care. To describe perceived barriers and facilitators to implementing and sustaining Centering Pregnancy Plus (CP+) group prenatal care, 24 in-depth interviews were conducted with 22 clinicians, staff, administrators, and study personnel in six of the 14 sites of a randomized trial of the model. All sites served low-income, minority women. Sites for the present evaluation were selected for variation in location, study arm, and initial implementation response. Implementing CP+ was challenging in all sites, requiring substantial adaptations of clinical systems. All sites had barriers to meeting the model’s demands, but how sites responded to these barriers affected whether implementation thrived or struggled. Thriving sites had organizational cultures that supported innovation, champions who advocated for CP+, and staff who viewed logistical demands as manageable hurdles. Struggling sites had bureaucratic organizational structures and lacked buy-in and financial resources, and staff were overwhelmed by the model’s challenges. Findings suggested that implementing and sustaining health care innovation requires new practices and different ways of thinking, and health systems may not fully recognize the magnitude of change required. Consequently, evidence-based practices are modified or discontinued, and outcomes may differ from those in the original controlled studies. Before implementing new models of care, clinical settings should anticipate model demands and assess capacity for adapting to the disruptions of innovation. PMID:26340483

Development and Evaluation of HawkLearn: A Next Generation Learning Management System

ERIC Educational Resources Information Center

Round, Kimberlee L.

2013-01-01

Cloud-based computing in higher education has the potential to impact institutions on a myriad of fronts, including technology governance, flexibility, financial, and intellectual property. As the demand for blended and online education increases, institutions are considering expedient approaches to implementing learning management systems (LMSs).…

Predicting quantitative and qualitative values of recreation participation

Treesearch

Elwood L., Jr. Shafer; George Moeller

1971-01-01

If future recreation consumption and associated intangible values can be predicted, the problem of rapid decision making in recreation-resource management can be reduced, and the problems of implementing those decisions can be anticipated. Management and research responsibilities for meeting recreation demand are discussed, and proved methods for forecasting recreation...

Views of implementation approaches by top managers in health service organizations.

PubMed

Nutt, P C

1996-01-01

This study examined how top managers view the prospects of success and resistance when using four implementation approaches in participative and control cultures that foster climates more or less conducive to change. An accommodation approach was viewed as having the best prospect of success and of lowering resistance in a participative culture. Bargaining and incentive approaches were thought to have successful and low resistance outcomes, which were just below those of accommodation, in a control type of culture. A persuasion approach was thought to be the least effective implementation approach in a control-oriented culture. These preferences differ from prescriptions found in the implementation literature. Assuming that preferences influence behavior, implementation success could be improved if managers selected an implementation approach according to the demands of the situation. More research is needed to appreciate fully the rationale that lies behind the preferences uncovered in this research.

Study on HOPE Management Mode of Coal Enterprises Based on Systematic Thinking

NASA Astrophysics Data System (ADS)

Zhaoran, Zhang; Tianzhu, Zhang; Wenjing, Tong

2018-02-01

The extensive management mode of coal enterprises is no longer applicable to the demand of enterprise development under the new economic situation. Combined with the characteristics of coal mine production, based on the system of thinking, integration of lean, people, comprehensive, job management theory, formed HOPE management model, including a core system and three support systems and 18 elements. There are three stages in the development and implementation of this model. To 6S site management for the initial stage to job process reengineering for the intermediate stage to post value process control for the advanced stage. The successful implementation of HOPE model in coal enterprises needs comprehensive control from five aspects: lean culture construction, flattening organizational structure, cost control system, performance appraisal system and lean information management platform. HOPE model can be implemented smoothly and make “win-win” between enterprises and employees.

Towards Decentralized and Goal-Oriented Models of Institutional Resource Allocation: The Spanish Case

ERIC Educational Resources Information Center

Lopez, Maria Jose Gonzalez

2006-01-01

The search for more flexibility in financial management of public universities demands adjustments in budgeting strategies. International studies on this topic recommend wider financial autonomy for management units, the use of budgeting models based on performance, the implementation of formula systems for the determination of financial needs of…

Strategic Management of Quality: An American and British Perspective.

ERIC Educational Resources Information Center

Weller, L. David; McElwee, Gerard

1997-01-01

Total Quality Management is being implemented in American and British schools to improve educational outcomes. The 14 points of Deming's quality model and Porter's models of competition and drivers of cost provide a systematic, structured template to promote educational excellence and meet the demands of social, political, and economic forces.…

7 CFR 1710.102 - Borrower eligibility for different types of loans.

Code of Federal Regulations, 2014 CFR

2014-01-01

... implementation of demand side management, energy conservation programs, and on grid and off grid renewable energy... management, energy conservation programs, and on grid and off grid renewable energy systems. (c) One hundred..., energy conservation programs, and on grid and off grid renewable energy systems. (See 7 CFR part 1712...

Amenable Performance Management in Higher Education: Integrating Principles of Agency and Stewardship Theories

ERIC Educational Resources Information Center

Seyama, Sadi Mokhaneli

2015-01-01

The considerable transformation of higher education (HE), driven by the South African government's demand for accountability of resources for the attainment of its mandate has altered the "business" of academia. In response to the financial austerity measures, performance management (PM) systems have been implemented in South African HE…

Capacity Takes Flight: A Vehicle-Centered Approach to Sustainable Airspace Productivity

NASA Technical Reports Server (NTRS)

Wing, David J.; Ballin, Mark G.; Barmore, Bryan E.

2005-01-01

The National Airspace System (NAS) faces a significant challenge. With the nation's economy growing stronger, and passengers returning to the skies, the demand for air transportation is steadily rising once again. The capacity of the current airspace system will struggle to keep pace in the near term, and with demand expected to double within a decade, air traffic delays are likely to escalate, soon becoming intolerable for aviation businesses. Recognition in the aviation community is forming that retaining a growing, thriving air transportation system for the benefit of the traveling public and the world economy will likely require implementing transformational ideas in air traffic management. This video illustrates an approach NASA is pursuing to this end: the notion that a major untapped resource available to air traffic management can be leveraged, the aircraft itself. The thesis presented is that implementation of vehicle-centric air traffic management capabilities into the NAS could have a profound, positive, and sustainable impact on system capacity, individual aircraft operators, and the economy through its dependency on air.

Estimating the impact of the home appliances trade-in policy on WEEE management in China.

PubMed

Zhu, Shuguang; He, Wenzhi; Li, Guangming; Zhuang, Xuning; Huang, Juwen; Liang, Honggen; Han, Yuebin

2012-11-01

The ever-increasing amount of waste electric and electronic equipment (WEEE) has become a global problem. In view of the deleterious effects of WEEE on the environment and the valuable materials that can be reused in them, many countries have focused their attention on the management of WEEE and the recovery technologies of WEEE. The Chinese government has been active in creating a legislative and institutional framework to realize WEEE recycling. In June 2009, Chinese government launched home appliances and electronics trade-in implementation solution. This paper elaborates the home appliances trade-in policy and its significant impact on the WEEE management. The trade-in policy is not only conducive to expanding the consumption demand and promoting the balance of domestic and overseas demand, but also favorable to improving the energy efficiency and reducing environmental pollution. Under this policy, China has successfully established an effective WEEE recycling system, using the financial means and network design. Experiences gained from the trade-in policy have shown that management systems of WEEE need to be designed and implemented in a multi-stakeholder dialogue.

Adaptation of water resource systems to an uncertain future

NASA Astrophysics Data System (ADS)

Walsh, C. L.; Blenkinsop, S.; Fowler, H. J.; Burton, A.; Dawson, R. J.; Glenis, V.; Manning, L. J.; Kilsby, C. G.

2015-09-01

Globally, water resources management faces significant challenges from changing climate and growing populations. At local scales, the information provided by climate models is insufficient to support the water sector in making future adaptation decisions. Furthermore, projections of change in local water resources are wrought with uncertainties surrounding natural variability, future greenhouse gas emissions, model structure, population growth and water consumption habits. To analyse the magnitude of these uncertainties, and their implications for local scale water resource planning, we present a top-down approach for testing climate change adaptation options using probabilistic climate scenarios and demand projections. An integrated modelling framework is developed which implements a new, gridded spatial weather generator, coupled with a rainfall-runoff model and water resource management simulation model. We use this to provide projections of the number of days, and associated uncertainty that will require implementation of demand saving measures such as hose pipe bans and drought orders. Results, which are demonstrated for the Thames basin, UK, indicate existing water supplies are sensitive to a changing climate and an increasing population, and that the frequency of severe demand saving measures are projected to increase. Considering both climate projections and population growth the median number of drought order occurrences may increase five-fold. The effectiveness of a range of demand management and supply options have been tested and shown to provide significant benefits in terms of reducing the number of demand saving days. We found that increased supply arising from various adaptation options may compensate for increasingly variable flows; however, without reductions in overall demand for water resources such options will be insufficient on their own to adapt to uncertainties in the projected changes in climate and population. For example, a 30 % reduction in overall demand by 2050 has a greater impact on reducing the frequency of drought orders than any of the individual or combinations of supply options; hence a portfolio of measures are required.

Opportunities for Energy Efficiency and Automated Demand Response in Industrial Refrigerated Warehouses in California

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

Lekov, Alex; Thompson, Lisa; McKane, Aimee

2009-05-11

This report summarizes the Lawrence Berkeley National Laboratory's research to date in characterizing energy efficiency and open automated demand response opportunities for industrial refrigerated warehouses in California. The report describes refrigerated warehouses characteristics, energy use and demand, and control systems. It also discusses energy efficiency and open automated demand response opportunities and provides analysis results from three demand response studies. In addition, several energy efficiency, load management, and demand response case studies are provided for refrigerated warehouses. This study shows that refrigerated warehouses can be excellent candidates for open automated demand response and that facilities which have implemented energy efficiencymore » measures and have centralized control systems are well-suited to shift or shed electrical loads in response to financial incentives, utility bill savings, and/or opportunities to enhance reliability of service. Control technologies installed for energy efficiency and load management purposes can often be adapted for open automated demand response (OpenADR) at little additional cost. These improved controls may prepare facilities to be more receptive to OpenADR due to both increased confidence in the opportunities for controlling energy cost/use and access to the real-time data.« less

Demand, Energy, and Power Factor

DTIC Science & Technology

1994-08-01

POWER FACTOR DEFINITION I Basically , power factor (pf) is a measure of how effectively the plant uses the electricity it purchases from the utility. It...not be made available by the plant. U 24 This video is relatively short, less than fifteen-minutes, and covers the basics on demand, block extenders...designing, implementing, and evaluation of the resultant project. 1 2. Thumann, Albeit. Plant Engineer and Managers Guide to Energv Conservation, 5th ed

Price Based Local Power Distribution Management System (Local Power Distribution Manager) v1.0

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

BROWN, RICHARD E.; CZARNECKI, STEPHEN; SPEARS, MICHAEL

2016-11-28

A trans-active energy micro-grid controller is implemented in the VOLTTRON distributed control platform. The system uses the price of electricity as the mechanism for conducting transactions that are used to manage energy use and to balance supply and demand. In order to allow testing and analysis of the control system, the implementation is designed to run completely as a software simulation, while allowing the inclusion of selected hardware that physically manages power. Equipment to be integrated with the micro-grid controller must have an IP (Internet Protocol)-based network connection and a software "driver" must exist to translate data communications between themore » device and the controller.« less

Integrating watershed hydrology and economics to establish a local market for water quality improvement: A field experiment.

PubMed

Uchida, Emi; Swallow, Stephen K; Gold, Arthur; Opaluch, James; Kafle, Achyut; Merrill, Nathaniel; Michaud, Clayton; Gill, Carrie Anne

2018-04-01

Innovative market mechanisms are being increasingly recognized as effective decision-making institutions to incorporate the value of ecosystem services into the economy. We present a field experiment that integrates an economic auction and a biophysical water flux model to develop a local market process consisting of both the supply and demand sides. On the supply side, we operate an auction with small-scale livestock owners who bid for contracts to implement site-specific manure management practices that reduce phosphorus loadings to a major reservoir. On the demand side, we implement a real money, multi-unit public good auction for these contracts with residents who potentially benefit from reduced water quality risks. The experiments allow us to construct supply and demand curves to find an equilibrium price for water quality improvement. The field experiments provide a proof-of-concept for practical implementation of a local market for environmental improvements, even for the challenging context of nonpoint pollution.

Building Consensus for Change: Developing an Administrative and Management Structure in a Southern African University.

ERIC Educational Resources Information Center

Ingalls, Wayne B.

1995-01-01

The way in which the University of Botswana went about building the consensus necessary to develop a new administrative and management structure is described. The process began with a commission review to address increasing demand, and progressed to recommendations, governing council response, a task force for reorganization, and implementation.…

Meeting the Growing Demand for Sustainability-Focused Management Education: A Case Study of a PRME Academic Institution

ERIC Educational Resources Information Center

Young, Suzanne; Nagpal, Swati

2013-01-01

The current business landscape has created the impetus to develop management graduates with capabilities that foster responsible leadership and sustainability. Through the lens of Gitsham's 3C Model (Complexity, Context and Connection) of graduate capabilities, this paper discusses the experience of implementing the United Nations Principles for…

Demand based signal retiming phase 2 - real-world implementation.

DOT National Transportation Integrated Search

2015-11-01

Monitoring and managing arterial operations represents a significant problem for many public agencies in the : US. Arterial streets, more numerous and covering much larger road networks than freeways, get less attention : when it comes to deployment ...

Joint Robotics Program

DTIC Science & Technology

2008-04-23

Kotler , P.M. (1997). Marketing management: Analysis, planning, implementation, and control. Upper Saddle River, NJ: Prentice Hall...needed to provide needed items. Production needed to be stable so suppliers could more easily meet demand ( Kotler , 1997, pp. 214-215). The Robotics

Demand based signal retiming phase 2 - real world implementation : [summary].

DOT National Transportation Integrated Search

2016-01-01

Monitoring and managing the operation of arterial operations represents a significant : challenge for many public agencies. While there are more arterial streets which cover a : larger road network, arterials generally have less Intelligent Transport...

Implementation of a Project Management Office (PMO)--experiences from year 1.

PubMed

Isola, Miriam; Polikaitis, Audrius; Laureto, Rose Ann

2006-01-01

Recognized as an early leader in clinical information systems, the University of Illinois Medical Center was challenged to meet the ever-increasing demand for information systems. Interviews with key stakeholders revealed unfavorable attitudes toward the Information Services department. Reasons given were that projects often are not aligned with business strategy, projects are delayed, IS itself is a barrier to progress, and a lack of proactive planning precipitates crises. Under the leadership of a new CIO, IS began developing a Project Management Office, or PMO, to better meet medical center business objectives and to more effectively manage technology projects. Successes during the first year included comprehensive IT strategic planning. Collaborative relationships were established with departmental leaders for planning, prioritizing, budgeting, and executing projects. A formal Web-based process for requesting IS projects was implemented, project management training was provided, and elements of standard project management methodology were implemented. While a framework for effective project management was created, significant effort is still required to firmly root these new processes within the organizational culture. Project management office goals for the second year include implementing a project portfolio management tool, refining the benefits methodology, and continuing the advancement of the project management methodology.

Preparing health care organizations for successful case management programs.

PubMed

Bonvissuto, C A; Kastens, J M; Atwell, S R

1997-01-01

This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program.

Adaptation of water resource systems to an uncertain future

NASA Astrophysics Data System (ADS)

Walsh, Claire L.; Blenkinsop, Stephen; Fowler, Hayley J.; Burton, Aidan; Dawson, Richard J.; Glenis, Vassilis; Manning, Lucy J.; Jahanshahi, Golnaz; Kilsby, Chris G.

2016-05-01

Globally, water resources management faces significant challenges from changing climate and growing populations. At local scales, the information provided by climate models is insufficient to support the water sector in making future adaptation decisions. Furthermore, projections of change in local water resources are wrought with uncertainties surrounding natural variability, future greenhouse gas emissions, model structure, population growth, and water consumption habits. To analyse the magnitude of these uncertainties, and their implications for local-scale water resource planning, we present a top-down approach for testing climate change adaptation options using probabilistic climate scenarios and demand projections. An integrated modelling framework is developed which implements a new, gridded spatial weather generator, coupled with a rainfall-runoff model and water resource management simulation model. We use this to provide projections of the number of days and associated uncertainty that will require implementation of demand saving measures such as hose pipe bans and drought orders. Results, which are demonstrated for the Thames Basin, UK, indicate existing water supplies are sensitive to a changing climate and an increasing population, and that the frequency of severe demand saving measures are projected to increase. Considering both climate projections and population growth, the median number of drought order occurrences may increase 5-fold by the 2050s. The effectiveness of a range of demand management and supply options have been tested and shown to provide significant benefits in terms of reducing the number of demand saving days. A decrease in per capita demand of 3.75 % reduces the median frequency of drought order measures by 50 % by the 2020s. We found that increased supply arising from various adaptation options may compensate for increasingly variable flows; however, without reductions in overall demand for water resources such options will be insufficient on their own to adapt to uncertainties in the projected changes in climate and population. For example, a 30 % reduction in overall demand by 2050 has a greater impact on reducing the frequency of drought orders than any of the individual or combinations of supply options; hence, a portfolio of measures is required.

Blockchain Based Decentralized Management of Demand Response Programs in Smart Energy Grids.

PubMed

Pop, Claudia; Cioara, Tudor; Antal, Marcel; Anghel, Ionut; Salomie, Ioan; Bertoncini, Massimo

2018-01-09

In this paper, we investigate the use of decentralized blockchain mechanisms for delivering transparent, secure, reliable, and timely energy flexibility, under the form of adaptation of energy demand profiles of Distributed Energy Prosumers, to all the stakeholders involved in the flexibility markets (Distribution System Operators primarily, retailers, aggregators, etc.). In our approach, a blockchain based distributed ledger stores in a tamper proof manner the energy prosumption information collected from Internet of Things smart metering devices, while self-enforcing smart contracts programmatically define the expected energy flexibility at the level of each prosumer, the associated rewards or penalties, and the rules for balancing the energy demand with the energy production at grid level. Consensus based validation will be used for demand response programs validation and to activate the appropriate financial settlement for the flexibility providers. The approach was validated using a prototype implemented in an Ethereum platform using energy consumption and production traces of several buildings from literature data sets. The results show that our blockchain based distributed demand side management can be used for matching energy demand and production at smart grid level, the demand response signal being followed with high accuracy, while the amount of energy flexibility needed for convergence is reduced.

The Value of Advanced Smart Metering in the Management of Urban Water Supply Services

NASA Astrophysics Data System (ADS)

Guardiola, J.; Pulido-Velazquez, M.; Giuliani, M.; Castelletti, A.; Cominola, A.; Arregui de la Cruz, F.; Escriva-Bou, A.; Soriano, J.; Pérez, J. J.; Castillo, J.; Barba, J.; González, V.; Rizzoli, A. E.

2016-12-01

This work intends to outline the experience of the implementation and further exploitation of an extensive network of smart meters (SM) in the city of Valencia by Aguas de Valencia, the water utility that offers water supply and sanitation services to the city of Valencia and its metropolitan area. Valencia has become the first large city in Europe fully equipped with a point-to-point fixed network of SM (currently with more than 430,000 units, about 90% of the meters of the city). The shift towards a water supply management system based on SM is a complex process that entails changes and impacts on different management areas of the water supply organization. A new data management and processing platform has been developed and is already proving notable benefits in the operation of the system. For example, a tool allows to automatically issue and manage work orders when abnormalities such as internal leaks (constant consumption) or meter alarms are detected. Another tool has been developed to reduce levels of non-revenue water by continuously balancing supply and demand in district metered areas. Improving leak detection and adjusting pressure levels has significantly increased the efficiency of the water distribution network. Finally, a service of post-meter leak detection has been also implemented. But the SM also contribute to improve demand management. The customers now receive detailed information on their water consumption, valuable for improving household water management and assessing the value of water conservation strategies. SM are also key tools for improving the level of understanding of demand patterns. Users have been categorized into different clusters depending in their consumption patterns characteristics. Within the EU SmartH2O project, a high resolution and frequency monitoring of residential uses has been conducted in a selected sample of households for a precise disaggregation of residential end-uses. The disaggregation of end-uses allows for a better characterization and modelling of residential water demand, and, ultimately, designing efficient user-oriented water management strategies.

Implications of the introduction of laboratory demand management at primary care clinics in South Africa on laboratory expenditure

PubMed Central

Lekalakala, Ruth; Asmall, Shaidah; Cassim, Naseem

2016-01-01

Background Diagnostic health laboratory services are regarded as an integral part of the national health infrastructure across all countries. Clinical laboratory tests contribute substantially to health system goals of increasing quality of care and improving patient outcomes. Objectives This study aimed to analyse current laboratory expenditures at the primary healthcare (PHC) level in South Africa as processed by the National Health Laboratory Service and to determine the potential cost savings of introducing laboratory demand management. Methods A retrospective cross-sectional analysis of laboratory expenditures for the 2013/2014 financial year across 11 pilot National Health Insurance health districts was conducted. Laboratory expenditure tariff codes were cross-tabulated to the PHC essential laboratory tests list (ELL) to determine inappropriate testing. Data were analysed using a Microsoft Access database and Excel software. Results Approximately R35 million South African Rand (10%) of the estimated R339 million in expenditures was for tests that were not listed within the ELL. Approximately 47% of expenditure was for laboratory tests that were indicated in the algorithmic management of patients on antiretroviral treatment. The other main cost drivers for non-ELL testing included full blood count and urea, as well as electrolyte profiles usually requested to support management of patients on antiretroviral treatment. Conclusions Considerable annual savings of up to 10% in laboratory expenditure are possible at the PHC level by implementing laboratory demand management. In addition, to achieve these savings, a standardised PHC laboratory request form and some form of electronic gatekeeping system that must be supported by an educational component should be implemented. PMID:28879107

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

Kim, Joyce Jihyun; Schetrit, Oren; Yin, Rongxin

Demand response (DR) – allowing customers to respond to reliability requests and market prices by changing electricity use from their normal consumption pattern – continues to be seen as an attractive means of demand-side management and a fundamental smart-grid improvement that links supply and demand. From October 2011 to December 2013, the Demand Response Research Center at Lawrence Berkeley National Laboratory, the New York State Energy Research and Development Authority, and partners Honeywell and Akuacom, have conducted a demonstration project enabling Automated Demand Response (Auto-DR) in large commercial buildings located in New York City using Open Automated Demand Response (OpenADR)more » communication protocols. In particular, this project focuses on demonstrating how the OpenADR platform, enabled by Akuacom, can automate and simplify interactions between buildings and various stakeholders in New York State and enable the automation of customers’ price response to yield bill savings under dynamic pricing. In this paper, the cost control opportunities under day-ahead hourly pricing and Auto-DR control strategies are presented for four demonstration buildings; present the breakdown of Auto-DR enablement costs; summarize the field test results and their load impact; and show potential bill savings by enabling automated price response under Consolidated Edison’s Mandatory Hourly Pricing (MHP) tariff. For one of the sites, the potential bill savings at the site’s current retail rate are shown. Facility managers were given granular equipment-level opt-out capability to ensure full control of the sites during the Auto-DR implementation. The expected bill savings ranged from 1.1% to 8.0% of the total MHP bill. The automation and enablement costs ranged from $70 to $725 per kW shed. The results show that OpenADR can facilitate the automation of price response, deliver savings to the customers and opt-out capability of the implementation retains control of the sites by facility managers.« less

The Implementation of Environmental Management towards Sustainable Universities and Education for Sustainable Development as an Ethical Imperative

ERIC Educational Resources Information Center

Nicolaides, Angelo

2006-01-01

Purpose: To show that the practices, processes and resources for the management of the university environment should be aligned to meet the ever-growing demands of sustainability and its motivations should be clearly spelt out to all stakeholders. Universities should also strive to become leaders in the development of effective environmental…

[The patient blood management concept : Joint recommendation of the German Society of Anaesthesiology and Intensive Care Medicine and the German Society of Surgery].

PubMed

Meybohm, P; Schmitz-Rixen, T; Steinbicker, A; Schwenk, W; Zacharowski, K

2017-10-01

Patient blood management is a multimodal concept that aims to detect, prevent and treat anemia, optimize hemostasis, minimize iatrogenic blood loss, and support a patient-centered decision to provide optimal use of allogeneic blood products. Although the World Health Organization (WHO) has already recommended patient blood management as a new standard in 2010, many hospitals have not implemented it at all or only in part in clinical practice. The German Society of Anaesthesiology and Intensive Care Medicine and the German Society of Surgery therefore demand that i) all professionals involved in the treatment should implement important aspects of patient blood management considering local conditions, and ii) the structural, administrative and budgetary conditions should be created in the health care system to implement more intensively many of the measures in Germany.

Academic Leadership: Management of Groups or Leadership of Teams? A Multiple-Case Study on Designing and Implementing a Team-Based Development Programme for Academic Leadership

ERIC Educational Resources Information Center

Söderhjelm, Teresa; Björklund, Christina; Sandahl, Christer; Bolander-Laksov, Klara

2018-01-01

Demands on academic leadership are increasing, which raises the need for leadership training. This article describes development and implementation of a group training intervention in academic leadership at a departmental level. Little systematic research has addressed the question of what forms of leadership training are associated with…

Defence Technology Strategy for the Demands of the 21st Century

DTIC Science & Technology

2006-10-01

understanding of human capability in the CBM role. Ownership of the intellectual property behind algorithms may be sovereign10, but implementation will...synchronisation schemes. · coding schemes. · modulation techniques. · access schemes. · smart spectrum usage . · low probability of intercept. · implementation...modulation techniques; access schemes; smart spectrum usage ; low probability of intercept Spectrum and bandwidth management · cross layer technologies to

Stroke unit Nurse Managers' views of individual and organizational factors liable to influence evidence-based practice: A survey.

PubMed

Drury, Peta; McInnes, Elizabeth; Hardy, Jennifer; Dale, Simeon; Middleton, Sandy

2016-04-01

The uptake of evidence into practice may be impeded or facilitated by individual and organizational factors within the local context. This study investigated Nurse Managers of New South Wales, Australia, stroke units (n = 19) in their views on: leadership ability (measured by the Leadership Practices Inventory), organizational learning (measured by the Organizational Learning Survey), attitudes and beliefs towards evidence-based practice (EBP) and readiness for change. Overall Nurse Managers reported high-level leadership skills and a culture of learning. Nurse Managers' attitude towards EBP was positive, although nursing colleague's attitudes were perceived as less positive. Nurse Managers agreed that implementing evidence in practice places additional demands on staff; and almost half (n = 9, 47%) reported that resources were not available for evidence implementation. The findings indicate that key persons responsible for evidence implementation are not allocated sufficient time to coordinate and implement guidelines into practice. The findings suggest that barriers to evidence uptake, including insufficient resources and time constraints, identified by Nurse Managers in this study are not likely to be unique to stroke units. Furthermore, Nurse Managers may be unable to address these organizational barriers (i.e. lack of resources) and thus provide all the components necessary to implement EBP. © 2015 John Wiley & Sons Australia, Ltd.

Integrating the simulation of domestic water demand behaviour to an urban water model using agent based modelling

NASA Astrophysics Data System (ADS)

Koutiva, Ifigeneia; Makropoulos, Christos

2015-04-01

The urban water system's sustainable evolution requires tools that can analyse and simulate the complete cycle including both physical and cultural environments. One of the main challenges, in this regard, is the design and development of tools that are able to simulate the society's water demand behaviour and the way policy measures affect it. The effects of these policy measures are a function of personal opinions that subsequently lead to the formation of people's attitudes. These attitudes will eventually form behaviours. This work presents the design of an ABM tool for addressing the social dimension of the urban water system. The created tool, called Urban Water Agents' Behaviour (UWAB) model, was implemented, using the NetLogo agent programming language. The main aim of the UWAB model is to capture the effects of policies and environmental pressures to water conservation behaviour of urban households. The model consists of agents representing urban households that are linked to each other creating a social network that influences the water conservation behaviour of its members. Household agents are influenced as well by policies and environmental pressures, such as drought. The UWAB model simulates behaviour resulting in the evolution of water conservation within an urban population. The final outcome of the model is the evolution of the distribution of different conservation levels (no, low, high) to the selected urban population. In addition, UWAB is implemented in combination with an existing urban water management simulation tool, the Urban Water Optioneering Tool (UWOT) in order to create a modelling platform aiming to facilitate an adaptive approach of water resources management. For the purposes of this proposed modelling platform, UWOT is used in a twofold manner: (1) to simulate domestic water demand evolution and (2) to simulate the response of the water system to the domestic water demand evolution. The main advantage of the UWAB - UWOT model integration is that it allows the investigation of the effects of different water demand management strategies to an urban population's water demand behaviour and ultimately the effects of these policies to the volume of domestic water demand and the water resources system. The proposed modelling platform is optimised to simulate the effects of water policies during the Athens drought period of 1988-1994. The calibrated modelling platform is then applied to evaluate scenarios of water supply, water demand and water demand management strategies.

Integrative freight demand management in the New York City metropolitan area : implementation phase.

DOT National Transportation Integrated Search

2013-09-01

Urban freight transportation is crucial to the quality of modern life, though at the same time it : produces significant negative externalities. Despite the relatively small proportion of freight with respect : to all traffic, urban freight movements...

Integration of human factors principles in LARG organizations--a conceptual model.

PubMed

Figueira, Sara; Machado, V Cruz; Nunes, Isabel L

2012-01-01

Nowadays many companies are undergoing organizational transformations in order to meet the changing market demands. Thus, in order to become more competitive, supply chains (SC) are adopting new management paradigms to improve SC performance: lean, agile, resilient and green (LARG paradigms). The implementation of new production paradigms demands particular care with the issues related with Human Factors to avoid health and safety problems to workers and losses to companies. Thus, the successful introduction of these new production paradigms depends among others on a Human Factors oriented approach. This work presents a conceptual framework that allows integrating ergonomic and safety design principles during the different implementation phases of lean, agile, resilient and green practices.

Adopting best practices: "Agility" moves from software development to healthcare project management.

PubMed

Kitzmiller, Rebecca; Hunt, Eleanor; Sproat, Sara Breckenridge

2006-01-01

It is time for a change in mindset in how nurses operationalize system implementations and manage projects. Computers and systems have evolved over time from unwieldy mysterious machines of the past to ubiquitous computer use in every aspect of daily lives and work sites. Yet, disconcertingly, the process used to implement these systems has not evolved. Technology implementation does not need to be a struggle. It is time to adapt traditional plan-driven implementation methods to incorporate agile techniques. Agility is a concept borrowed from software development and is presented here because it encourages flexibility, adaptation, and continuous learning as part of the implementation process. Agility values communication and harnesses change to an advantage, which facilitates the natural evolution of an adaptable implementation process. Specific examples of agility in an implementation are described, and plan-driven implementation stages are adapted to incorporate relevant agile techniques. This comparison demonstrates how an agile approach enhances traditional implementation techniques to meet the demands of today's complex healthcare environments.

Smart Grid Constraint Violation Management for Balancing and Regulating Purposes

DOE PAGES

Bhattarai, Bishnu; Kouzelis, Konstantinos; Mendaza, Iker; ...

2017-03-29

The gradual active load penetration in low voltage distribution grids is expected to challenge their network capacity in the near future. Distribution system operators should for this reason resort to either costly grid reinforcements or to demand side management mechanisms. Since demand side management implementation is usually cheaper, it is also the favorable solution. To this end, this article presents a framework for handling grid limit violations, both voltage and current, to ensure a secure and qualitative operation of the distribution grid. This framework consists of two steps, namely a proactive centralized and subsequently a reactive decentralized control scheme. Themore » former is employed to balance the one hour ahead load while the latter aims at regulating the consumption in real-time. In both cases, the importance of fair use of electricity demand flexibility is emphasized. Thus, it is demonstrated that this methodology aids in keeping the grid status within preset limits while utilizing flexibility from all flexibility participants.« less

Co-management of Water, Energy, and Food Systems: Where Are We and What Does it Take for Implementation?

NASA Astrophysics Data System (ADS)

Akhbari, M.

2015-12-01

Water, energy, and food are closely bound in consumption and production patterns. To increase resource efficiency and productivity in a sustainable fashion, co-management of water, energy, and food resources is becoming inevitable. These co-management schemes require implementation of nexus-based approaches, which takes the interconnections of water, energy, and food systems into account and considers that development in one area may have major effects on others. While society, economy and environment are the action areas to implement a nexus approach, finance, governance, infrastructure and technology can create solutions. Existing obstacles in the action areas and challenges associated with creating solutions increase the complexities to develop nexus-based approaches and complicate their implementation. This study, identifies existing social, economic, and environmental obstacles, financial demands and constraints, shortcomings in governance, and infrastructure problems in the United States as the main challenges that need to be overcome. Then, it will be discussed how advanced technology could be employed to facilitate implementation of nexus-based approaches, followed by providing some recommendations to enable institutions to employ new technology, overcome existing obstacles, and address challenges in order to implement nexus-based management approaches.

Autonomous Hybrid Priority Queueing for Scheduling Residential Energy Demands

NASA Astrophysics Data System (ADS)

Kalimullah, I. Q.; Shamroukh, M.; Sahar, N.; Shetty, S.

2017-05-01

The advent of smart grid technologies has opened up opportunities to manage the energy consumption of the users within a residential smart grid system. Demand response management is particularly being employed to reduce the overall load on an electricity network which could in turn reduce outages and electricity costs. The objective of this paper is to develop an intelligible scheduler to optimize the energy available to a micro grid through hybrid queueing algorithm centered around the consumers’ energy demands. This is achieved by shifting certain schedulable load appliances to light load hours. Various factors such as the type of demand, grid load, consumers’ energy usage patterns and preferences are considered while formulating the logical constraints required for the algorithm. The algorithm thus obtained is then implemented in MATLAB workspace to simulate its execution by an Energy Consumption Scheduler (ECS) found within smart meters, which automatically finds the optimal energy consumption schedule tailor made to fit each consumer within the micro grid network.

Data Mining for Understanding and Improving Decision-making Affecting Ground Delay Programs

NASA Technical Reports Server (NTRS)

Kulkarni, Deepak; Wang, Yao; Sridhar, Banavar

2013-01-01

The continuous growth in the demand for air transportation results in an imbalance between airspace capacity and traffic demand. The airspace capacity of a region depends on the ability of the system to maintain safe separation between aircraft in the region. In addition to growing demand, the airspace capacity is severely limited by convective weather. During such conditions, traffic managers at the FAA's Air Traffic Control System Command Center (ATCSCC) and dispatchers at various Airlines' Operations Center (AOC) collaborate to mitigate the demand-capacity imbalance caused by weather. The end result is the implementation of a set of Traffic Flow Management (TFM) initiatives such as ground delay programs, reroute advisories, flow metering, and ground stops. Data Mining is the automated process of analyzing large sets of data and then extracting patterns in the data. Data mining tools are capable of predicting behaviors and future trends, allowing an organization to benefit from past experience in making knowledge-driven decisions.

Intelligent demand side management of residential building energy systems

NASA Astrophysics Data System (ADS)

Sinha, Maruti N.

Advent of modern sensing technologies, data processing capabilities and rising cost of energy are driving the implementation of intelligent systems in buildings and houses which constitute 41% of total energy consumption. The primary motivation has been to provide a framework for demand-side management and to improve overall reliability. The entire formulation is to be implemented on NILM (Non-Intrusive Load Monitoring System), a smart meter. This is going to play a vital role in the future of demand side management. Utilities have started deploying smart meters throughout the world which will essentially help to establish communication between utility and consumers. This research is focused on investigation of a suitable thermal model of residential house, building up control system and developing diagnostic and energy usage forecast tool. The present work has considered measurement based approach to pursue. Identification of building thermal parameters is the very first step towards developing performance measurement and controls. The proposed identification technique is PEM (Prediction Error Method) based, discrete state-space model. The two different models have been devised. First model is focused toward energy usage forecast and diagnostics. Here one of the novel idea has been investigated which takes integral of thermal capacity to identify thermal model of house. The purpose of second identification is to build up a model for control strategy. The controller should be able to take into account the weather forecast information, deal with the operating point constraints and at the same time minimize the energy consumption. To design an optimal controller, MPC (Model Predictive Control) scheme has been implemented instead of present thermostatic/hysteretic control. This is a receding horizon approach. Capability of the proposed schemes has also been investigated.

Designing cost effective water demand management programs in Australia.

PubMed

White, S B; Fane, S A

2002-01-01

This paper describes recent experience with integrated resource planning (IRP) and the application of least cost planning (LCP) for the evaluation of demand management strategies in urban water. Two Australian case studies, Sydney and Northern New South Wales (NSW) are used in illustration. LCP can determine the most cost effective means of providing water services or alternatively the cheapest forms of water conservation. LCP contrasts to a traditional approach of evaluation which looks only at means of increasing supply. Detailed investigation of water usage, known as end-use analysis, is required for LCP. End-use analysis allows both rigorous demand forecasting, and the development and evaluation of conservation strategies. Strategies include education campaigns, increasing water use efficiency and promoting wastewater reuse or rainwater tanks. The optimal mix of conservation strategies and conventional capacity expansion is identified based on levelised unit cost. IRP uses LCP in the iterative process, evaluating and assessing options, investing in selected options, measuring the results, and then re-evaluating options. Key to this process is the design of cost effective demand management programs. IRP however includes a range of parameters beyond least economic cost in the planning process and program designs, including uncertainty, benefit partitioning and implementation considerations.

Blockchain Based Decentralized Management of Demand Response Programs in Smart Energy Grids

PubMed Central

Pop, Claudia; Cioara, Tudor; Antal, Marcel; Anghel, Ionut; Salomie, Ioan; Bertoncini, Massimo

2018-01-01

In this paper, we investigate the use of decentralized blockchain mechanisms for delivering transparent, secure, reliable, and timely energy flexibility, under the form of adaptation of energy demand profiles of Distributed Energy Prosumers, to all the stakeholders involved in the flexibility markets (Distribution System Operators primarily, retailers, aggregators, etc.). In our approach, a blockchain based distributed ledger stores in a tamper proof manner the energy prosumption information collected from Internet of Things smart metering devices, while self-enforcing smart contracts programmatically define the expected energy flexibility at the level of each prosumer, the associated rewards or penalties, and the rules for balancing the energy demand with the energy production at grid level. Consensus based validation will be used for demand response programs validation and to activate the appropriate financial settlement for the flexibility providers. The approach was validated using a prototype implemented in an Ethereum platform using energy consumption and production traces of several buildings from literature data sets. The results show that our blockchain based distributed demand side management can be used for matching energy demand and production at smart grid level, the demand response signal being followed with high accuracy, while the amount of energy flexibility needed for convergence is reduced. PMID:29315250

Opportunities for Energy Efficiency and Open Automated Demand Response in Wastewater Treatment Facilities in California -- Phase I Report

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

Lekov, Alex; Thompson, Lisa; McKane, Aimee

This report summarizes the Lawrence Berkeley National Laboratory?s research to date in characterizing energy efficiency and automated demand response opportunities for wastewater treatment facilities in California. The report describes the characteristics of wastewater treatment facilities, the nature of the wastewater stream, energy use and demand, as well as details of the wastewater treatment process. It also discusses control systems and energy efficiency and automated demand response opportunities. In addition, several energy efficiency and load management case studies are provided for wastewater treatment facilities.This study shows that wastewater treatment facilities can be excellent candidates for open automated demand response and thatmore » facilities which have implemented energy efficiency measures and have centralized control systems are well-suited to shift or shed electrical loads in response to financial incentives, utility bill savings, and/or opportunities to enhance reliability of service. Control technologies installed for energy efficiency and load management purposes can often be adapted for automated demand response at little additional cost. These improved controls may prepare facilities to be more receptive to open automated demand response due to both increased confidence in the opportunities for controlling energy cost/use and access to the real-time data.« less

Pilot In Command: A Feasibility Assessment of Autonomous Flight Management Operations

NASA Technical Reports Server (NTRS)

Wing, David J.; Ballin, Mark G.; Krishnamurthy, Karthik

2004-01-01

Several years of NASA research have produced the air traffic management operational concept of Autonomous Flight Management with high potential for operational feasibility, significant system and user benefits, and safety. Among the chief potential benefits are demand-adaptive or scalable capacity, user flexibility and autonomy that may finally enable truly successful business strategies, and compatibility with current-day operations such that the implementation rate can be driven from within the user community. A concept summary of Autonomous Flight Management is provided, including a description of how these operations would integrate in shared airspace with existing ground-controlled flight operations. The mechanisms enabling the primary benefits are discussed, and key findings of a feasibility assessment of airborne autonomous operations are summarized. Concept characteristics that impact safety are presented, and the potential for initially implementing Autonomous Flight Management is discussed.

"If You Don't Do Parking Management .. Forget Your Behaviour Change, It's Not Going to Work.": Health and Transport Practitioner Perspectives on Workplace Active Travel Promotion.

PubMed

Petrunoff, Nick; Rissel, Chris; Wen, Li Ming

2017-01-01

After having conducted two studies of the effectiveness of workplace travel plans for promoting active travel, we investigated health and transport practitioners' perspectives on implementing workplace travel plans to share some of the lessons learnt. The objectives of this study were to describe perceived elements of effective workplace travel plans, barriers and enablers to workplace travel planning, their experiences of working with the other profession on travel plan implementation, their recommendations for workplace travel planning, and also to explore similarities and differences in transport and health practitioner perspectives. Fourteen health and ten transport practitioners who had prior involvement in workplace travel plan programs were purposefully selected from workplaces in Australia. We conducted 20 in-depth interviews since data saturation had been reached at this point, and data were subject to framework analysis. Perceived essential elements of effective workplace travel plans included parking management; leadership, organisational commitment and governance; skills and other resources like a dedicated travel plan coordinator; and, pre-conditions including supportive transport infrastructure in the surrounds. Recommendations for promoting travel plans included supportive government policy, focusing on business benefits and working at different scales of implementation (e.g. single large worksites and business precincts). Health and transport practitioner perspectives differed, with transport practitioners believing that parking management is the key action for managing travel demand at a worksite. Health practitioners implementing travel plans may require training including concepts of travel demand management, and support from transport planners on parking management strategies. Promoting an understanding of the shared travel behaviour change skills of transport and health practitioners may assist further collaboration. For take-up by organisations to be of sufficient scale to create meaningful population level reductions in driving and increases in active travel, promotion and travel plans should be focused on the priorities of the organisations. Supportive government policy is also required.

“If You Don’t Do Parking Management .. Forget Your Behaviour Change, It’s Not Going to Work.”: Health and Transport Practitioner Perspectives on Workplace Active Travel Promotion

PubMed Central

Rissel, Chris; Wen, Li Ming

2017-01-01

Objectives After having conducted two studies of the effectiveness of workplace travel plans for promoting active travel, we investigated health and transport practitioners’ perspectives on implementing workplace travel plans to share some of the lessons learnt. The objectives of this study were to describe perceived elements of effective workplace travel plans, barriers and enablers to workplace travel planning, their experiences of working with the other profession on travel plan implementation, their recommendations for workplace travel planning, and also to explore similarities and differences in transport and health practitioner perspectives. Materials and Methods Fourteen health and ten transport practitioners who had prior involvement in workplace travel plan programs were purposefully selected from workplaces in Australia. We conducted 20 in-depth interviews since data saturation had been reached at this point, and data were subject to framework analysis. Results Perceived essential elements of effective workplace travel plans included parking management; leadership, organisational commitment and governance; skills and other resources like a dedicated travel plan coordinator; and, pre-conditions including supportive transport infrastructure in the surrounds. Recommendations for promoting travel plans included supportive government policy, focusing on business benefits and working at different scales of implementation (e.g. single large worksites and business precincts). Health and transport practitioner perspectives differed, with transport practitioners believing that parking management is the key action for managing travel demand at a worksite. Conclusions Health practitioners implementing travel plans may require training including concepts of travel demand management, and support from transport planners on parking management strategies. Promoting an understanding of the shared travel behaviour change skills of transport and health practitioners may assist further collaboration. For take-up by organisations to be of sufficient scale to create meaningful population level reductions in driving and increases in active travel, promotion and travel plans should be focused on the priorities of the organisations. Supportive government policy is also required. PMID:28135301

Developing a regional approach to transportation demand management and nonmotorized transportation : best practice case studies

DOT National Transportation Integrated Search

1995-01-01

This report is being forwarded to Congress pursuant to Section 6054 (c) of the Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA). The first Implementation Report, transmitted to Congress in June 1994, described the achievements of DOT ...

Software Defined Networking challenges and future direction: A case study of implementing SDN features on OpenStack private cloud

NASA Astrophysics Data System (ADS)

Shamugam, Veeramani; Murray, I.; Leong, J. A.; Sidhu, Amandeep S.

2016-03-01

Cloud computing provides services on demand instantly, such as access to network infrastructure consisting of computing hardware, operating systems, network storage, database and applications. Network usage and demands are growing at a very fast rate and to meet the current requirements, there is a need for automatic infrastructure scaling. Traditional networks are difficult to automate because of the distributed nature of their decision making process for switching or routing which are collocated on the same device. Managing complex environments using traditional networks is time-consuming and expensive, especially in the case of generating virtual machines, migration and network configuration. To mitigate the challenges, network operations require efficient, flexible, agile and scalable software defined networks (SDN). This paper discuss various issues in SDN and suggests how to mitigate the network management related issues. A private cloud prototype test bed was setup to implement the SDN on the OpenStack platform to test and evaluate the various network performances provided by the various configurations.

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

Bhattarai, Bishnu; Kouzelis, Konstantinos; Mendaza, Iker

The gradual active load penetration in low voltage distribution grids is expected to challenge their network capacity in the near future. Distribution system operators should for this reason resort to either costly grid reinforcements or to demand side management mechanisms. Since demand side management implementation is usually cheaper, it is also the favorable solution. To this end, this article presents a framework for handling grid limit violations, both voltage and current, to ensure a secure and qualitative operation of the distribution grid. This framework consists of two steps, namely a proactive centralized and subsequently a reactive decentralized control scheme. Themore » former is employed to balance the one hour ahead load while the latter aims at regulating the consumption in real-time. In both cases, the importance of fair use of electricity demand flexibility is emphasized. Thus, it is demonstrated that this methodology aids in keeping the grid status within preset limits while utilizing flexibility from all flexibility participants.« less

Reducing Gridlock on the Grid: Utility Trends in Managing Peak Electric Load through Residential Demand Response

NASA Astrophysics Data System (ADS)

McDonald, Betsy

Utilities across the United States are piloting residential demand response programs to help manage peak electric demand. Using publicly available program evaluations, this thesis analyzes nine such programs to uncover and synthesize the range of program offerings, goals, enrollment strategies, and customer experiences. This review reveals that program participation, components, and results differ based on a variety of factors, including geographic characteristics, program goals, and implementation strategies. The diversity of program designs and evaluation findings suggests an underlying tension between the need to generate cost-effective program impacts and the desire to increase accessibility so that program benefits are not exclusive to certain segments of the population. For more significant and impactful engagement, program goals may need to shift. State level policy support could help shift program goals toward increasing program accessibility. Future research should explore creative strategies that target existing barriers and allow for more inclusive deployment.

Controlling disasters: Local emergency management perceptions about Federal Emergency Management and Homeland Security actions after September 11, 2001.

PubMed

Hildebrand, Sean

This article examines local emergency manager's beliefs regarding control over tasks during various stages of the hazard cycle since federal policies went into effect following the September 11 attacks. The study considers whether a disparity exists between the actions of local officials during each phase of the "hazard cycle" and the policy expectations of the federal government, which call for greater federal control over activities in emergency management and homeland security. To do so, hypothesis testing investigates the jurisdiction's use of comprehensive emergency management (CEM) practices, the perceived "clarity" of the federal policy demands, and if the local actors feel coerced to comply with federal policy demands so that grant funding is not compromised. Using a model developed from "third-generation" policy implementation research, the results show that the odds of local officials citing federal control over these actions have very limited statistical significance. This signals that the perceived lack of local input into the development of these federal policies and the policies' limited use of traditional CEM measures may not be in concert with what local actors perform in the field. Simply put, the respondents claim to understand the federal policy demands, support the concept of federal control as the policies describe, yet follow their own plans or traditional CEM principles, even if such actions do not support the federal policy demands. These results align with pre-existing research in the emergency management field that show issues with efforts to centralize policies under the Department of Homeland Security and Federal Emergency Management Agency.

The UARS and open data concept and analysis study. [upper atmosphere

NASA Technical Reports Server (NTRS)

Mittal, M.; Nebb, J.; Woodward, H.

1983-01-01

Alternative concepts for a common design for the UARS and OPEN Central Data Handling Facility (CDHF) are offered. Costs for alternative implementations of the UARS designs are presented, showing that the system design does not restrict the implementation to a single manufacturer. Processing demands on the alternative UARS CDHF implementations are then discussed. With this information at hand together with estimates for OPEN processing demands, it is shown that any shortfall in system capability for OPEN support can be remedied by either component upgrades or array processing attachments rather than a system redesign. In addition to a common system design, it is shown that there is significant potential for common software design, especially in the areas of data management software and non-user-unique production software. Archiving the CDHF data are discussed. Following that, cost examples for several modes of communications between the CDHF and Remote User Facilities are presented. Technology application is discussed.

The Advantage of Standardisation as a Management Instrument in Companies

DTIC Science & Technology

2003-09-01

possible synergistic effects between different but related business units and allocate all kinds of resources in the best possible way. The management... allocating the necessary resources. This pragmatic approach corresponds to the "structure follows strategy thesis". Under the term strategy this thesis...implementation of the necessary arrangements in the functional areas as well as the allocation of existing resources. In this connection the demand for

Report of CEC Study Committee on Construction Management.

ERIC Educational Resources Information Center

Consulting Engineers Council of the U.S., Washington, DC.

Changing times place new demands on those involved in the implementation of construction projects. Within a relatively few years, the size and complexity of projects has grown substantially. Environmental and other public and social considerations are increasingly significant. With growing complexity, the requirements for effective project…

Design and Implementation Issues in Longitudinal Research

ERIC Educational Resources Information Center

Ludlow, Larry H.; Pedulla, Joseph; Reagan, Emile Mitescu; Enterline, Sarah; Cannady, Mac; Chappe, Stephanie

2011-01-01

To meet demands for accountability, most schools and departments of education at institutions of higher education (IHEs) gather information on their current students and graduates. This paper describes issues to consider when designing a longitudinal data collection and management system, drawing on seven years' experience developing such a…

The strategic nature of individual change behavior: How physicians and their staff implement medical home care.

PubMed

Hoff, Timothy; Scott, Sarah

The patient-centered medical home (PCMH) model of care is central to primary care system success and transformation. Less is known about which PCMH activities primary care workers most frequently perform, if or why they might view that work more favorably, and how such work may function strategically to advance individual and organizational adaptation to new demands, as well as deliver good patient care. Understanding better how primary care physicians and staff perceive, experience, and use certain types of PCMH work for adapting to new demands looms a key imperative for gaining insights into PCMH implementation at the workplace level. Using a worker adaptation perspective that emphasizes the role of social learning and individual agency, this study explores the strategic nature of PCMH implementation through 51 in-depth interviews with physicians and staff in six accredited PCMHs. Select medical home activities were identified, in which primary care physicians and staff most engaged on a daily basis, and they fell into five distinct PCMH work domains labeled team care, medical home responsibilities, care management, access, and medication management. These activities had common features such as high levels of familiarity, simplicity, and camaraderie. In addition, through their experiences performing these activities, physicians and staff appeared to gain strategic benefits for themselves and the larger organization including enhanced self-efficacy and readiness for change. The findings show that particular forms of PCMH work not only advance patient care in favorable ways but also enhance individual and organizational capacity for adapting to this innovative model and its demands. This knowledge adds to our understanding of how to implement PCMH care in ways that are good for workers, primary care organizations, and patients and offers practical guidance as to which forms of PCMH work should be encouraged, incented, and rewarded.

The design and implementation of GML data management information system based on PostgreSQL

NASA Astrophysics Data System (ADS)

Zhang, Aiguo; Wu, Qunyong; Xu, Qifeng

2008-10-01

GML expresses geographic information in text, and it provides an extensible and standard way of spatial information encoding. At the present time, the management of GML data is in terms of document. By this way, the inquiry and update of GML data is inefficient, and it demands high memory when the document is comparatively large. In this respect, the paper put forward a data management of GML based on PostgreSQL. It designs four kinds of inquiries, which are inquiry of metadata, inquiry of geometry based on property, inquiry of property based on spatial information, and inquiry of spatial data based on location. At the same time, it designs and implements the visualization of the inquired WKT data.

[Lean thinking and brain-dead patient assistance in the organ donation process].

PubMed

Pestana, Aline Lima; dos Santos, José Luís Guedes; Erdmann, Rolf Hermann; da Silva, Elza Lima; Erdmann, Alacoque Lorenzini

2013-02-01

Organ donation is a complex process that challenges health system professionals and managers. This study aimed to introduce a theoretical model to organize brain-dead patient assistance and the organ donation process guided by the main lean thinking ideas, which enable production improvement through planning cycles and the development of a proper environment for successful implementation. Lean thinking may make the process of organ donation more effective and efficient and may contribute to improvements in information systematization and professional qualifications for excellence of assistance. The model is configured as a reference that is available for validation and implementation by health and nursing professionals and managers in the management of potential organ donors after brain death assistance and subsequent transplantation demands.

Instituting organizational learning for quality improvement through strategic planning nominal group processes.

PubMed

White, D B

2000-01-01

Healthcare managers are faced with unprecedented challenges as characterized by managed care constraints, downsizing, increased client needs, and a society demanding more responsive services. Managers must initiate change for quality, efficiency, and survival. This article provides information and strategies for (a) assessing the change readiness of an organization, (b) conducting an organizational diagnosis, (c) instituting a team culture, (d) developing a change strategy, (e) integrating the strategy with a quality improvement process, and (f) identifying the leadership skills to implement organization renewal. Nominal group processes, namely, SWOT and the Search Conference, are described, and case examples are provided. The implementation strategies have been used successfully in a variety of milieus; practical advice for success is described in detail.

Gold and Silver Health Plans: Accommodating Demand Heterogeneity in Managed Competition

PubMed Central

Glazer, Jacob; McGuire, Thomas G.

2011-01-01

New regulation of health insurance markets creates multiple levels of health plans, with designations like “Gold” and “Silver”. The underlying rationale for the heavy-metal approach to insurance regulation is that heterogeneity in demand for health care is not only due to health status (sick demand more than the healthy) but also to other, “taste” related factors (rich demand more than the poor). This paper models managed competition with demand heterogeneity to consider plan payment and enrollee premium policies in relation to efficiency (net consumer benefit) and fairness (the European concept of “solidarity”). Specifically, this paper studies how to implement a “Silver” and “Gold” health plan efficiently and fairly in a managed competition context. We show that there are sharp tradeoffs between efficiency and fairness. When health plans cannot or may not (because of regulation) base premiums on any factors affecting demand, enrollees do not choose the efficient plan. When taste (e.g. income) can be used as a basis of payment, a simple tax can achieve both efficiency and fairness. When only health status (and not taste) can be used as a basis of payment, health status-based taxes and subsidies are required and efficiency can only be achieved with a modified version of fairness we refer to as “weak solidarity.” An overriding conclusion is that the regulation of premiums for both the basic and the higher level plans is necessary for efficiency. PMID:21767887

Smart Grid Risk Management

NASA Astrophysics Data System (ADS)

Abad Lopez, Carlos Adrian

Current electricity infrastructure is being stressed from several directions -- high demand, unreliable supply, extreme weather conditions, accidents, among others. Infrastructure planners have, traditionally, focused on only the cost of the system; today, resilience and sustainability are increasingly becoming more important. In this dissertation, we develop computational tools for efficiently managing electricity resources to help create a more reliable and sustainable electrical grid. The tools we present in this work will help electric utilities coordinate demand to allow the smooth and large scale integration of renewable sources of energy into traditional grids, as well as provide infrastructure planners and operators in developing countries a framework for making informed planning and control decisions in the presence of uncertainty. Demand-side management is considered as the most viable solution for maintaining grid stability as generation from intermittent renewable sources increases. Demand-side management, particularly demand response (DR) programs that attempt to alter the energy consumption of customers either by using price-based incentives or up-front power interruption contracts, is more cost-effective and sustainable in addressing short-term supply-demand imbalances when compared with the alternative that involves increasing fossil fuel-based fast spinning reserves. An essential step in compensating participating customers and benchmarking the effectiveness of DR programs is to be able to independently detect the load reduction from observed meter data. Electric utilities implementing automated DR programs through direct load control switches are also interested in detecting the reduction in demand to efficiently pinpoint non-functioning devices to reduce maintenance costs. We develop sparse optimization methods for detecting a small change in the demand for electricity of a customer in response to a price change or signal from the utility, dynamic learning methods for scheduling the maintenance of direct load control switches whose operating state is not directly observable and can only be inferred from the metered electricity consumption, and machine learning methods for accurately forecasting the load of hundreds of thousands of residential, commercial and industrial customers. These algorithms have been implemented in the software system provided by AutoGrid, Inc., and this system has helped several utilities in the Pacific Northwest, Oklahoma, California and Texas, provide more reliable power to their customers at significantly reduced prices. Providing power to widely spread out communities in developing countries using the conventional power grid is not economically feasible. The most attractive alternative source of affordable energy for these communities is solar micro-grids. We discuss risk-aware robust methods to optimally size and operate solar micro-grids in the presence of uncertain demand and uncertain renewable generation. These algorithms help system operators to increase their revenue while making their systems more resilient to inclement weather conditions.

The planning and implementation of a demand-side management/distribution automation system at Taiwan Power Company

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

Liu, S.S.; Chen, Yun-Wu

1994-12-31

This paper would describe the Taipower`s experience of DSM/DAS development. For the past 5 years, the demand of electricity has maintained a high annual growth rate of 8.45% due to economic prosperity in Taiwan. As the environmental protection consciousness has recently made Taipower difficult to develope and construct new power plants, substations, transmission and distribution lines, and our power grid is an independent system, we do need to concern how to do DSM to manage the load problems. Since 1984, Taipower has established two pilot systems and these systems performed the functions of fault detect and isolation certainly good formore » Distribution Automation. With the rapid development of computer, communication and control technology, the concept of the DAS has gradually been implemented in real cases. Taipower organized an engineering task group to study DAS several years ago, and based on the operation experience of the existing systems, today Taipower is planning to launch a new DAS project for Tai-Chung area. According to Taipower requirements, the DAS will have the functions of feeder automation, automatic meter reading, load management and disteibution system analysis.« less

Life cycle and hydrologic modeling of rainwater harvesting in urban neighborhoods: Implications of urban form and water demand patterns in the US and Spain.

PubMed

Petit-Boix, Anna; Devkota, Jay; Phillips, Robert; Vargas-Parra, María Violeta; Josa, Alejandro; Gabarrell, Xavier; Rieradevall, Joan; Apul, Defne

2018-04-15

Water management plays a major role in any city, but applying alternative strategies might be more or less feasible depending on the urban form and water demand. This paper aims to compare the environmental performance of implementing rainwater harvesting (RWH) systems in American and European cities. To do so, two neighborhoods with a water-stressed Mediterranean climate were selected in contrasting cities, i.e., Calafell (Catalonia, Spain) and Ukiah (California, US). Calafell is a high-density, tourist city, whereas Ukiah is a typical sprawled area. We studied the life cycle impacts of RWH in urban contexts by using runoff modeling before (i.e. business as usual) and after the implementation of this system. In general, cisterns were able to supply >75% of the rainwater demand for laundry and toilet flushing. The exception were multi-story buildings with roofs smaller than 200m 2 , where the catchment area was insufficient to meet demand. The implementation of RWH was environmentally beneficial with respect to the business-as-usual scenario, especially because of reduced runoff treatment needs. Along with soil features, roof area and water demand were major parameters that affected this reduction. RWH systems are more attractive in Calafell, which had 60% lower impacts than in Ukiah. Therefore, high-density areas can potentially benefit more from RWH than sprawled cities. Copyright © 2017 Elsevier B.V. All rights reserved.

[Certified medical centers--A measurable benefit to patients?!].

PubMed

Eberlein-Gonska, Maria; Schellong, Sebastian; Baumann, Michael

2007-01-01

The establishment of medical centers should meet the high requirements of the healthcare system. They should provide innovative solutions for a number of problems, e.g. the interdisciplinary collaboration of various health departments with due regard to their autonomy. This is reminiscent of the implementation and advancement of a quality management system required by law where a clear idea of how to manage the organizational and procedural structures as an integral part of the management concept implemented is missing. The genuine efforts to implement and advance interdisciplinary medical centers are up against "bogus models" created out of sheer marketing interests. The term "medical center" has so far not been protected under trademark law, leaving patients, relatives or even the referring physicians unsure about how to judge a medical center's actual performance. The same is true of certified centers. Their numbers are growing, but not so the transparency about the amount of measurable, traceable and understandable benefits that a certified center provides to the patient. Therefore clear demands need to be placed on certified centers, especially with regard to the implementation of a concept that provides interdisciplinarity and process-oriented transparent structures and defines quality ratios and quality objectives. This includes providing resources for the continuous collection and evaluation of hard and soft data as well as deriving improvement measures. The three centers of the University Hospital Dresden--the University Cancer Center, the University Vascular Center and the University Pain Center--fulfil this high demand. They have created fundamentals for measurable improvement of patient care and are able to present first results.

Time-motion analysis of clinical nursing documentation during implementation of an electronic operating room management system for ophthalmic surgery.

PubMed

Read-Brown, Sarah; Sanders, David S; Brown, Anna S; Yackel, Thomas R; Choi, Dongseok; Tu, Daniel C; Chiang, Michael F

2013-01-01

Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design.

Time-Motion Analysis of Clinical Nursing Documentation During Implementation of an Electronic Operating Room Management System for Ophthalmic Surgery

PubMed Central

Read-Brown, Sarah; Sanders, David S.; Brown, Anna S.; Yackel, Thomas R.; Choi, Dongseok; Tu, Daniel C.; Chiang, Michael F.

2013-01-01

Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design. PMID:24551402

A secure file manager for UNIX

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

DeVries, R.G.

1990-12-31

The development of a secure file management system for a UNIX-based computer facility with supercomputers and workstations is described. Specifically, UNIX in its usual form does not address: (1) Operation which would satisfy rigorous security requirements. (2) Online space management in an environment where total data demands would be many times the actual online capacity. (3) Making the file management system part of a computer network in which users of any computer in the local network could retrieve data generated on any other computer in the network. The characteristics of UNIX can be exploited to develop a portable, secure filemore » manager which would operate on computer systems ranging from workstations to supercomputers. Implementation considerations making unusual use of UNIX features, rather than requiring extensive internal system changes, are described, and implementation using the Cray Research Inc. UNICOS operating system is outlined.« less

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2014 CFR

2014-01-01

... maturities for loans for the implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS... finance working capital required for the initial operation of a new system are a separate class of loans...

7 CFR 1710.105 - State regulatory approvals.

Code of Federal Regulations, 2012 CFR

2012-01-01

... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

7 CFR 1710.105 - State regulatory approvals.

Code of Federal Regulations, 2013 CFR

2013-01-01

... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

7 CFR 1710.105 - State regulatory approvals.

Code of Federal Regulations, 2011 CFR

2011-01-01

... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

7 CFR 1710.105 - State regulatory approvals.

Code of Federal Regulations, 2014 CFR

2014-01-01

... (3) Loans for the purpose of assisting borrowers to implement demand side management and energy conservation programs and on and off grid renewable energy systems. (b) At minimum, in the case of all loans in... to obtain approval of a project or its financing from a state regulatory authority, RUS may require...

Collaborations among Diverse Support Areas for Hybrid Success

ERIC Educational Resources Information Center

Haggar, Faye; Kelley, Bruce; Chen, Weichao

2017-01-01

Successful implementation of hybrid courses typically demands collaboration among diverse support areas on campus. This article examines these collaborations through the lens of Badrul Khan's theory of managing blended learning support. Also discussed is the central role that faculty developers can play in connecting these support areas to ensure…

Web 2.0 Strategy in Libraries and Information Services

ERIC Educational Resources Information Center

Byrne, Alex

2008-01-01

Web 2.0 challenges libraries to change from their predominantly centralised service models with integrated library management systems at the hub. Implementation of Web 2.0 technologies and the accompanying attitudinal shifts will demand reconceptualisation of the nature of library and information service around a dynamic, ever changing, networked,…

A Practical Guide for Building a Digital Library: User-Focused Collection

ERIC Educational Resources Information Center

Zhu, Qin; Guevara, Sophia

2009-01-01

With changing user expectations, many libraries are moving toward digital content. Accessible from anywhere at any time, digital content provides users with efficient, on-demand information experiences. Accordingly, librarians are presented with challenges and opportunities to build, manage, and implement outreach strategies that promote their…

Linking Agricultural Crop Management and Air Quality Models for Regional to National-Scale Nitrogen Assessments

EPA Science Inventory

While nitrogen (N) is an essential element for life, human population growth and demands for energy, transportation and food can lead to excess nitrogen in the environment. A modeling framework is described and implemented to promote a more integrated, process-based and system le...

A Multiagent Energy Management System for a Small Microgrid Equipped with Power Sources and Energy Storage Units

NASA Astrophysics Data System (ADS)

Radziszewska, Weronika; Nahorski, Zbigniew

An Energy Management System (EMS) for a small microgrid is presented, with both demand and production side management. The microgrid is equipped with renewable and controllable power sources (like a micro gas turbine), energy storage units (batteries and flywheels). Energy load is partially scheduled to avoid extreme peaks of power demand and to possibly match forecasted energy supply from the renewable power sources. To balance the energy in the network on line, a multiagent system is used. Intelligent agents of each device are proactively acting towards balancing the energy in the network, and at the same time optimizing the cost of operation of the whole system. A semi-market mechanism is used to match a demand and a production of the energy. Simulations show that the time of reaching a balanced state does not exceed 1 s, which is fast enough to let execute proper balancing actions, e.g. change an operating point of a controllable energy source. Simulators of sources and consumption devices were implemented in order to carry out exhaustive tests.

Energy Management of An Extended Hybrid Renewable Energy System For Isolated Sites Using A Fuzzy Logic Controller

NASA Astrophysics Data System (ADS)

Faquir, Sanaa; Yahyaouy, Ali; Tairi, Hamid; Sabor, Jalal

2018-05-01

This paper presents the implementation of a fuzzy logic controller to manage the flow of energy in an extended hybrid renewable energy system employed to satisfy the load for a wide isolated site at the city of Essaouira in Morocco. To achieve Efficient energy management, the system is combining two important renewable energies: solar and wind. Lithium Ion batteries were also used as storage devices to store the excess of energy provided by the renewable sources or to supply the system with the required energy when the energy delivered by the input sources is not enough to satisfy the load demand. To manage the energy in the system, a controller based on fuzzy logic was implemented. Real data taken from previous research and meteorological sites was used to test the controller.

Joint Real-Time Energy and Demand-Response Management using a Hybrid Coalitional-Noncooperative Game

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

He, Fulin; Gu, Yi; Hao, Jun

In order to model the interactions among utility companies, building demands and renewable energy generators (REGs), a hybrid coalitional-noncooperative game framework has been proposed. We formulate a dynamic non-cooperative game to study the energy dispatch within multiple utility companies, while we take a coalitional perspective on REGs and buildings demands through a hedonic coalition formation game approach. In this case, building demands request different power supply from REGs, then the building demands can be organized into an ultimate coalition structure through a distributed hedonic shift algorithm. At the same time, utility companies can also obtain a stable power generation profile.more » In addition, the interactive progress among the utility companies and building demands which cannot be supplied by REGs is implemented by distributed game theoretic algorithms. Numerical results illustrate that the proposed hybrid coalitional-noncooperative game scheme reduces the cost of both building demands and utility companies compared with the initial scene.« less

ERM for Health Care Organizations: An Economic Enterprise Risk Management Innovation Program (E2RMhealth care).

PubMed

da Silva Etges, Ana Paula Beck; Grenon, Veronique; de Souza, Joana Siqueira; Kliemann Neto, Francisco José; Felix, Elaine Aparecida

2018-05-14

In recent years, health care organizations have looked to enterprise risk management (ERM) for novel systems to obtain more accurate data on which to base risk strategies. This study proposes a conceptual ERM framework specifically designed for health care organizations. We explore how hospitals in the United States and Brazil are structuring and implementing ERM processes within their management structure. This study incorporates interviews with 15 chief risk officers (8 from the United States and 7 from Brazil) with qualitative data analysis using NVivo (QSR International software). The interviews confirm that adopting ERM for health care organizations has gained momentum and become a priority, and that the demand for risk economic assessment orientation is common among health care risk managers. We propose an ERM model for health care (Economic Enterprise Risk Management in Health Care) divided into four maturity levels and complemented by an implementation timeline. The model is accompanied by guidelines to orient the gradual implementation of ERM, including orientation to perform risk economic assessment. Copyright © 2018. Published by Elsevier Inc.

The Climaware project: Impacts of climate change on water resources management - regional strategies and European view

NASA Astrophysics Data System (ADS)

Thirel, Guillaume; D'Agostino, Daniela; Démerliac, Stéphane; Dorchies, David; Flörke, Martina; Jay-Allemand, Maxime; Jost, Claudine; Kehr, Katrin; Perrin, Charles; Scardigno, Alessandra; Schneider, Christof; Theobald, Stephan; Träbing, Klaus

2014-05-01

Climate projections produced with CMIP5 and applied by the Intergovernmental Panel on Climate Change (IPCC) in its fifth assessment report indicate that changes in precipitation and temperature are expected to occur throughout Europe in the 21th century, with a likely decrease of water availability in many regions. Besides, water demand is also expected to increase, in link with these expected climate modifications, but also due to socio-economic and demographic changes. In this respect, the use of future freshwater resources may not be sustainable from the current water management perspective. Therefore adaptation strategies will most likely be needed to cope with these evolutions. In this context, the main objective of the ClimAware project (2010-2013 - www.uni-kassel.de/fb14/wasserbau/CLIMAWARE/, a project implemented within the IWRM-NET Funding Initiative) was to analyse the impacts of climate change (CC) on freshwater resources at the continental and regional scales and to identify efficient adaptation strategies to improve water management for various socio-economic sectors. This should contribute to a more effective implementation of the Water Framework Directive (WFD) and its instruments (river basin management plans, programmes of measures). The project developed integrated measures for improved freshwater management under CC constraints. More specifically, the objectives of the ClimAware project were to: • elaborate quantitative projections of changes in river flows and consequences such as flood frequency, drought occurrence and sectorial water uses. • analyse the effect of CC on the hydromorphological reference conditions of rivers and therefore the definition of "good status". • define management rules/strategies concerning dam management and irrigation practices on different time perspectives. • investigate uncertainties in climate model - scenario combinations. The research approach considered both European and regional perspectives, to get an integrated analysis across different spatial scales. To fulfil the objectives of the ClimAware project, the following modelling methodology was implemented. Starting from a European modelling approach of water availability and use based on the WaterGAP3 model, the changes in the hydrologic regimes and water use of different sectors were analysed. Subsequently three case studies were used to investigate the impacts of CC at a regional scale. Regional models from three different countries and focusing on three types of water management issues were developed: • Hydromorphology (Eder basin, Germany): By using different scenarios, the influence of CC on the hydromorphological characteristics of the River Weser according to the WFD was evaluated and proposals for implementation were given. The objective was to examine, on typical river sections, how the WFD objectives can be implemented under CC constraints. • Dam management (Seine basin, France): Water management on the River Seine for water supply and flood alleviation is partly based on the management of artificial reservoirs. The case study developed scenarios linking the impact of CC on water resources and the expected change on the uses and on the management of the system. • Agricultural water use (Apulia region, Italy): In this region, economic and demographic changes cause an increase in the demand for good-quality municipal and industrial water. Besides, changes in the agricultural practices increase the demand for water in the agricultural sector. Since water is scarce in this region, the study focuses on the agricultural sector, which has the largest water saving potential. The final assessment comprises a cross-scale integration between the European and regional modelling frameworks in order to facilitate knowledge transfer and to help establishing sustainable and integrated water resources management plans.

Hospital customer service in a changing healthcare world: does it matter?

PubMed

Howard, J

1999-01-01

The healthcare industry is undergoing a rapid transformation to meet the ever-increasing needs and demands of the patient population. Employers and health plans such as HMOs are demanding better service and higher quality care, and hospitals are trying to tackle reimbursement cutbacks, streamline services, and serve a diverse population. Hospitals have begun to realize that to overcome these obstacles and meet the needs of the health care plans and consumers, they must focus on the demands of the customer. Customer service initiatives increase patient satisfaction and loyalty and overall hospital quality, and many hospitals have found that consumer demands can be met through initiating and maintaining a customer service program. This article describes how the administrator can create, implement, and manage customer service initiatives within the hospital.

Integrated care management: aligning medical call centers and nurse triage services.

PubMed

Kastens, J M

1998-01-01

Successful integrated delivery systems must aggressively design new approaches to managing patient care. Implementing a comprehensive care management model to coordinate patient care across the continuum is essential to improving patient care and reducing costs. The practice of telephone nursing and the need for experienced registered nurses to staff medical call centers, nurse triage centers, and outbound telemanagement is expanding as the penetration of full-risk capitated managed care contracts are signed. As health systems design their new care delivery approaches and care management models, medical call centers will be an integral approach to managing demand for services, chronic illnesses, and prevention strategies.

Self-rostering and psychosocial work factors - a mixed methods intervention study.

PubMed

Hansen, Åse Marie; Nabe-Nielsen, Kirsten; Albertsen, Karen; Hogh, Annie; Lund, Henrik; Hvid, Helge; Garde, Anne Helene

2015-03-01

This study aims at 1) examining the effect of self-rostering on emotional demands, quantitative demands, work pace, influence, social community at work, social support from leaders and colleagues, job satisfaction, and negative acts, 2) examining whether this effect was mediated through increased influence on the scheduling of working hours, and interpreting the results in light of the different implementation processes that emerged in the study and by including qualitative data. We conducted a 12 months follow-up, quasi-experimental study of self-rostering among 28 workplaces out of which 14 served as reference workplaces. We also interviewed 26 employees and 14 managers about their expectations of introducing self-rostering. In the present study implementation of self-rostering had a positive effect on job demands and the social environment of the workplace, especially if the intervention does not comprise drastic changes of the organisation of the employees' work and private life. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Operational considerations for implementing regional sediment management plans in the northern Gulf of Mexico

USGS Publications Warehouse

Underwood, Steven G.; Khalil, Syed M.; Byrnes, Mark R.; Steyer, Gregory D.; Raynie, Richard C

2015-01-01

Development of a comprehensive and stakeholder-driven Regional Sediment Management plan can provide the basis for long-term sustainable resource use and protection. This paper highlights three operational components that can positively influence sediment management at a regional scale, including (1) integration of an operational sediment budget, (2) development of a monitoring and adaptive management plan, and (3) development of a regional sediment availability and allocation program. These components seek to incorporate science and adaptive management through implementation of an organized and well-documented decision making process. They represent a coordinated framework that could serve as a guide for unifying financial investments in regional sediment management plans. Collectively, they establish an integrated process for addressing uncertainties about future system change in light of shrinking federal and state budgets, competing demands for sediment resources within riverine and marine waters, and policy considerations related to sediment/water use (e.g., navigation and commerce versus environmental management).

Smart Grid Development: Multinational Demo Project Analysis

NASA Astrophysics Data System (ADS)

Oleinikova, I.; Mutule, A.; Obushevs, A.; Antoskovs, N.

2016-12-01

This paper analyses demand side management (DSM) projects and stakeholders' experience with the aim to develop, promote and adapt smart grid tehnologies in Latvia. The research aims at identifying possible system service posibilites, including demand response (DR) and determining the appropriate market design for such type of services to be implemented at the Baltic power system level, with the cooperation of distribution system operator (DSO) and transmission system operator (TSO). This paper is prepared as an extract from the global smart grid best practices, smart solutions and business models.

The documentation of pain management during aeromedical evacuation missions.

PubMed

Lamb, Di

2010-06-01

Modern warfare has generated a significant increase in blast injuries, which demand careful management during planning and while undertaking air transfer. Pain management following multiple injuries can be challenging even when a patient is cared for in a stationary health care setting; this is further complicated by the additional stressors of flight. This article describes health care governance initiatives implemented by the Aeromedical Evacuation Squadron, based at Royal Air Force (RAF), United Kingdom. It focuses on quality and performance improvements via a program of clinical-effectiveness auditing. Copyright (c) 2010. Published by Elsevier Inc.

Veterans Health Administration Office of Nursing Services exploration of positive patient care synergies fueled by consumer demand: care coordination, advanced clinic access, and patient self-management.

PubMed

Wertenberger, Sydney; Yerardi, Ruth; Drake, Audrey C; Parlier, Renee

2006-01-01

The consumers who utilize the Veterans Health Administration healthcare system are older, and most are learning to live with chronic diseases. Their desires and needs have driven changes within the Veterans Health Administration. Through patient satisfaction initiatives and other feedback sources, consumers have made it clear that they do not want to wait for their care, they want a say in what care is provided to them, and they want to remain as independent as possible. Two interdisciplinary processes/models of healthcare are being implemented on the national level to address these issues: advanced clinic access and care coordination. These programs have a synergistic relationship and are integrated with patient self-management initiatives. Positive outcomes of these programs also meet the needs of our staff. As these new processes and programs are implemented nationwide, skills of both patients and nursing staff who provide their care need to be enhanced to meet the challenges of providing nursing care now and into the 21st century. Veterans Health Administration Office of Nursing Services Strategic Planning Work Group is defining and implementing processes/programs to ensure nurses have the knowledge, information, and skills to meet these patient care demands at all levels within the organization.

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2012 CFR

2012-01-01

... implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS. Due to the uncertainty of... operation of a new system are a separate class of loans and usually have a final maturity of less than 10...

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2013 CFR

2013-01-01

... implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS. Due to the uncertainty of... operation of a new system are a separate class of loans and usually have a final maturity of less than 10...

7 CFR 1710.115 - Final maturity.

Code of Federal Regulations, 2011 CFR

2011-01-01

... implementation of programs for demand side management and energy resource conservation and on and off grid renewable energy sources not owned by the borrower will be determined by RUS. Due to the uncertainty of... operation of a new system are a separate class of loans and usually have a final maturity of less than 10...

Multiscale socioeconomic assessment across large ecosystems: lessons from practice

Treesearch

Rebecca J. McLain; Ellen M. Donoghue; Jonathan Kusel; Lita Buttolph; Susan Charnley

2008-01-01

Implementation of ecosystem management projects has created a demand for socioeconomic assessments to predict or evaluate the impacts of ecosystem policies. Social scientists for these assessments face challenges that, although not unique to such projects, are more likely to arise than in smaller scale ones. This article summarizes lessons from our experiences with...

Attaining Visual Literacy Using Simplified Graphics in Industry.

ERIC Educational Resources Information Center

Burton, Terry

In the current milieu of ISO 9000 certification, just-in-time engineering (JIT), demand flow technology (DFT), and total quality management (TQM), industry is attempting to implement available technology for the creation, control, and delivery of documentation. In most cases, their efforts are in need of outside resources to analyze, develop,…

Staff perceptions of leadership during implementation of task-shifting in three surgical units.

PubMed

Henderson, Amanda; Paterson, Karyn; Burmeister, Liz; Thomson, Bernadette; Young, Louise

2013-03-01

Registered nurses are difficult to recruit and retain. Task shifting, which involves reallocation of delegation, can reduce demand for registered nurses. Effective leadership is needed for successful task shifting. This study explored leadership styles of three surgical nurse unit managers. Staff completed surveys before and after the implementation of task shifting. Task shifting involved the introduction of endorsed enrolled nurses (licensed nurses who must practise under registered nurse supervision) to better utilize registered nurses. Implementation of task shifting occurred over 4 months in a 700-bed tertiary hospital, in southeast Queensland, Australia. A facilitator assisted nurse unit managers during implementation. The impact was assessed by comparison of data before (n = 49) and after (n = 72) task shifting from registered nurses and endorsed enrolled nurses (n = 121) who completed the Ward Organization Features Survey. Significant differences in leadership and staff organization subscales across the settings suggest that how change involving task shifting is implemented influences nurses' opinions of leadership. Leadership behaviours of nurse unit managers is a key consideration in managing change such as task shifting. Consistent and clear messages from leaders about practice change are viewed positively by nursing staff. In the short term, incremental change possibly results in staff maintaining confidence in leadership. © 2012 Blackwell Publishing Ltd.

Electric load management and energy conservation

NASA Technical Reports Server (NTRS)

Kheir, N. A.

1976-01-01

Electric load management and energy conservation relate heavily to the major problems facing power industry at present. The three basic modes of energy conservation are identified as demand reduction, increased efficiency and substitution for scarce fuels. Direct and indirect load management objectives are to reduce peak loads and have future growth in electricity requirements in such a manner to cause more of it to fall off the system's peak. In this paper, an overview of proposed and implemented load management options is presented. Research opportunities exist for the evaluation of socio-economic impacts of energy conservation and load management schemes specially on the electric power industry itself.

Strategic and Operational Considerations for the Implementation of Performance Based Logistics (PBL) Within the Japan Maritime Self Defense Force

DTIC Science & Technology

2010-06-01

logistics in support of weapon systems (D-2004-110). Washington, DC: Young , S. R. Keating , S., & Huff, K. (2005). Managing risk in the new supply chain...implementing PBL ( Keating & Huff, 2005; Reeve, 2001). Cohen (2007) found that cost-sharing support and maintenance services can generate "up to seven times as...to suppliers (Cohen, 2007; Keating & Huff, 2005); therefore, suppliers demand a risk premium (Cohen, & Nines, 2008). The degree of risk

Dryden Flight Research Center Critical Chain Project Management Implementation

NASA Technical Reports Server (NTRS)

Hines, Dennis O.

2012-01-01

In Fiscal Year 2011 Dryden Flight Research Center (DFRC) implemented a new project management system called Critical Chain Project Management (CCPM). Recent NASA audits have found that the Dryden workforce is strained under increasing project demand and that multi-tasking has been carried to a whole new level at Dryden. It is very common to have an individual work on 10 different projects during a single pay period. Employee surveys taken at Dryden have identified work/life balance as the number one issue concerning employees. Further feedback from the employees indicated that project planning is the area needing the most improvement. In addition, employees have been encouraged to become more innovative, improve job skills, and seek ways to improve overall job efficiency. In order to deal with these challenges, DFRC management decided to adopt the CCPM system that is specifically designed to operate in a resource constrained multi-project environment. This paper will discuss in detail the rationale behind the selection of CCPM and the goals that will be achieved through this implementation. The paper will show how DFRC is tailoring the CCPM system to the flight research environment as well as laying out the implementation strategy. Results of the ongoing implementation will be discussed as well as change management challenges and organizational cultural changes. Finally this paper will present some recommendations on how this system could be used by selected NASA projects or centers.

Analysis of human tissue management models for medical research: preparation for implementation of the 2012 revision of the Bioethics and Safety Act of Korea.

PubMed

Ryu, Young-Joon; Kim, Hankyeom; Jang, Sejin; Koo, Young-Mo

2013-06-01

Efficient management of human tissue samples is a critical issue; the supply of samples is unable to satisfy the current demands for research. Lack of informed consent is also an ethical problem. One of the goals of the 2012 revision of Korea's Bioethics and Safety Act was to implement regulations that govern the management of human tissue samples. To remain competitive, medical institutions must prepare for these future changes. In this report, we review two tissue management models that are currently in use; model 1 is the most common system utilized by hospitals in Korea and model 2 is implemented by some of the larger institutions. We also propose three alternative models that offer advantages over the systems currently in use. Model 3 is a multi-bank model that protects the independence of physicians and pathologists. Model 4 utilizes a comprehensive single bioresource bank; although in this case, the pathologists gain control of the samples, which may make it difficult to implement. Model 5, which employs a bioresource utilization steering committee (BUSC), is viable to implement and still maintains the advantages of Model 4. To comply with the upcoming law, we suggest that physicians and pathologists in an institution should collaborate to choose one of the improved models of tissue management system that best fits for their situation.

Comparison of groundwater flow in Southern California coastal aquifers

USGS Publications Warehouse

Hanson, Randall T.; Izbicki, John A.; Reichard, Eric G.; Edwards, Brian D.; Land, Michael; Martin, Peter

2009-01-01

Maintaining the sustainability of Southern California coastal aquifers requires joint management of surface water and groundwater (conjunctive use). This requires new data collection and analyses (including research drilling, modern geohydrologic investigations, and development of detailed computer groundwater models that simulate the supply and demand components separately), implementation of new facilities (including spreading and injection facilities for artificial recharge), and establishment of new institutions and policies that help to sustain the water resources and better manage regional development.

Implementation strategies influence the structure, process and outcome of quality systems: an empirical study of hospital departments in Sweden.

PubMed

Kunkel, S; Rosenqvist, U; Westerling, R

2009-02-01

To analyse whether the organisation of quality systems (structure, process, and outcome) is related to how these systems were implemented (implementation prerequisites, cooperation between managers and staff, and source of initiative). A questionnaire was developed, piloted and distributed to 600 hospital departments. Questions were included to reflect implementation prerequisites (adequate resources, competence, problem-solving capacity and high expectations), cooperative implementation, source of initiative (manager, staff and purchaser), structure (resources and administration), process (culture and cooperation) and outcome (goal evaluation and competence development). The adjusted response rate was 75%. Construct validity and reliability was assessed by confirmatory factor analysis, and Cronbach alpha scores were calculated. The relationships among the variables were analysed with structural equation modelling with LISREL. Implementation prerequisites were highly related to structure (0.51) and process (0.33). Cooperative implementation was associated with process (0.26) and outcome (0.34). High manager initiative was related to structure (0.19) and process (0.17). The numbers in parentheses can be interpreted as correlations. Construct validity was good, and reliability was excellent for all factors (Cronbach alpha>0.78). The model was a good representation of reality (model fit p value = 0.082). The implementation of organisationally demanding quality systems may require managers to direct and lead the process while assuring that their staff get opportunities to contribute to the planning and designing of the new system. This would correspond to a cooperative implementation strategy rather than to top-down or bottom-up strategies. The results of this study could be used to adjust implementation processes.

Total quality management in the hospital setting.

PubMed

Ernst, D F

1994-01-01

With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

Making Medicare Advantage a Middle-Class Program

PubMed Central

Glazer, Jacob; McGuire, Thomas

2013-01-01

This paper studies the role of Medicare's premium policy in sorting beneficiaries between traditional Medicare (TM) and managed care plans in the Medicare Advantage (MA) program. Beneficiaries vary in their demand for care. TM fully accommodates demand but creates a moral hazard inefficiency. MA rations care but disregards some elements of the demand. We describe an efficient assignment of beneficiaries to these two options, and argue that efficiency requires an MA program oriented to serve the large middle part of the distribution of demand: the “middle class.” Current Medicare policy of a “single premium” for MA plans cannot achieve efficient sorting. We characterize the demand-based premium policy that can implement the efficient assignment of enrollees to plans. If only a single premium is feasible, the second-best policy involves too many of the low-demand individuals in MA and a too low level of services relative to the first best. We identify approaches to using premium policy to revitalize MA and improve the efficiency of Medicare. PMID:23454916

Making Medicare advantage a middle-class program.

PubMed

Glazer, Jacob; McGuire, Thomas G

2013-03-01

This paper studies the role of Medicare's premium policy in sorting beneficiaries between traditional Medicare (TM) and managed care plans in the Medicare advantage (MA) program. Beneficiaries vary in their demand for care. TM fully accommodates demand but creates a moral hazard inefficiency. MA rations care but disregards some elements of the demand. We describe an efficient assignment of beneficiaries to these two options, and argue that efficiency requires an MA program oriented to serve the large middle part of the distribution of demand: the "middle class." Current Medicare policy of a "single premium" for MA plans cannot achieve efficient sorting. We characterize the demand-based premium policy that can implement the efficient assignment of enrollees to plans. If only a single premium is feasible, the second-best policy involves too many of the low-demand individuals in MA and a too low level of services relative to the first best. We identify approaches to using premium policy to revitalize MA and improve the efficiency of Medicare. Copyright © 2012 Elsevier B.V. All rights reserved.

Creating pharmacy staffing-to-demand models: predictive tools used at two institutions.

PubMed

Krogh, Paul; Ernster, Jason; Knoer, Scott

2012-09-15

The creation and implementation of data-driven staffing-to-demand models at two institutions are described. Predictive workload tools provide a guideline for pharmacy managers to adjust staffing needs based on hospital volume metrics. At Abbott Northwestern Hospital, management worked with the department's staff and labor management committee to clearly outline the productivity monitoring system and the process for reducing hours. Reference charts describing the process for reducing hours and a form to track the hours of involuntary reductions for each employee were created to further enhance communication, explain the rationale behind the new process, and promote transparency. The University of Minnesota Medical Center-Fairview, found a strong correlation between measured pharmacy workload and an adjusted census formula. If the daily census and admission report indicate that the adjusted census will provide enough workload for the fully staffed department, no further action is needed. If the census report indicates the adjusted census is less than the breakeven point, staff members are asked to leave work, either voluntarily or involuntarily. The opposite holds true for days when the adjusted census is higher than the breakeven point, at which time additional staff are required to synchronize worked hours with predicted workload. Successful staffing-to- demand models were implemented in two hospital pharmacies. Financial savings, as indicated by decreased labor costs secondary to reduction of staffed shifts, were approximately $42,000 and $45,500 over a three-month period for Abbott Northwestern Hospital and the University of Minnesota Medical Center-Fairview, respectively. Maintenance of 100% productively allowed the departments to continue to replace vacant positions and avoid permanent staff reductions.

Efficient methods and readily customizable libraries for managing complexity of large networks.

PubMed

Dogrusoz, Ugur; Karacelik, Alper; Safarli, Ilkin; Balci, Hasan; Dervishi, Leonard; Siper, Metin Can

2018-01-01

One common problem in visualizing real-life networks, including biological pathways, is the large size of these networks. Often times, users find themselves facing slow, non-scaling operations due to network size, if not a "hairball" network, hindering effective analysis. One extremely useful method for reducing complexity of large networks is the use of hierarchical clustering and nesting, and applying expand-collapse operations on demand during analysis. Another such method is hiding currently unnecessary details, to later gradually reveal on demand. Major challenges when applying complexity reduction operations on large networks include efficiency and maintaining the user's mental map of the drawing. We developed specialized incremental layout methods for preserving a user's mental map while managing complexity of large networks through expand-collapse and hide-show operations. We also developed open-source JavaScript libraries as plug-ins to the web based graph visualization library named Cytsocape.js to implement these methods as complexity management operations. Through efficient specialized algorithms provided by these extensions, one can collapse or hide desired parts of a network, yielding potentially much smaller networks, making them more suitable for interactive visual analysis. This work fills an important gap by making efficient implementations of some already known complexity management techniques freely available to tool developers through a couple of open source, customizable software libraries, and by introducing some heuristics which can be applied upon such complexity management techniques to ensure preserving mental map of users.

Dispatch Strategy Development for Grid-tied Household Energy Systems

NASA Astrophysics Data System (ADS)

Cardwell, Joseph

The prevalence of renewable generation will increase in the next several decades and offset conventional generation more and more. Yet this increase is not coming without challenges. Solar, wind, and even some water resources are intermittent and unpredictable, and thereby create scheduling challenges due to their inherent "uncontrolled" nature. To effectively manage these distributed renewable assets, new control algorithms must be developed for applications including energy management, bridge power, and system stability. This can be completed through a centralized control center though efforts are being made to parallel the control architecture with the organization of the renewable assets themselves--namely, distributed controls. Building energy management systems are being employed to control localized energy generation, storage, and use to reduce disruption on the net utility load. One such example is VOLTTRONTM, an agent-based platform for building energy control in real time. In this thesis, algorithms developed in VOLTTRON simulate a home energy management system that consists of a solar PV array, a lithium-ion battery bank, and the grid. Dispatch strategies are implemented to reduce energy charges from overall consumption (/kWh) and demand charges (/kW). Dispatch strategies for implementing storage devices are tuned on a month-to-month basis to provide a meaningful economic advantage under simulated scenarios to explore algorithm sensitivity to changing external factors. VOLTTRON agents provide automated real-time optimization of dispatch strategies to efficiently manage energy supply and demand, lower consumer costs associated with energy usage, and reduce load on the utility grid.

Systems Modelling of the Socio-Technical Aspects of Residential Electricity Use and Network Peak Demand.

PubMed

Lewis, Jim; Mengersen, Kerrie; Buys, Laurie; Vine, Desley; Bell, John; Morris, Peter; Ledwich, Gerard

2015-01-01

Provision of network infrastructure to meet rising network peak demand is increasing the cost of electricity. Addressing this demand is a major imperative for Australian electricity agencies. The network peak demand model reported in this paper provides a quantified decision support tool and a means of understanding the key influences and impacts on network peak demand. An investigation of the system factors impacting residential consumers' peak demand for electricity was undertaken in Queensland, Australia. Technical factors, such as the customers' location, housing construction and appliances, were combined with social factors, such as household demographics, culture, trust and knowledge, and Change Management Options (CMOs) such as tariffs, price, managed supply, etc., in a conceptual 'map' of the system. A Bayesian network was used to quantify the model and provide insights into the major influential factors and their interactions. The model was also used to examine the reduction in network peak demand with different market-based and government interventions in various customer locations of interest and investigate the relative importance of instituting programs that build trust and knowledge through well designed customer-industry engagement activities. The Bayesian network was implemented via a spreadsheet with a tickbox interface. The model combined available data from industry-specific and public sources with relevant expert opinion. The results revealed that the most effective intervention strategies involve combining particular CMOs with associated education and engagement activities. The model demonstrated the importance of designing interventions that take into account the interactions of the various elements of the socio-technical system. The options that provided the greatest impact on peak demand were Off-Peak Tariffs and Managed Supply and increases in the price of electricity. The impact in peak demand reduction differed for each of the locations and highlighted that household numbers, demographics as well as the different climates were significant factors. It presented possible network peak demand reductions which would delay any upgrade of networks, resulting in savings for Queensland utilities and ultimately for households. The use of this systems approach using Bayesian networks to assist the management of peak demand in different modelled locations in Queensland provided insights about the most important elements in the system and the intervention strategies that could be tailored to the targeted customer segments.

Systems Modelling of the Socio-Technical Aspects of Residential Electricity Use and Network Peak Demand

PubMed Central

Lewis, Jim; Mengersen, Kerrie; Buys, Laurie; Vine, Desley; Bell, John; Morris, Peter; Ledwich, Gerard

2015-01-01

Provision of network infrastructure to meet rising network peak demand is increasing the cost of electricity. Addressing this demand is a major imperative for Australian electricity agencies. The network peak demand model reported in this paper provides a quantified decision support tool and a means of understanding the key influences and impacts on network peak demand. An investigation of the system factors impacting residential consumers’ peak demand for electricity was undertaken in Queensland, Australia. Technical factors, such as the customers’ location, housing construction and appliances, were combined with social factors, such as household demographics, culture, trust and knowledge, and Change Management Options (CMOs) such as tariffs, price, managed supply, etc., in a conceptual ‘map’ of the system. A Bayesian network was used to quantify the model and provide insights into the major influential factors and their interactions. The model was also used to examine the reduction in network peak demand with different market-based and government interventions in various customer locations of interest and investigate the relative importance of instituting programs that build trust and knowledge through well designed customer-industry engagement activities. The Bayesian network was implemented via a spreadsheet with a tickbox interface. The model combined available data from industry-specific and public sources with relevant expert opinion. The results revealed that the most effective intervention strategies involve combining particular CMOs with associated education and engagement activities. The model demonstrated the importance of designing interventions that take into account the interactions of the various elements of the socio-technical system. The options that provided the greatest impact on peak demand were Off-Peak Tariffs and Managed Supply and increases in the price of electricity. The impact in peak demand reduction differed for each of the locations and highlighted that household numbers, demographics as well as the different climates were significant factors. It presented possible network peak demand reductions which would delay any upgrade of networks, resulting in savings for Queensland utilities and ultimately for households. The use of this systems approach using Bayesian networks to assist the management of peak demand in different modelled locations in Queensland provided insights about the most important elements in the system and the intervention strategies that could be tailored to the targeted customer segments. PMID:26226511

Design and Implementation of Demand Response Information Interactive Service Platform Based on “Internet Plus” Smart Energy

NASA Astrophysics Data System (ADS)

Cui, Gaoying; Fan, Jie; Qin, Yuchen; Wang, Dong; Chen, Guangyan

2017-05-01

In order to promote the effective use of demand response load side resources, promote the interaction between supply and demand, enhance the level of customer service and achieve the overall utilization of energy, this paper briefly explain the background significance of design demand response information platform and current situation of domestic and foreign development; Analyse the new demand of electricity demand response combined with the application of Internet and big data technology; Design demand response information platform architecture, construct demand responsive system, analyse process of demand response strategy formulate and intelligent execution implement; study application which combined with the big data, Internet and demand response technology; Finally, from information interaction architecture, control architecture and function design perspective design implementation of demand response information platform, illustrate the feasibility of the proposed platform design scheme implemented in a certain extent.

Strategic Energy Management Plan for the Santa Ynez Band of Chumash Indians

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

Davenport, Lars; Smythe, Louisa; Sarquilla, Lindsey

2015-03-27

This plan outlines the Santa Ynez Band of Chumash Indians’ comprehensive energy management strategy including an assessment of current practices, a commitment to improving energy performance and reducing overall energy use, and recommended actions to achieve these goals. Vision Statement The primary objective of the Strategic Energy Management Plan is to implement energy efficiency, energy security, conservation, education, and renewable energy projects that align with the economic goals and cultural values of the community to improve the health and welfare of the tribe. The intended outcomes of implementing the energy plan include job creation, capacity building, and reduced energy costsmore » for tribal community members, and tribal operations. By encouraging energy independence and local power production the plan will promote self-sufficiency. Mission & Objectives The Strategic Energy Plan will provide information and suggestions to guide tribal decision-making and provide a foundation for effective management of energy resources within the Santa Ynez Band of Chumash Indians (SYBCI) community. The objectives of developing this plan include; Assess current energy demand and costs of all tribal enterprises, offices, and facilities; Provide a baseline assessment of the SYBCI’s energy resources so that future progress can be clearly and consistently measured, and current usage better understood; Project future energy demand; Establish a system for centralized, ongoing tracking and analysis of tribal energy data that is applicable across sectors, facilities, and activities; Develop a unifying vision that is consistent with the tribe’s long-term cultural, social, environmental, and economic goals; Identify and evaluate the potential of opportunities for development of long-term, cost effective energy sources, such as renewable energy, energy efficiency and conservation, and other feasible supply- and demand-side options; and Build the SYBCI’s capacity for understanding, managing, and developing energy resources by identifying training, distribution of information materials, and community meeting needs and opportunities« less

Regional Renewable Energy Cooperatives

NASA Astrophysics Data System (ADS)

Hazendonk, P.; Brown, M. B.; Byrne, J. M.; Harrison, T.; Mueller, R.; Peacock, K.; Usher, J.; Yalamova, R.; Kroebel, R.; Larsen, J.; McNaughton, R.

2014-12-01

We are building a multidisciplinary research program linking researchers in agriculture, business, earth science, engineering, humanities and social science. Our goal is to match renewable energy supply and reformed energy demands. The program will be focused on (i) understanding and modifying energy demand, (ii) design and implementation of diverse renewable energy networks. Geomatics technology will be used to map existing energy and waste flows on a neighbourhood, municipal, and regional level. Optimal sites and combinations of sites for solar and wind electrical generation (ridges, rooftops, valley walls) will be identified. Geomatics based site and grid analyses will identify best locations for energy production based on efficient production and connectivity to regional grids and transportation. Design of networks for utilization of waste streams of heat, water, animal and human waste for energy production will be investigated. Agriculture, cities and industry produce many waste streams that are not well utilized. Therefore, establishing a renewable energy resource mapping and planning program for electrical generation, waste heat and energy recovery, biomass collection, and biochar, biodiesel and syngas production is critical to regional energy optimization. Electrical storage and demand management are two priorities that will be investigated. Regional scale cooperatives may use electric vehicle batteries and innovations such as pump storage and concentrated solar molten salt heat storage for steam turbine electrical generation. Energy demand management is poorly explored in Canada and elsewhere - our homes and businesses operate on an unrestricted demand. Simple monitoring and energy demand-ranking software can easily reduce peaks demands and move lower ranked uses to non-peak periods, thereby reducing the grid size needed to meet peak demands. Peak demand strains the current energy grid capacity and often requires demand balancing projects and infrastructure that is highly inefficient due to overall low utilization.

[Development and application of a medical device maintenance information platform based on BS architecture].

PubMed

Liu, Shenglin; Zhang, Xutian; Wang, Guohong; Zhang, Qiang

2012-03-01

Based on specified demands on medical devices maintenance for clinical engineers and Browser/Server architecture technology, a medical device maintenance information platform was developed, which implemented the following modules such as repair, preventive maintenance, accessories management, training, document, system management and regional cooperation. The characteristics of this system were summarized and application in increase of repair efficiency, improvement of preventive maintenance and cost control was introduced. The application of this platform increases medical device maintenance service level.

Efforts to improve patient safety in large, capitated medical groups: description and conceptual model.

PubMed

Miller, Robert H; Bovbjerg, Randall R

2002-06-01

Medical care should be safer. Inpatient problems and solutions have received the most attention; this outpatient qualitative case study addresses a gap in knowledge. We describe safety improvements among large physician groups, model the key influences on their behavior, and identify beneficial public and private policies. All groups were trying to reduce medical injury, which was part of the sample design. The most commonly targeted problems are those that are similar across groups: shortcomings in diagnosis, abnormal tests follow-up, scope of practice and referral patterns, and continuity of care. Medical group innovators vary greatly, however, in implementation of improvements, that is, in the extent to which they implement process changes that identify events/problems, analyze and track incidents, decide how to change clinical and administrative practices, and monitor impacts of the changes. Our conceptual model identifies key determinants: (1) demand for safety comes from external factors: legal, market, and professional; (2) organizational responses depend on internal factors: group size, scope, and integration; leadership and governance; professional culture; information-system assets; and financial and intellectual capital. Further, safety is an aspect of quality (the same tools, decision making, interventions, and monitoring apply), and safety management benefits from prior efficiency management (similar skills and culture of innovation). Observed variation in even simple safeguards shows that existing safety incentives are too weak. Our model suggests that the biggest improvement would come from boosting the demand for quality and safety from both private and public larger group purchasers. Current policy relies too much on litigation and discipline, which have sometimes helped, but not solved, problems because they are inefficient, tend to drive needed information underground, and complicate needed cultural change. Patients' safety demand is also weak for want of information and market power. Big purchasers' demands, however, quickly influence the internal environment of medical groups, helping managers advance quality safety toward the top of groups' congested decision-making "queues."

Integrated water resources management using engineering measures

NASA Astrophysics Data System (ADS)

Huang, Y.

2015-04-01

The management process of Integrated Water Resources Management (IWRM) consists of aspects of policies/strategies, measures (engineering measures and non-engineering measures) and organizational management structures, etc., among which engineering measures such as reservoirs, dikes, canals, etc., play the backbone that enables IWRM through redistribution and reallocation of water in time and space. Engineering measures are usually adopted for different objectives of water utilization and water disaster prevention, such as flood control and drought relief. The paper discusses the planning and implementation of engineering measures in IWRM of the Changjiang River, China. Planning and implementation practices of engineering measures for flood control and water utilization, etc., are presented. Operation practices of the Three Gorges Reservoir, particularly the development and application of regulation rules for flood management, power generation, water supply, ecosystem needs and sediment issues (e.g. erosion and siltation), are also presented. The experience obtained in the implementation of engineering measures in Changjiang River show that engineering measures are vital for IWRM. However, efforts should be made to deal with changes of the river system affected by the operation of engineering measures, in addition to escalatory development of new demands associated with socio-economic development.

Building an Efficient and Effective Test Management System in an ODL Institution

ERIC Educational Resources Information Center

Yusof, Safiah Md; Lim, Tick Meng; Png, Leo; Khatab, Zainuriyah Abd; Singh, Harvinder Kaur Dharam

2017-01-01

Open University Malaysia (OUM) is progressively moving towards implementing assessment on demand and online assessment. This move is deemed necessary for OUM to continue to be the leading provider of flexible learning. OUM serves a very large number of students each semester and these students are vastly distributed throughout the country. As the…

An Internal, Demand-Side Approach Toward Implementing Strategic Sourcing: Political, Legal, and Economic Considerations

DTIC Science & Technology

2013-04-01

Architecture, DASN (RDT&E)  Program Executive Officer, Littoral Combat Ships James B. Greene Jr. Keith F. Snider, PhD Rear Admiral, U.S. Navy (Ret...Personnel Management. Andreski, S. (1994). Max Weber’s insights and errors. London, UK: Routledge & Kegan Paul. Chan, T. C. T., & Chin, K. S. (2007

Fostering the Development and Implementation of Principles for Managing Ethics in Higher Education Institutions: An International Comparative Perspective

ERIC Educational Resources Information Center

Marmolejo, Francisco

2006-01-01

In today's world, higher education faces important opportunities and challenges, many of which are new and unexpected. The increased complexity of higher education institutions themselves is reflected in the expansion of their roles and responsibilities. These roles and responsibilities include: greater demands for regional engagement and other…

Green Infrastructure Management Techniques in Arid and Semi-arid Regions: Software Implementation and Demonstration using the AGWA/KINEROS2 Watershed Model

EPA Science Inventory

Increasing urban development in the arid and semi-arid regions of the southwestern United States has led to greater demand for water in a region with limited water resources and has fundamentally altered the hydrologic response of developed watersheds. Green Infrastructure (GI) p...

Representing Green Infrastructure Management Techniques in Arid and Semi-arid Regions: Software Implementation and Demonstration using the AGWA/KINEROS2 Watershed Model

EPA Science Inventory

Increasing urban development in the arid and semi-arid regions of the southwestern United States has led to greater demand for water from a region of limited water resources which has fundamentally altered the hydrologic response of developed watersheds. Green Infrastructure (GI)...

Improving regulatory capacity to manage risks associated with trade agreements.

PubMed

Walls, Helen L; Smith, Richard D; Drahos, Peter

2015-03-21

Modern trade negotiations have delivered a plethora of bilateral and regional preferential trade agreements (PTAs), which involve considerable risk to public health, thus placing demands on governments to strengthen administrative regulatory capacities in regard to the negotiation, implementation and on-going management of PTAs. In terms of risk management, the administrative regulatory capacity requisite for appropriate negotiation of PTAs is different to that for the implementation or on-going management of PTAs, but at all stages the capacity needed is expensive, skill-intensive and requires considerable infrastructure, which smaller and poorer states especially struggle to find. It is also a task generally underestimated. If states do not find ways to increase their capacities then PTAs are likely to become much greater drivers of health inequities. Developing countries especially struggle to find this capacity. In this article we set out the importance of administrative regulatory capacity and coordination to manage the risks to public health associated with PTAs, and suggest ways countries can improve their capacity.

Estimating irrigation water demand in the Moroccan Drâa Valley using contingent valuation.

PubMed

Storm, Hugo; Heckelei, Thomas; Heidecke, Claudia

2011-10-01

Irrigation water management is crucial for agricultural production and livelihood security in Morocco as in many other parts of the world. For the implementation of an effective water management, knowledge about farmers' demand for irrigation water is crucial to assess reactions to water pricing policy, to establish a cost-benefit analysis of water supply investments or to determine the optimal water allocation between different users. Previously used econometric methods providing this information often have prohibitive data requirements. In this paper, the Contingent Valuation Method (CVM) is adjusted to derive a demand function for irrigation water along farmers' willingness to pay for one additional unit of surface water or groundwater. An application in the Middle Drâa Valley in Morocco shows that the method provides reasonable results in an environment with limited data availability. For analysing the censored survey data, the Least Absolute Deviation estimator was found to be a more suitable alternative to the Tobit model as errors are heteroscedastic and non-normally distributed. The adjusted CVM to derive demand functions is especially attractive for water scarce countries under limited data availability. Copyright © 2011 Elsevier Ltd. All rights reserved.

Quantifying Impact of Biofeedstock Production on Hydrology/Water Quality in Midwest USA

NASA Astrophysics Data System (ADS)

Chaubey, Indrajeet; Engel, Bernard; Thomas, Mark; Raj, Cibin; Saraswat, Dharmendra

2010-05-01

The production of biofeedstocks for biofuels is likely to impact the hydrology and water quality of watersheds. Communities potentially impacted are increasingly concerned, and at present, little is known regarding the magnitude of impacts of biofeedstock production on hydrology and water quality. We have initiated a national facilitation project to answer the following questions: What are the unintended environmental consequences of increased corn production to meet biofuel demands? What are the environmental impacts of various second generation biofeedstock production systems to meet cellulosic ethanol demands? Would the management of cropping systems involving corn silage meet cellulosic ethanol demands with minimal environmental impact? What are the broad-scale water quality implications of energy crops, such as switchgrass, grown for bioenergy production on highly erodible soils? This presentation will discuss development of multi-regional agricultural land management practices that can be implemented to mitigate potential negative environmental impacts associated with biofeedstock production while meeting the biofuel production demand. Specifically, we will discuss how watershed scale modeling can be utilized to evaluate the environmental impacts of various biofeedstock production strategies. We will also discuss regional differences in alternative biofeedstock production and associated hydrologic/water quality impacts.

Management of blood shortages in a tertiary care academic medical center: the Yale-New Haven Hospital frozen blood reserve.

PubMed

Erickson, Michelle L; Champion, Melanie H; Klein, Roger; Ross, Rebecca L; Neal, Zena M; Snyder, Edward L

2008-10-01

Threats to national and local blood supplies in America mandate development of an effective blood management system for emergency preparedness and efficient blood inventory management. Seasonal or acute blood shortages could be compounded by the unavoidable distribution inefficiencies of the blood pipeline during an emergency. The Yale-New Haven Hospital (YNHH) Blood Bank has developed a comprehensive emergency blood management plan, which includes maintenance of a tactical, limited frozen blood supply. A computer spreadsheet-based disaster prediction model has been designed to guide the use of the frozen reserve by testing various emergency scenarios. The frozen blood reserve can likely support normal hospital red blood cell (RBC) demands during typical (3-4 days) seasonal shortages, provide a reduced supply for up to 10 days, or meet an unexpected transient increased RBC demand without requiring intensive support from the regional blood center. However, the frozen blood supply is not designed to meet the massive transfusion demand associated with extreme or sustained disasters. Rather, it serves as a short-term bridge-over supply until blood center support can be reestablished. We review the reasons for initiating a blood management plan and describe how YNHH has implemented and sustains a frozen blood reserve as part of a comprehensive disaster management plan. Despite the operational complexity, the benefits of self-sufficiency, the ability to support routine hospital requirements, and the security of having a backup supply justify the expense and difficulty of maintaining a frozen blood reserve.

Nanooptics for high efficient photon managment

NASA Astrophysics Data System (ADS)

Wyrowski, Frank; Schimmel, Hagen

2005-09-01

Optical systems for photon management, that is the generation of tailored electromagnetic fields, constitute one of the keys for innovation through photonics. An important subfield of photon management deals with the transformation of an incident light field into a field of specified intensity distribution. In this paper we consider some basic aspects of the nature of systems for those light transformations. It turns out, that the transversal redistribution of energy (TRE) is of central concern to achieve systems with high transformation efficiency. Besides established techniques nanostructured optical elements (NOE) are demanded to implement transversal energy redistribution. That builds a bridge between the needs of photon management, optical engineering, and nanooptics.

NASA Automatic Information Security Handbook

NASA Technical Reports Server (NTRS)

1993-01-01

This handbook details the Automated Information Security (AIS) management process for NASA. Automated information system security is becoming an increasingly important issue for all NASA managers and with rapid advancements in computer and network technologies and the demanding nature of space exploration and space research have made NASA increasingly dependent on automated systems to store, process, and transmit vast amounts of mission support information, hence the need for AIS systems and management. This handbook provides the consistent policies, procedures, and guidance to assure that an aggressive and effective AIS programs is developed, implemented, and sustained at all NASA organizations and NASA support contractors.

Factors Influencing Implementation of OHSAS 18001 in Indian Construction Organizations: Interpretive Structural Modeling Approach

PubMed Central

Rajaprasad, Sunku Venkata Siva; Chalapathi, Pasupulati Venkata

2015-01-01

Background Construction activity has made considerable breakthroughs in the past two decades on the back of increases in development activities, government policies, and public demand. At the same time, occupational health and safety issues have become a major concern to construction organizations. The unsatisfactory safety performance of the construction industry has always been highlighted since the safety management system is neglected area and not implemented systematically in Indian construction organizations. Due to a lack of enforcement of the applicable legislation, most of the construction organizations are forced to opt for the implementation of Occupational Health Safety Assessment Series (OHSAS) 18001 to improve safety performance. Methods In order to better understand factors influencing the implementation of OHSAS 18001, an interpretive structural modeling approach has been applied and the factors have been classified using matrice d'impacts croises-multiplication appliqué a un classement (MICMAC) analysis. The study proposes the underlying theoretical framework to identify factors and to help management of Indian construction organizations to understand the interaction among factors influencing in implementation of OHSAS 18001. Results Safety culture, continual improvement, morale of employees, and safety training have been identified as dependent variables. Safety performance, sustainable construction, and conducive working environment have been identified as linkage variables. Management commitment and safety policy have been identified as the driver variables. Conclusion Management commitment has the maximum driving power and the most influential factor is safety policy, which states clearly the commitment of top management towards occupational safety and health. PMID:26929828

A study of the effectiveness of ergonomically-based functional screening tests and their relationship to reducing worker compensation injuries.

PubMed

Anderson, Charles; Briggs, Jim

2008-01-01

This paper summarizes a series of studies of the effectiveness of ergonomically based functional screening tests for post offer pre-placement of applicants for physically demanding jobs, and their relationship to reducing worker compensation injuries. Three predictive validation studies and a meta-analysis of injury rates pre- and post-implementation of physical ability testing at 175 locations are included. The strength and energy expenditure demands of physically-strenuous warehouse jobs in three industries were documented through ergonomic analysis. A battery of strength and endurance tests were developed to assess applicants' abilities to meet the measured physical demands. Predictive validation studies were performed for the jobs in each of the three industries. In each study, new-hires were given the physical ability test battery and then placed on the job. Management was not informed of the results of the tests. Injury experience and work history were then monitored over a two year period in each study. Injury rates and retention were then compared for individuals who passed and individuals who failed the battery. As the battery was implemented in other locations, the injury rate for individuals starting employment in the year prior to implementation was compared to the injury rate for individuals starting employment in the year after implementation. A meta-analysis of the three predictive validation studies indicated that new-hires who passed the battery had a 47% lower worker compensation injury rate and 21% higher retention. A meta-analysis of the 175 pre/post-implementation studies indicated a 41% reduction in worker compensation injuries associated with implementation of ergonomically based physical ability tests.

Chronic kidney disease guideline implementation in primary care: a qualitative report from the TRANSLATE CKD study

PubMed Central

Vest, Bonnie M.; York, Trevor R.M.; Sand, Jessica; Fox, Chester H.; Kahn, Linda S.

2016-01-01

Background Primary care physicians (PCPs) are optimally situated to identify and manage early-stage chronic kidney disease (CKD). Nonetheless, studies have documented suboptimal PCP understanding, awareness, and management of early CKD. The TRANSLATE CKD study is an ongoing national mixed-methods cluster randomized control trial that examines the implementation of evidence-based guidelines for CKD into primary care practice. Methods As part of mixed-methods process evaluation, semi-structured interviews were conducted by phone with 27 providers participating in the study. Interviews were audio-taped and transcribed. Thematic content analysis was used to identify themes. Themes were categorized according to the four domains of Normalization Process Theory (NPT). Results Identified themes illuminated the complex work undertaken in primary care practices to manage CKD. Barriers to guideline implementation were identified in each of the four NPT domains, including: 1) lack of knowledge and understanding around CKD (coherence), 2) difficulties engaging providers and patients in CKD management (cognitive participation), 3) limited time and competing demands (collective action), and 4) challenges obtaining and utilizing data to monitor progress (reflexive monitoring). Conclusions Addressing the barriers to implementation with concrete interventions at the levels at which they occur, informed by NPT, will ultimately improve the quality of CKD patient care. PMID:26355134

Chronic Kidney Disease Guideline Implementation in Primary Care: A Qualitative Report from the TRANSLATE CKD Study.

PubMed

Vest, Bonnie M; York, Trevor R M; Sand, Jessica; Fox, Chester H; Kahn, Linda S

2015-01-01

Primary care physicians (PCPs) are optimally situated to identify and manage early stage chronic kidney disease (CKD). Nonetheless, studies have documented suboptimal PCP understanding, awareness, and management of early CKD. The TRANSLATE CKD study is an ongoing national, mixed-methods, cluster randomized control trial that examines the implementation of evidence-based guidelines for CKD into primary care practice. As part of the mixed-methods process evaluation, semistructured interviews were conducted by phone with 27 providers participating in the study. Interviews were audio-taped and transcribed. Thematic content analysis was used to identify themes. Themes were categorized according to the 4 domains of Normalization Process Theory (NPT). Identified themes illuminated the complex work undertaken to manage CKD in primary care practices. Barriers to guideline implementation were identified in each of the 4 NPT domains, including (1) lack of knowledge and understanding around CKD (coherence), (2) difficulties engaging providers and patients in CKD management (cognitive participation), (3) limited time and competing demands (collective action), and (4) challenges obtaining and using data to monitor progress (reflexive monitoring). Addressing the barriers to implementation with concrete interventions at the levels at which they occur, informed by NPT, will ultimately improve the quality of CKD patient care. © Copyright 2015 by the American Board of Family Medicine.

Vouchers for primary healthcare services in an ageing world? The perspectives of elderly voucher recipients in Hong Kong.

PubMed

Lai, Angel Hor-Yan; Kuang, Zoey; Yam, Carrie Ho-Kwan; Ayub, Shereen; Yeoh, Eng-Kiong

2018-05-01

Considering the ageing population in economically advanced regions across the world, measures are necessary to enhance the health of the older population as well as contain public healthcare spending. Hong Kong implements the Elderly Health Care Voucher Scheme (EHCVS), providing older people aged 65 or above an annual subsidy of visiting private healthcare service providers for chronic disease prevention and management. The services also aim at reallocating demand from the public to private sector as well as improve quality of services. This qualitative study explored the experiences of EHCVS recipients (n = 55, aged 61-94) with eight focus group interviews in Hong Kong in the year 2016. Convenience sampling was used. Research questions were: (1) Why do older people choose not to use EHCVS for preventive as well as disease management services among older people in Hong Kong? (2) What are the barriers to reallocating demand from the public to private sector? (3) In what ways did EHCVS improve the quality of primary care services for older people? Using a deductive and inductive approach, eight qualitative themes were identified. Findings suggested that the non-targeted services and inadequate knowledge on EHCVS deterred older people from using the vouchers for disease management and prevention. The relatively expensive private services, lack of trust in the private sector, low public clinic fees and good services quality of the public sector, together with inadequate private practitioners in the healthcare market were barriers that hinder demand reallocation. Nevertheless, the quality of primary care services had been improved after the implementation of EHCVS with shortened wait times and opportunities to discuss health-related issues with private practitioners. Findings were discussed with practice, policy and research implications. © 2017 John Wiley & Sons Ltd.

Resource efficient data compression algorithms for demanding, WSN based biomedical applications.

PubMed

Antonopoulos, Christos P; Voros, Nikolaos S

2016-02-01

During the last few years, medical research areas of critical importance such as Epilepsy monitoring and study, increasingly utilize wireless sensor network technologies in order to achieve better understanding and significant breakthroughs. However, the limited memory and communication bandwidth offered by WSN platforms comprise a significant shortcoming to such demanding application scenarios. Although, data compression can mitigate such deficiencies there is a lack of objective and comprehensive evaluation of relative approaches and even more on specialized approaches targeting specific demanding applications. The research work presented in this paper focuses on implementing and offering an in-depth experimental study regarding prominent, already existing as well as novel proposed compression algorithms. All algorithms have been implemented in a common Matlab framework. A major contribution of this paper, that differentiates it from similar research efforts, is the employment of real world Electroencephalography (EEG) and Electrocardiography (ECG) datasets comprising the two most demanding Epilepsy modalities. Emphasis is put on WSN applications, thus the respective metrics focus on compression rate and execution latency for the selected datasets. The evaluation results reveal significant performance and behavioral characteristics of the algorithms related to their complexity and the relative negative effect on compression latency as opposed to the increased compression rate. It is noted that the proposed schemes managed to offer considerable advantage especially aiming to achieve the optimum tradeoff between compression rate-latency. Specifically, proposed algorithm managed to combine highly completive level of compression while ensuring minimum latency thus exhibiting real-time capabilities. Additionally, one of the proposed schemes is compared against state-of-the-art general-purpose compression algorithms also exhibiting considerable advantages as far as the compression rate is concerned. Copyright © 2015 Elsevier Inc. All rights reserved.

Quantifying human impact on hydrological drought using an Earth System Model

NASA Astrophysics Data System (ADS)

van Huijgevoort, Marjolein; Chaney, Nathaniel; Malyshev, Sergey; Shevliakova, Elena; Milly, Chris

2017-04-01

Predicting the human impact on the present and future hydrological cycle remains a significant scientific challenge. Anthropogenic impact includes water management practices like diverting water for irrigation, abstraction of groundwater, and reservoirs. Hydrological extremes, in particular, are heavily affected by water management practices, due to the existing stress on the system during droughts and floods. Therefore, to prepare adaptation plans for hydrological extremes in the future, it is essential to account for water management and other human influences in Earth System Models. In this study we have implemented water management practices in the state-of-the-art GFDL land model, which includes terrestrial water, energy, and carbon balances. Both irrigation practices and reservoirs have been added in the land surface model component of the model. Irrigation amounts are determined from the soil water balance, the evaporative demand of the vegetation and fractional coverage of croplands. The resulting water demand is fulfilled by abstractions from surface water and groundwater. Reservoir outflow is dynamically coupled to the downstream water demand and available reservoir storage. Retrospective model simulations over the contiguous United States indicate a strong human influence on hydrological drought. A water management attribution analysis shows a significant impact on the water availability, mostly in the Midwest of the United States and California. Implementation of reservoirs alters the flow regime, thereby decreasing the short-term drought impact, however, in the case of multi-year drought, impacts are delayed due to the dependency on the reservoir outflow. Irrigation, on the other hand, decreases the water availability in rivers due to increased evapotranspiration leading to a higher drought impact. The average increase in evapotranspiration amounted up to 2 mm/day for cropland areas in California and Texas. Overall, the results show the importance of including water management in global scale models. This new modelling framework can be used to understand how humans will impact future water availability, water scarcity, and drought. Next steps will include coupled model simulations to investigate the human impact on feedbacks in land-atmosphere interactions.

Environmental management practices in the Lebanese pharmaceutical industries: implementation strategies and challenges.

PubMed

Massoud, May A; Makarem, N; Ramadan, W; Nakkash, R

2015-03-01

This research attempts to provide an understanding of the Lebanese pharmaceutical industries' environmental management strategies, priorities, and perceptions as well as drivers, barriers, and incentives regarding the implementation of the voluntary ISO 14001 Environmental Management System. Accordingly, a semistructured in-depth interview was conducted with the pharmaceutical industries. The findings revealed a significant lack of knowledge about the standard among the industries. The main perceived drivers for adopting the ISO 14001 are improving the companies' image and overcoming international trade. The main perceived barriers for acquiring the standard are the lack of government support and the fact that ISO 14001 is not being legally required or enforced by the government. Moreover, results revealed that adopting the ISO 14001 standard is not perceived as a priority for the Lebanese pharmaceutical industries. Although the cost of certification was not considered as a barrier for the implementation of ISO 14001, the majority of the pharmaceutical industries are neither interested nor willing to adopt the Standard if they are not exposed to any regulatory pressure or external demand. They are more concerned with quality and safety issues with the most adopted international standard among the industries being the ISO 9001 quality management system. This study highlights the aspect that financial barriers are not always the hurdles for implementing environmental management strategies in developing countries and underscores the need for regulatory frameworks and enforcement.

Nutrition and Hyperglycemia Management in the Inpatient Setting (Meals on Demand, Parenteral, or Enteral Nutrition).

PubMed

Drincic, Andjela T; Knezevich, Jon T; Akkireddy, Padmaja

2017-08-01

The goal of this paper is to provide the latest evidence and expert recommendations for management of hospitalized patients with diabetes or hyperglycemia receiving enteral (EN), parenteral (PN) nutrition support or, those with unrestricted oral diet, consuming meals on demand. Patients with and without diabetes mellitus commonly develop hyperglycemia while receiving EN or PN support, placing them at increased risk of adverse outcomes, including in-hospital mortality. Very little new evidence is available in the form of randomized controlled trials (RCT) to guide the glycemic management of these patients. Reduction in the dextrose concentration within parenteral nutrition as well as selection of an enteral formula that diminishes the carbohydrate exposure to a patient receiving enteral nutrition are common strategies utilized in practice. No specific insulin regimen has been shown to be superior in the management of patients receiving EN or PN nutrition support. For those receiving oral nutrition, new challenges have been introduced with the most recent practice allowing patients to eat meals on demand, leading to extreme variability in carbohydrate exposure and risk of hypo and hyperglycemia. Synchronization of nutrition delivery with the astute use of intravenous or subcutaneous insulin therapy to match the physiologic action of insulin in patients receiving nutritional support should be implemented to improve glycemic control in hospitalized patients. Further RCTs are needed to evaluate glycemic and other clinical outcomes of patients receiving nutritional support. For patients eating meals on demand, development of hospital guidelines and policies are needed, ensuring optimization and coordination of meal insulin delivery in order to facilitate patient safety.

Potential climate change impacts on water availability and cooling water demand in the Lusatian Lignite Mining Region, Central Europe

NASA Astrophysics Data System (ADS)

Pohle, Ina; Koch, Hagen; Gädeke, Anne; Grünewald, Uwe; Kaltofen, Michael; Redetzky, Michael

2014-05-01

In the catchments of the rivers Schwarze Elster, Spree and Lusatian Neisse, hydrologic and socioeconomic systems are coupled via a complex water management system in which water users, reservoirs and water transfers are included. Lignite mining and electricity production are major water users in the region: To allow for open pit lignite mining, ground water is depleted and released into the river system while cooling water is used in the thermal power plants. In order to assess potential climate change impacts on water availability in the catchments as well as on the water demand of the thermal power plants, a climate change impact assessment was performed using the hydrological model SWIM and the long term water management model WBalMo. The potential impacts of climate change were considered by using three regional climate change scenarios of the statistical regional climate model STAR assuming a further temperature increase of 0, 2 or 3 K by the year 2050 in the region respectively. Furthermore, scenarios assuming decreasing mining activities in terms of a decreasing groundwater depression cone, lower mining water discharges, and reduced cooling water demand of the thermal power plants are considered. In the standard version of the WBalMo model cooling water demand is considered as static with regard to climate variables. However, changes in the future cooling water demand over time according to the plans of the local mining and power plant operator are considered. In order to account for climate change impacts on the cooling water demand of the thermal power plants, a dynamical approach for calculating water demand was implemented in WBalMo. As this approach is based on air temperature and air humidity, the projected air temperature and air humidity of the climate scenarios at the locations of the power plants are included in the calculation. Due to increasing temperature and decreasing precipitation declining natural and managed discharges, and hence a lower water availability in the region, were simulated by SWIM and WBalMo respectively. Next to changing climate conditions, also the different mining scenarios have considerable impacts on natural and managed discharges. Using the dynamic approach for cooling water demand, the simulated water demands are lower in winter, but higher in summer compared to the static approach. As a consequence of changes in the seasonal pattern of the cooling water demand of the power plants, lower summer discharges downstream of the thermal power plants are simulated using the dynamical approach. Due to the complex water management system in the region included in the water management model WBalMo, also the simulation of reservoir releases and volumes is impacted by the choice of either the static or the dynamic approach for calculating the cooling water demand of the thermal power plants.

The Impact of Implementing a Demand Forecasting System into a Low-Income Country’s Supply Chain

PubMed Central

Mueller, Leslie E.; Haidari, Leila A.; Wateska, Angela R.; Phillips, Roslyn J.; Schmitz, Michelle M.; Connor, Diana L.; Norman, Bryan A.; Brown, Shawn T.; Welling, Joel S.; Lee, Bruce Y.

2016-01-01

OBJECTIVE To evaluate the potential impact and value of applications (e.g., ordering levels, storage capacity, transportation capacity, distribution frequency) of data from demand forecasting systems implemented in a lower-income country’s vaccine supply chain with different levels of population change to urban areas. MATERIALS AND METHODS Using our software, HERMES, we generated a detailed discrete event simulation model of Niger’s entire vaccine supply chain, including every refrigerator, freezer, transport, personnel, vaccine, cost, and location. We represented the introduction of a demand forecasting system to adjust vaccine ordering that could be implemented with increasing delivery frequencies and/or additions of cold chain equipment (storage and/or transportation) across the supply chain during varying degrees of population movement. RESULTS Implementing demand forecasting system with increased storage and transport frequency increased the number of successfully administered vaccine doses and lowered the logistics cost per dose up to 34%. Implementing demand forecasting system without storage/transport increases actually decreased vaccine availability in certain circumstances. DISCUSSION The potential maximum gains of a demand forecasting system may only be realized if the system is implemented to both augment the supply chain cold storage and transportation. Implementation may have some impact but, in certain circumstances, may hurt delivery. Therefore, implementation of demand forecasting systems with additional storage and transport may be the better approach. Significant decreases in the logistics cost per dose with more administered vaccines support investment in these forecasting systems. CONCLUSION Demand forecasting systems have the potential to greatly improve vaccine demand fulfillment, and decrease logistics cost/dose when implemented with storage and transportation increases direct vaccines. Simulation modeling can demonstrate the potential health and economic benefits of supply chain improvements. PMID:27219341

The impact of implementing a demand forecasting system into a low-income country's supply chain.

PubMed

Mueller, Leslie E; Haidari, Leila A; Wateska, Angela R; Phillips, Roslyn J; Schmitz, Michelle M; Connor, Diana L; Norman, Bryan A; Brown, Shawn T; Welling, Joel S; Lee, Bruce Y

2016-07-12

To evaluate the potential impact and value of applications (e.g. adjusting ordering levels, storage capacity, transportation capacity, distribution frequency) of data from demand forecasting systems implemented in a lower-income country's vaccine supply chain with different levels of population change to urban areas. Using our software, HERMES, we generated a detailed discrete event simulation model of Niger's entire vaccine supply chain, including every refrigerator, freezer, transport, personnel, vaccine, cost, and location. We represented the introduction of a demand forecasting system to adjust vaccine ordering that could be implemented with increasing delivery frequencies and/or additions of cold chain equipment (storage and/or transportation) across the supply chain during varying degrees of population movement. Implementing demand forecasting system with increased storage and transport frequency increased the number of successfully administered vaccine doses and lowered the logistics cost per dose up to 34%. Implementing demand forecasting system without storage/transport increases actually decreased vaccine availability in certain circumstances. The potential maximum gains of a demand forecasting system may only be realized if the system is implemented to both augment the supply chain cold storage and transportation. Implementation may have some impact but, in certain circumstances, may hurt delivery. Therefore, implementation of demand forecasting systems with additional storage and transport may be the better approach. Significant decreases in the logistics cost per dose with more administered vaccines support investment in these forecasting systems. Demand forecasting systems have the potential to greatly improve vaccine demand fulfilment, and decrease logistics cost/dose when implemented with storage and transportation increases. Simulation modeling can demonstrate the potential health and economic benefits of supply chain improvements. Copyright © 2016 Elsevier Ltd. All rights reserved.

Using microgrids to enhance energy security and resilience

DOE PAGES

Lu, Xiaonan; Wang, Jianhui; Guo, Liping

2016-12-05

Although microgrids are now widely studied, challenges still exist. A reliable control architecture needs to be developed to coordinate different devices. Advanced forecasting and demand response management approaches should be implemented to cope with the intermittence of renewable generation. Furthermore, interconnection issues should be further studied to eliminate the influence of microgrid integration and achieve coordinated operation throughout the system.

Supply-chain management: exceeding the customer's expectations.

PubMed

Ramsay, B

2000-10-01

Driven by increasing competition, manufacturers are desperate to cut costs and are looking for increased efficiency and customer service from their supply chains. E-commerce offers a new model of supply and demand, but many companies do not have the processes in place to support this new model. By implementing the techniques discussed here they can achieve substantial improvements in performance.

Water demand management in times of drought: What matters for water conservation

NASA Astrophysics Data System (ADS)

Maggioni, Elena

2015-01-01

Southern California is subject to long droughts and short wet spells. Its water agencies have put in place voluntary, mandatory, and market-based conservation strategies since the 1980s. By analyzing water agencies' data between 2006 and 2010, this research studies whether rebates for water efficient fixtures, water rates, or water ordinances have been effective, and tests whether structural characteristics of water agencies have affected the policy outcome. It finds that mandates to curb outdoor water uses are correlated with reductions in residential per capita water usage, while water rates and subsidies for water saving devices are not. It also confirms that size is a significant policy implementation factor. In a policy perspective, the transition from a water supply to a water demand management-oriented strategy appears guided by mandates and by contextual factors such as the economic cycle and the weather that occur outside the water governance system. Three factors could improve the conservation effort: using prices as a conservation tool, not only as a cost recovering instrument; investing in water efficient tools only when they provide significant water savings; supporting smaller agencies in order to give them opportunities to implement conservation strategies more effectively or to help them consolidate.

Organization of Biomedical Data for Collaborative Scientific Research: A Research Information Management System

PubMed Central

Myneni, Sahiti; Patel, Vimla L.

2010-01-01

Biomedical researchers often work with massive, detailed and heterogeneous datasets. These datasets raise new challenges of information organization and management for scientific interpretation, as they demand much of the researchers’ time and attention. The current study investigated the nature of the problems that researchers face when dealing with such data. Four major problems identified with existing biomedical scientific information management methods were related to data organization, data sharing, collaboration, and publications. Therefore, there is a compelling need to develop an efficient and user-friendly information management system to handle the biomedical research data. This study evaluated the implementation of an information management system, which was introduced as part of the collaborative research to increase scientific productivity in a research laboratory. Laboratory members seemed to exhibit frustration during the implementation process. However, empirical findings revealed that they gained new knowledge and completed specified tasks while working together with the new system. Hence, researchers are urged to persist and persevere when dealing with any new technology, including an information management system in a research laboratory environment. PMID:20543892

Organization of Biomedical Data for Collaborative Scientific Research: A Research Information Management System.

PubMed

Myneni, Sahiti; Patel, Vimla L

2010-06-01

Biomedical researchers often work with massive, detailed and heterogeneous datasets. These datasets raise new challenges of information organization and management for scientific interpretation, as they demand much of the researchers' time and attention. The current study investigated the nature of the problems that researchers face when dealing with such data. Four major problems identified with existing biomedical scientific information management methods were related to data organization, data sharing, collaboration, and publications. Therefore, there is a compelling need to develop an efficient and user-friendly information management system to handle the biomedical research data. This study evaluated the implementation of an information management system, which was introduced as part of the collaborative research to increase scientific productivity in a research laboratory. Laboratory members seemed to exhibit frustration during the implementation process. However, empirical findings revealed that they gained new knowledge and completed specified tasks while working together with the new system. Hence, researchers are urged to persist and persevere when dealing with any new technology, including an information management system in a research laboratory environment.

A literature review for large-scale health information system project planning, implementation and evaluation.

PubMed

Sligo, Judith; Gauld, Robin; Roberts, Vaughan; Villa, Luis

2017-01-01

Information technology is perceived as a potential panacea for healthcare organisations to manage pressure to improve services in the face of increased demand. However, the implementation and evaluation of health information systems (HIS) is plagued with problems and implementation shortcomings and failures are rife. HIS implementation is complex and relies on organisational, structural, technological, and human factors to be successful. It also requires reflective, nuanced, multidimensional evaluation to provide ongoing feedback to ensure success. This article provides a comprehensive review of the literature about evaluating and implementing HIS, detailing the challenges and recommendations for both evaluators and healthcare organisations. The factors that inhibit or promote successful HIS implementation are identified and effective evaluation strategies are described with the goal of informing teams evaluating complex HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Technical experiences of implementing a wireless tracking and facial biometric verification system for a clinical environment

NASA Astrophysics Data System (ADS)

Liu, Brent; Lee, Jasper; Documet, Jorge; Guo, Bing; King, Nelson; Huang, H. K.

2006-03-01

By implementing a tracking and verification system, clinical facilities can effectively monitor workflow and heighten information security in today's growing demand towards digital imaging informatics. This paper presents the technical design and implementation experiences encountered during the development of a Location Tracking and Verification System (LTVS) for a clinical environment. LTVS integrates facial biometrics with wireless tracking so that administrators can manage and monitor patient and staff through a web-based application. Implementation challenges fall into three main areas: 1) Development and Integration, 2) Calibration and Optimization of Wi-Fi Tracking System, and 3) Clinical Implementation. An initial prototype LTVS has been implemented within USC's Healthcare Consultation Center II Outpatient Facility, which currently has a fully digital imaging department environment with integrated HIS/RIS/PACS/VR (Voice Recognition).

Exploring Tradeoffs in Demand-side and Supply-side Management of Urban Water Resources using Agent-based Modeling and Evolutionary Computation

NASA Astrophysics Data System (ADS)

Kanta, L.; Berglund, E. Z.

2015-12-01

Urban water supply systems may be managed through supply-side and demand-side strategies, which focus on water source expansion and demand reductions, respectively. Supply-side strategies bear infrastructure and energy costs, while demand-side strategies bear costs of implementation and inconvenience to consumers. To evaluate the performance of demand-side strategies, the participation and water use adaptations of consumers should be simulated. In this study, a Complex Adaptive Systems (CAS) framework is developed to simulate consumer agents that change their consumption to affect the withdrawal from the water supply system, which, in turn influences operational policies and long-term resource planning. Agent-based models are encoded to represent consumers and a policy maker agent and are coupled with water resources system simulation models. The CAS framework is coupled with an evolutionary computation-based multi-objective methodology to explore tradeoffs in cost, inconvenience to consumers, and environmental impacts for both supply-side and demand-side strategies. Decisions are identified to specify storage levels in a reservoir that trigger (1) increases in the volume of water pumped through inter-basin transfers from an external reservoir and (2) drought stages, which restrict the volume of water that is allowed for residential outdoor uses. The proposed methodology is demonstrated for Arlington, Texas, water supply system to identify non-dominated strategies for an historic drought decade. Results demonstrate that pumping costs associated with maximizing environmental reliability exceed pumping costs associated with minimizing restrictions on consumer water use.

Analysis and Prediction of Weather Impacted Ground Stop Operations

NASA Technical Reports Server (NTRS)

Wang, Yao Xun

2014-01-01

When the air traffic demand is expected to exceed the available airport's capacity for a short period of time, Ground Stop (GS) operations are implemented by Federal Aviation Administration (FAA) Traffic Flow Management (TFM). The GS requires departing aircraft meeting specific criteria to remain on the ground to achieve reduced demands at the constrained destination airport until the end of the GS. This paper provides a high-level overview of the statistical distributions as well as causal factors for the GSs at the major airports in the United States. The GS's character, the weather impact on GSs, GS variations with delays, and the interaction between GSs and Ground Delay Programs (GDPs) at Newark Liberty International Airport (EWR) are investigated. The machine learning methods are used to generate classification models that map the historical airport weather forecast, schedule traffic, and other airport conditions to implemented GS/GDP operations and the models are evaluated using the cross-validations. This modeling approach produced promising results as it yielded an 85% overall classification accuracy to distinguish the implemented GS days from the normal days without GS and GDP operations and a 71% accuracy to differentiate the GS and GDP implemented days from the GDP only days.

POLARIS: Agent-based modeling framework development and implementation for integrated travel demand and network and operations simulations

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

Auld, Joshua; Hope, Michael; Ley, Hubert

This paper discusses the development of an agent-based modelling software development kit, and the implementation and validation of a model using it that integrates dynamic simulation of travel demand, network supply and network operations. A description is given of the core utilities in the kit: a parallel discrete event engine, interprocess exchange engine, and memory allocator, as well as a number of ancillary utilities: visualization library, database IO library, and scenario manager. The overall framework emphasizes the design goals of: generality, code agility, and high performance. This framework allows the modeling of several aspects of transportation system that are typicallymore » done with separate stand-alone software applications, in a high-performance and extensible manner. The issue of integrating such models as dynamic traffic assignment and disaggregate demand models has been a long standing issue for transportation modelers. The integrated approach shows a possible way to resolve this difficulty. The simulation model built from the POLARIS framework is a single, shared-memory process for handling all aspects of the integrated urban simulation. The resulting gains in computational efficiency and performance allow planning models to be extended to include previously separate aspects of the urban system, enhancing the utility of such models from the planning perspective. Initial tests with case studies involving traffic management center impacts on various network events such as accidents, congestion and weather events, show the potential of the system.« less

Demonstration of application-driven network slicing and orchestration in optical/packet domains: on-demand vDC expansion for Hadoop MapReduce optimization.

PubMed

Kong, Bingxin; Liu, Siqi; Yin, Jie; Li, Shengru; Zhu, Zuqing

2018-05-28

Nowadays, it is common for service providers (SPs) to leverage hybrid clouds to improve the quality-of-service (QoS) of their Big Data applications. However, for achieving guaranteed latency and/or bandwidth in its hybrid cloud, an SP might desire to have a virtual datacenter (vDC) network, in which it can manage and manipulate the network connections freely. To address this requirement, we design and implement a network slicing and orchestration (NSO) system that can create and expand vDCs across optical/packet domains on-demand. Considering Hadoop MapReduce (M/R) as the use-case, we describe the proposed architectures of the system's data, control and management planes, and present the operation procedures for creating, expanding, monitoring and managing a vDC for M/R optimization. The proposed NSO system is then realized in a small-scale network testbed that includes four optical/packet domains, and we conduct experiments in it to demonstrate the whole operations of the data, control and management planes. Our experimental results verify that application-driven on-demand vDC expansion across optical/packet domains can be achieved for M/R optimization, and after being provisioned with a vDC, the SP using the NSO system can fully control the vDC network and further optimize the M/R jobs in it with network orchestration.

The effect of normative social forces on managed care organizations: implications for strategic management.

PubMed

Kirby, E G; Sebastian, J G

1998-01-01

Drawing on institutional theory, this study examines how adherence to a number of "institutional" and "technical" environmental forces can influence the business success of managed care organizations (MCOs). The standards studied include: (1) institutional forces: socially accepted procedures for delivering care (access to quality care, availability of information, and delivery of care in a personal manner); and (2) technical forces: industry standards for cost control and efficient use of financial and medical resources. The most significant finding is that successful MCOs must conform to both institutional and technical forces to be successful. MCOs that conform to either one or the other type of standard were no more successful than those that conformed to neither. These findings have several important implications for MCO strategy. First, to be successful, MCO executives must understand the external environment in which they operate. They must anticipate and respond to shifts in that environment. Second, this understanding of the external environment must place equal emphasis on societal demands (e.g., for accessible care and information) and on technical demands (e.g., for cost-efficient care). These findings may well reflect that once managed care penetration reaches relatively high levels, marketshare can no longer be gained through cost-efficiency alone; rather, enrollee satisfaction based on societal demands becomes a key factor in maintaining and gaining marketshare. Institutional theory provides' some strategies for accomplishing these goals. Cost-containment strategies include implementing policies for cutting costs in areas that do not affect the quality of care, such as using generic drugs and reducing administrative excesses and redundancies. At the same time, MCOs must implement strategies aimed at improving conformity to prevailing societal perceptions of appropriate care, including providing patients more freedom to choose their physicians and encouraging and rewarding care providers for being friendly and personable. An MCO should work to inform the public of the organization's efforts to provide high-quality, low-cost medical care in a friendly, convenient manner.

A proposed model to conduct process and outcome evaluations and implementation research of child health programs in Africa using integrated community case management as an example.

PubMed

Diaz, Theresa; Guenther, Tanya; Oliphant, Nicholas P; Muñiz, Maria

2014-12-01

To use a newly devised set of criteria to review the study design and scope of collection of process, outcomes and contextual data for evaluations and implementation research of integrated community case management (iCCM) in Sub-Saharan African. We examined 24 program evaluations and implementation research studies of iCCM in sub-Saharan Africa conducted in the last 5 years (2008-2013), assessed the design used and categorized them according to whether or not they collected sufficient information to conduct process and outcome evaluations. Five of the 24 studies used a stepped wedge design and two were randomized control trials. The remaining 17 were quasi-experimental of which 10 had comparison areas; however, not all comparison areas had a pre and post household survey. With regard to process data, 22 of the studies collected sufficient information to report on implementation strength, and all, except one, could report on program implementation. Most common missing data elements were health facility treatments, service costs, and qualitative data to assess demand. For the measurement of program outcomes, 7 of the 24 studies had a year or less of implementation at scale before the endline survey, 6 of the household surveys did not collect point of service, 10 did not collect timeliness (care seeking within 24 hours of symptoms) and 12 did not have socioeconomic (SES) information. Among the 16 studies with comparison areas, only 5 randomly selected comparison areas, while 10 had appropriate comparison areas. Several evaluations were done too soon after implementation, lacked information on health facility treatments, costs, demand, timeliness or SES and/or did not have a counterfactual. We propose several study designs and minimal data elements to be collected to provide sufficient information to assess whether iCCM increased timely coverage of treatment for the neediest children in a cost-efficient manner.

Demand driven decision support for efficient water resources allocation in irrigated agriculture

NASA Astrophysics Data System (ADS)

Schuetze, Niels; Grießbach, Ulrike Ulrike; Röhm, Patric; Stange, Peter; Wagner, Michael; Seidel, Sabine; Werisch, Stefan; Barfus, Klemens

2014-05-01

Due to climate change, extreme weather conditions, such as longer dry spells in the summer months, may have an increasing impact on the agriculture in Saxony (Eastern Germany). For this reason, and, additionally, declining amounts of rainfall during the growing season the use of irrigation will be more important in future in Eastern Germany. To cope with this higher demand of water, a new decision support framework is developed which focuses on an integrated management of both irrigation water supply and demand. For modeling the regional water demand, local (and site-specific) water demand functions are used which are derived from the optimized agronomic response at farms scale. To account for climate variability the agronomic response is represented by stochastic crop water production functions (SCWPF) which provide the estimated yield subject to the minimum amount of irrigation water. These functions take into account the different soil types, crops and stochastically generated climate scenarios. By applying mathematical interpolation and optimization techniques, the SCWPF's are used to compute the water demand considering different constraints, for instance variable and fix costs or the producer price. This generic approach enables the computation for both multiple crops at farm scale as well as of the aggregated response to water pricing at a regional scale for full and deficit irrigation systems. Within the SAPHIR (SAxonian Platform for High Performance Irrigation) project a prototype of a decision support system is developed which helps to evaluate combined water supply and demand management policies for an effective and efficient utilization of water in order to meet future demands. The prototype is implemented as a web-based decision support system and it is based on a service-oriented geo-database architecture.

How CEOs use management information systems for strategy implementation in hospitals.

PubMed

Naranjo-Gil, David; Hartmann, Frank

2007-04-01

Institutional and market changes seem to force hospitals across the Western world to revitalize their corporate strategies towards more cost efficiency on the one hand, and more flexibility towards customer demands on the other hand. Hospitals, however, apparently differ in the extent to which they are able to implement such strategies effectively. This paper explores whether these different levels of effectiveness depend on how hospitals' top managers' use of the available management information systems (MIS). Based on data obtained from the 218 CEOs of public hospitals in Spain, we analyze how CEOs' professional and educational backgrounds affect their use of MIS, and how the use of the MIS subsequently supports or inhibits the implementation of these strategic goals. The results indicate that CEOs with a predominant clinical background focus more on non-financial information for decision-making and prefer an interactive style of using MIS, which together support flexibility strategies. CEOs with a predominant administrative background seem more effective in establishing cost-reduction strategies, through their larger inclination to emphasize financial information in combination with a diagnostic use of the MIS. Implications for the strategic management of hospitals are outlined.

Concepts for a standard based cross-organisational information security management system in the context of a nationwide EHR.

PubMed

Mense, Alexander; Hoheiser-Pförtner, Franz; Schmid, Martin; Wahl, Harald

2013-01-01

Working with health related data necessitates appropriate levels of security and privacy. Information security, meaning ensuring confidentiality, integrity, and availability, is more organizational, than technical in nature. It includes many organizational and management measures, is based on well-defined security roles, processes, and documents, and needs permanent adaption of security policies, continuously monitoring, and measures assessment. This big challenge for any organization leads to implementation of an information security management system (ISMS). In the context of establishing a regional or national electronic health record for integrated care (ICEHR), the situation is worse. Changing the medical information exchange from on-demand peer-to-peer connections to health information networks requires all organizations participating in the EHR system to have consistent security levels and to follow the same security guidelines and rules. Also, the implementation must be monitored and audited, establishing cross-organizational information security management systems (ISMS) based on international standards. This paper evaluates requirements and defines basic concepts for an ISO 27000 series-based cross-organizational ISMS in the healthcare domain and especially for the implementation of the nationwide electronic health record in Austria (ELGA).

Obesity disease management opportunities and barriers.

PubMed

Sidorov, Jaan E; Fitzner, Karen

2006-04-01

Disease management, a system of coordinated health care interventions and communications for chronically ill populations, relies on patient education and case management to engage individuals in the management of their condition. Disease management also aims to enhance the quality of interactions between doctors and patients and advance evidence-based medicine. Because these programs' interventions frequently include helping individuals who suffer comorbidities associated with obesity to reduce their BMI, adaptation of disease management to populations with obesity seems a viable option. A major barrier for implementing disease management for obesity, however, is the lack of proven return on investment, which limits health plan and disease management organization interest. Purchaser demand may overcome this reluctance. Further research is needed to objectively test whether disease management interventions would be clinically effective for obese populations, produce positive financial outcomes for insurers, and enhance workplace productivity.

Offering integrated medical equipment management in an application service provider model.

PubMed

Cruz, Antonio Miguel; Barr, Cameron; Denis, Ernesto Rodríguez

2007-01-01

With the advancement of medical technology and thus the complexity of the equipment under their care, clinical engineering departments (CEDs) must continue to make use of computerized tools in the management of departmental activities. Authors of this paper designed, installed, and implemented an application service provider (ASP) model at the laboratory level to offer value added management tools in an online format to CEDs. The project, designed to investigate how to help meet demands across multiple healthcare organizations and provide a means of access for organizations that otherwise might not be able to take advantage of the benefits of those tools, has been well received. Ten hospitals have requested the service, and five of those are ready to proceed with the implementation of the ASP. With the proposed centralized system architecture, the model has shown promise in reducing network infrastructure labor and equipment costs, benchmarking of equipment performance indicators, and developing avenues for proper and timely problem reporting. The following is a detailed description of the design process from conception to implementation of the five main software modules and supporting system architecture.

How much land-based greenhouse gas mitigation can be achieved without compromising food security and environmental goals?

PubMed

Smith, Pete; Haberl, Helmut; Popp, Alexander; Erb, Karl-Heinz; Lauk, Christian; Harper, Richard; Tubiello, Francesco N; de Siqueira Pinto, Alexandre; Jafari, Mostafa; Sohi, Saran; Masera, Omar; Böttcher, Hannes; Berndes, Göran; Bustamante, Mercedes; Ahammad, Helal; Clark, Harry; Dong, Hongmin; Elsiddig, Elnour A; Mbow, Cheikh; Ravindranath, Nijavalli H; Rice, Charles W; Robledo Abad, Carmenza; Romanovskaya, Anna; Sperling, Frank; Herrero, Mario; House, Joanna I; Rose, Steven

2013-08-01

Feeding 9-10 billion people by 2050 and preventing dangerous climate change are two of the greatest challenges facing humanity. Both challenges must be met while reducing the impact of land management on ecosystem services that deliver vital goods and services, and support human health and well-being. Few studies to date have considered the interactions between these challenges. In this study we briefly outline the challenges, review the supply- and demand-side climate mitigation potential available in the Agriculture, Forestry and Other Land Use AFOLU sector and options for delivering food security. We briefly outline some of the synergies and trade-offs afforded by mitigation practices, before presenting an assessment of the mitigation potential possible in the AFOLU sector under possible future scenarios in which demand-side measures codeliver to aid food security. We conclude that while supply-side mitigation measures, such as changes in land management, might either enhance or negatively impact food security, demand-side mitigation measures, such as reduced waste or demand for livestock products, should benefit both food security and greenhouse gas (GHG) mitigation. Demand-side measures offer a greater potential (1.5-15.6 Gt CO2 -eq. yr(-1) ) in meeting both challenges than do supply-side measures (1.5-4.3 Gt CO2 -eq. yr(-1) at carbon prices between 20 and 100 US$ tCO2 -eq. yr(-1) ), but given the enormity of challenges, all options need to be considered. Supply-side measures should be implemented immediately, focussing on those that allow the production of more agricultural product per unit of input. For demand-side measures, given the difficulties in their implementation and lag in their effectiveness, policy should be introduced quickly, and should aim to codeliver to other policy agenda, such as improving environmental quality or improving dietary health. These problems facing humanity in the 21st Century are extremely challenging, and policy that addresses multiple objectives is required now more than ever. © 2013 John Wiley & Sons Ltd.

Demand-based provision of housing, welfare and care services to elderly clients: from policy to daily practice through operations management.

PubMed

de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

2009-03-01

Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the daily routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation's policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes.

Improvement of hospital processes through business process management in Qaem Teaching Hospital: A work in progress.

PubMed

Yarmohammadian, Mohammad H; Ebrahimipour, Hossein; Doosty, Farzaneh

2014-01-01

In a world of continuously changing business environments, organizations have no option; however, to deal with such a big level of transformation in order to adjust the consequential demands. Therefore, many companies need to continually improve and review their processes to maintain their competitive advantages in an uncertain environment. Meeting these challenges requires implementing the most efficient possible business processes, geared to the needs of the industry and market segments that the organization serves globally. In the last 10 years, total quality management, business process reengineering, and business process management (BPM) have been some of the management tools applied by organizations to increase business competiveness. This paper is an original article that presents implementation of "BPM" approach in the healthcare domain that allows an organization to improve and review its critical business processes. This project was performed in "Qaem Teaching Hospital" in Mashhad city, Iran and consists of four distinct steps; (1) identify business processes, (2) document the process, (3) analyze and measure the process, and (4) improve the process. Implementing BPM in Qaem Teaching Hospital changed the nature of management by allowing the organization to avoid the complexity of disparate, soloed systems. BPM instead enabled the organization to focus on business processes at a higher level.

Quality circles: the nurse executive as mentor.

PubMed

Flarey, D L

1991-12-01

Changes within and around the health care environment are forcing health care executives to reexamine their managerial and leadership styles to confront the resulting turbulence. The nurse executive is charged with the profound responsibility of directing the delivery of nursing care throughout the organization. Care delivered today must be of high quality. Declining financial resources as well as personnel shortages cause the executive to be an effective innovator in meeting the increasing demands. Quality circles offer the nurse executive an avenue of recourse. Circles have been effectively implemented in the health care setting, as has been consistently documented over time. By way of a participative management approach, quality circles may lead to increased employee morale and productivity, cost savings, and decreased employee turnover rates, as well as realization of socialization and self-actualization needs. A most effective approach to their introduction would be implementation at the first-line manager level. This promotes an acceptance of the concept at the management level as well as a training course for managers to implement the process at the unit level. The nurse executive facilitates the process at the first-line manager level. This facilitation will cause a positive outcome to diffuse throughout the entire organization. Quality circles offer the nurse executive the opportunity to challenge the existing environmental turmoil and effect a positive and lasting change.

Enhancing Price Response Programs through Auto-DR: California's 2007 Implementation Experience

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

Kiliccote, Sila; Wikler, Greg; Chiu, Albert

2007-12-18

This paper describes automated demand response (Auto-DR) activities, an innovative effort in California to ensure that DR programs produce effective and sustainable impacts. Through the application of automation and communication technologies coupled with well-designed incentives and DR programs such as Critical Peak Pricing (CPP) and Demand Bidding (DBP), Auto-DR is opening up the opportunity for many different types of buildings to effectively participate in DR programs. We present the results of Auto-DR implementation efforts by the three California investor-owned utilities for the Summer of 2007. The presentation emphasizes Pacific Gas and Electric Company's (PG&E) Auto-DR efforts, which represents the largestmore » in the state. PG&E's goal was to recruit, install, test and operate 15 megawatts of Auto-DR system capability. We describe the unique delivery approaches, including optimizing the utility incentive structures designed to foster an Auto-DR service provider community. We also show how PG&E's Critical Peak Pricing (CPP) and Demand Bidding (DBP) options were called and executed under the automation platform. Finally, we show the results of the Auto-DR systems installed and operational during 2007, which surpassed PG&E's Auto-DR goals. Auto-DR is being implemented by a multi-disciplinary team including the California Investor Owned Utilities (IOUs), energy consultants, energy management control system vendors, the Lawrence Berkeley National Laboratory (LBNL), and the California Energy Commission (CEC).« less

Modelling Electrical Energy Consumption in Automotive Paint Shop

NASA Astrophysics Data System (ADS)

Oktaviandri, Muchamad; Safiee, Aidil Shafiza Bin

2018-03-01

Industry players are seeking ways to reduce operational cost to sustain in a challenging economic trend. One key aspect is an energy cost reduction. However, implementing energy reduction strategy often struggle with obstructions, which slow down their realization and implementation. Discrete event simulation method is an approach actively discussed in current research trend to overcome such obstructions because of its flexibility and comprehensiveness. Meanwhile, in automotive industry, paint shop is considered the most energy consumer area which is reported consuming about 50%-70% of overall automotive plant consumption. Hence, this project aims at providing a tool to model and simulate energy consumption at paint shop area by conducting a case study at XYZ Company, one of the automotive companies located at Pekan, Pahang. The simulation model was developed using Tecnomatix Plant Simulation software version 13. From the simulation result, the model was accurately within ±5% for energy consumption and ±15% for maximum demand after validation with real system. Two different energy saving scenarios were tested. Scenario 1 was based on production scheduling approach under low demand situation which results energy saving up to 30% on the consumption. Meanwhile scenario 2 was based on substituting high power compressor with the lower power compressor. The results were energy consumption saving of approximately 1.42% and maximum demand reduction about 1.27%. This approach would help managers and engineers to justify worthiness of investment for implementing the reduction strategies.

[Changes in the forms of industrial production and their effects on workers' health].

PubMed

Fernandes, Rita de Cássia Pereira; Assunção, Ada Avila; Carvalho, Fernando Martins

2010-06-01

This study aimed to identify determinants of health in workers of plastic industries. Production organization, machinery from maintenance and productive areas, and workers' characteristics of 14 plastic industries from Greater Salvador, Bahia State, Brazil, were described. Data were collected about development policy of each company; marketing, operational procedures; production and quality requirements, and formal rules of work organization. High strain management techniques for production time reduction have been implemented. The increase of work rhythm, reduction of break time, and a situation of high cognitive demand impose to workers anomalous body positioning for performing tasks that imply repetitive movements. Physical and psychosocial demands (repetitive work, lower control of the worker on his own tasks, time pressure and job dissatisfaction) compose a complex of conditions adverse to workers' health. Changes in production management, personnel and business impose new strains into the development of task by the workers and bringing in new risk factors to workers' health.

Demand-side management glossary

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

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

Demand-side management glossary. Final report

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

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

A reduced energy supply strategy in active vibration control

NASA Astrophysics Data System (ADS)

Ichchou, M. N.; Loukil, T.; Bareille, O.; Chamberland, G.; Qiu, J.

2011-12-01

In this paper, a control strategy is presented and numerically tested. This strategy aims to achieve the potential performance of fully active systems with a reduced energy supply. These energy needs are expected to be comparable to the power demands of semi-active systems, while system performance is intended to be comparable to that of a fully active configuration. The underlying strategy is called 'global semi-active control'. This control approach results from an energy investigation based on management of the optimal control process. Energy management encompasses storage and convenient restitution. The proposed strategy monitors a given active law without any external energy supply by considering purely dissipative and energy-demanding phases. Such a control law is offered here along with an analysis of its properties. A suboptimal form, well adapted for practical implementation steps, is also given. Moreover, a number of numerical experiments are proposed in order to validate test findings.

Design/build vs traditional construction user delay modeling : an evaluation of the cost effectiveness of innovative construction methods for new construction. Part 2 : VISUM Online for Salt Lake, Davis, and Utah Counties

DOT National Transportation Integrated Search

2007-05-01

VISUM Online is a traffic management system for processing online traffic data. The system implements both a road network model and a traffic demand model. VISUM Online uses all available real-time and historic data to calculate current and forecaste...

Enhancing Library Business Performance by Implementation of Enterprise 2.0 via Intrapreneurship: The Case of a Serbian Library

ERIC Educational Resources Information Center

Sofronijevic, Adam; Milicevic, Vesna; Ilic, Bojan; Seaman, Scott

2011-01-01

As academic libraries around the world face the dual challenges of rising demand but limits on funding, managers look for ways to improve library performance that do not add significantly to the budget. This paper presents a novel relationship between intrapreneurship and Enterprise 2.0 that suggests there are relatively cheap and easy ways to…

Dental solid and hazardous waste management and safety practices in developing countries: Nablus district, Palestine.

PubMed

Al-Khatib, Issam A; Monou, Maria; Mosleh, Salem A; Al-Subu, Mohammed M; Kassinos, Despo

2010-05-01

This study investigated the dental waste management practices and safety measures implemented by dentists in the Nablus district, Palestine. A comprehensive survey was conducted for 97 of the 134 dental clinics to assess the current situation. Focus was placed on hazardous waste produced by clinics and the handling, storage, treatment and disposal measures taken. Mercury, found in dental amalgam, is one of the most problematic hazardous waste. The findings revealed that there is no proper separation of dental waste by classification as demanded by the World Health Organization. Furthermore, medical waste is often mixed with general waste during production, collection and disposal. The final disposal of waste ends up in open dumping sites sometimes close to communities where the waste is burned. Correct management and safety procedures that could be effectively implemented in developing countries were examined. It was concluded that cooperation between dental associations, government-related ministries and authorities needs to be established, to enhance dental waste management and provide training and capacity building programs for all professionals in the medical waste management field.

An Architecture for Cross-Cloud System Management

NASA Astrophysics Data System (ADS)

Dodda, Ravi Teja; Smith, Chris; van Moorsel, Aad

The emergence of the cloud computing paradigm promises flexibility and adaptability through on-demand provisioning of compute resources. As the utilization of cloud resources extends beyond a single provider, for business as well as technical reasons, the issue of effectively managing such resources comes to the fore. Different providers expose different interfaces to their compute resources utilizing varied architectures and implementation technologies. This heterogeneity poses a significant system management problem, and can limit the extent to which the benefits of cross-cloud resource utilization can be realized. We address this problem through the definition of an architecture to facilitate the management of compute resources from different cloud providers in an homogenous manner. This preserves the flexibility and adaptability promised by the cloud computing paradigm, whilst enabling the benefits of cross-cloud resource utilization to be realized. The practical efficacy of the architecture is demonstrated through an implementation utilizing compute resources managed through different interfaces on the Amazon Elastic Compute Cloud (EC2) service. Additionally, we provide empirical results highlighting the performance differential of these different interfaces, and discuss the impact of this performance differential on efficiency and profitability.

Communication and implementation of change in crop protection.

PubMed

Escalada, M M; Heong, K L

1993-01-01

The slow adoption of integrated pest management (IPM) has been attributed to the widespread gaps in farmers' knowledge of rational pest management. Other factors such as farmers' perception of high input use and promotion of pesticides also influence decisions to practise rational pest management. To bridge these gaps and improve farmers' pest management practices, most IPM implementation programmes rely on communication strategies. These communication approaches utilize either mass media or interpersonal channels or a combination. The choice of which communication approach to employ depends on project objectives and resources. Among extension and communication approaches used in crop protection, strategic extension campaigns, farmer field schools and farmer participatory research stand out in their ability to bring about significant changes in farmers' pest management practices. While extension campaigns have greater reach, farmer participation and experiential learning achieve more impact because learning effects are sustained. Communication media are important in raising awareness and creating a demand for IPM information but interpersonal channels and group methods such as the farmer field school and farmer participatory research are essential to accomplish the tasks of discovery and experiential learning of IPM skills.

Interaction of Airspace Partitions and Traffic Flow Management Delay

NASA Technical Reports Server (NTRS)

Palopo, Kee; Chatterji, Gano B.; Lee, Hak-Tae

2010-01-01

To ensure that air traffic demand does not exceed airport and airspace capacities, traffic management restrictions, such as delaying aircraft on the ground, assigning them different routes and metering them in the airspace, are implemented. To reduce the delays resulting from these restrictions, revising the partitioning of airspace has been proposed to distribute capacity to yield a more efficient airspace configuration. The capacity of an airspace partition, commonly referred to as a sector, is limited by the number of flights that an air traffic controller can safely manage within the sector. Where viable, re-partitioning of the airspace distributes the flights over more efficient sectors and reduces individual sector demand. This increases the overall airspace efficiency, but requires additional resources in some sectors in terms of controllers and equipment, which is undesirable. This study examines the tradeoff of the number of sectors designed for a specified amount of traffic in a clear-weather day and the delays needed for accommodating the traffic demand. Results show that most of the delays are caused by airport arrival and departure capacity constraints. Some delays caused by airspace capacity constraints can be eliminated by re-partitioning the airspace. Analyses show that about 360 high-altitude sectors, which are approximately today s operational number of sectors of 373, are adequate for delays to be driven solely by airport capacity constraints for the current daily air traffic demand. For a marginal increase of 15 seconds of average delay, the number of sectors can be reduced to 283. In addition, simulations of traffic growths of 15% and 20% with forecasted airport capacities in the years 2018 and 2025 show that delays will continue to be governed by airport capacities. In clear-weather days, for small increases in traffic demand, increasing sector capacities will have almost no effect on delays.

Implementation of a diabetes self-management education program in primary care for adults using shared medical appointments.

PubMed

Sanchez, Iris

2011-01-01

The purpose of this study was to implement diabetes self-management education in primary care using the Chronic Care Model and shared medical appointments (SMA) to provide evidence-based interventions to improve process and measure outcomes. A quality improvement project using the Plan-Do-Check-Act cycle was implemented in a primary care setting in South Texas to provide diabetes self-management education for adults. Biological measures were evaluated in 70 patients at initiation of the project and thereafter based on current practice guidelines. The results of the project were consistent with the literature regarding the benefits, sustainability, and viability of SMA. As compared with that in studies presented in the literature, the patient population who participated in SMA had similar outcomes regarding improvement in A1C, self-management skills, and satisfaction. SMA are an innovative system redesign concept with the potential to provide comprehensive and coordinated care for patients with multiple and chronic health conditions while still being an efficient, effective, financially viable, and sustainable program. As the incidence and prevalence of diabetes increase, innovative models of care can meet the growing demand for access and utilization of diabetes self-management education programs. Programs focusing on chronic conditions to improve outcomes can be replicated by health care providers in primary care settings. SMA can increase revenue and productivity, improve disease management, and increase provider and patient satisfaction.

Implementing chronic disease management in the public healthcare sector in Singapore: the role of hospitals.

PubMed

Cheah, J; Heng, B H

2001-01-01

The public health care delivery system in Singapore faces the challenges of a rapidly ageing population, an increasing chronic disease burden, increasing healthcare cost, rising expectations and demand for better health services, and shortage of resources. It is also fragmented, resulting in duplication and lack of coordination between institutions. A disease management approach has been adopted by the National Healthcare Group (NHG) as a critical strategy to provide holistic, cost-effective, seamless and well-coordinated care across the continuum. The framework in the development of the disease management plan included identifying the diseases and defining the target population, organizing a multi-disciplinary team lead by a clinician champion, defining the core components, treatment protocols and evaluation methods, defining the goals, and measuring and managing the outcomes. As disease management and case management for chronic diseases are new approaches adopted in the healthcare delivery system, there is a lack of understanding by healthcare professionals. The leadership and participation of hospital physicians was sought in the planning, design and outcomes monitoring to ensure their 'buy-in' and the successful implementation and effectiveness of the program. The episodic diagnosis related group (DRG)-based framework of funding and subvention for healthcare, and the shortage of step-care care facilities, have been recognized by the Ministry of Health as an impediments to the implementation, and these are currently being addressed.

A method of demand-driven and data-centric Web service configuration for flexible business process implementation

NASA Astrophysics Data System (ADS)

Xu, Boyi; Xu, Li Da; Fei, Xiang; Jiang, Lihong; Cai, Hongming; Wang, Shuai

2017-08-01

Facing the rapidly changing business environments, implementation of flexible business process is crucial, but difficult especially in data-intensive application areas. This study aims to provide scalable and easily accessible information resources to leverage business process management. In this article, with a resource-oriented approach, enterprise data resources are represented as data-centric Web services, grouped on-demand of business requirement and configured dynamically to adapt to changing business processes. First, a configurable architecture CIRPA involving information resource pool is proposed to act as a scalable and dynamic platform to virtualise enterprise information resources as data-centric Web services. By exposing data-centric resources as REST services in larger granularities, tenant-isolated information resources could be accessed in business process execution. Second, dynamic information resource pool is designed to fulfil configurable and on-demand data accessing in business process execution. CIRPA also isolates transaction data from business process while supporting diverse business processes composition. Finally, a case study of using our method in logistics application shows that CIRPA provides an enhanced performance both in static service encapsulation and dynamic service execution in cloud computing environment.

Drivers and challenges for implementing ISO 14001 environmental management systems in an emerging Gulf Arab country.

PubMed

Waxin, Marie-France; Knuteson, Sandra L; Bartholomew, Aaron

2017-11-13

Worldwide, ISO 14001 certification for organizations has become the norm, but the Arab world accounts for an insignificant portion of all the certified organizations. There is a dearth of research on environmental management systems (EMS) in Arab and emerging countries and in public organizations. The objectives of this research are to: (1) examine the key drivers and challenges related to implementation of ISO 14001 certified EMS in the United Arab Emirates, an emerging Arab country and (2) compare and contrast these drivers and challenges between private and public organizations. We adopt an explorative, qualitative methodology, using semi-structured interviews with environmental managers in 11 organizations (6 private and 5 public) from different industrial sectors. Drivers of EMS certification were mostly similar between private and public organizations, with some differences. Compliance with regulations and standards, and increasing environmental performance were the main drivers for ISO 14001 certification in both private and public organizations. Commitment to sustainability was more important for public organizations. Cost reduction, competitors, leadership commitment and customers' demands were shared drivers, but more stressed by private organizations. Local community and employees' pressures were reported by private organizations only. The challenges to ISO 14001 implementation were similar for private and public organizations. They were: a lack of qualified human resources, practical challenges associated with implementation, a lack of regulations, a lack of support from management, and high costs. Our findings have implications for managers, academics, consultants, and policy makers in the UAE and other emerging markets.

Water-Energy Nexus Challenges & Opportunities in the Arabian Peninsula under Climate Change

NASA Astrophysics Data System (ADS)

Flores-Lopez, F.; Yates, D. N.; Galaitsi, S.; Binnington, T.; Dougherty, W.; Vinnaccia, M.; Glavan, J. C.

2016-12-01

Demand for water in the GCC countries relies mainly on fossil groundwater resources and desalination. Satisfying water demand requires a great deal of energy as it treats and moves water along the supply chain from sources, through treatment processes, and ultimately to the consumer. Hence, there is an inherent connection between water and energy and with climate change, the links between water and energy are expected to become even stronger. As part of AGEDI's Local, National, and Regional Climate Change Programme, a study of the water-energy nexus of the countries in the Arabian Peninsula was implemented. For water, WEAP models both water demand - and its main drivers - and water supply, simulating policies, priorities and preferences. For energy, LEAP models both energy supply and demand, and is able to capture the impacts of low carbon development strategies. A coupled WEAP-LEAP model was then used to evaluate the future performance of the energy-water system under climate change and policy scenarios. The coupled models required detailed data, which were obtained through literature reviews and consultations with key stakeholders in the region. As part of this process, the outputs of both models were validated for historic periods using existing data The models examined 5 policy scenarios of different futures of resource management to the year 2060. A future under current management practices with current climate and a climate projection based on the RCP8.5; a High Efficiency scenario where each country gradually implements policies to reduce the consumption of water and electricity; a Natural Resource Protection scenario with resource efficiency and phasing out of groundwater extraction and drastic reduction of fossil fuel usage in favor of solar; and an Integrated Policy scenario that integrates the prior two policy scenarios Water demands can mostly be met in any scenario through supply combinations of groundwater, desalination and wastewater reuse, with some regional fossil groundwater basins draw to extinction by 2060. While the analysis includes both demand and supply oriented scenarios, the results of the analysis strongly suggest that the region will need to simultaneously purse demand and supply side policies to achieve more sustainable uses of water and energy into the second half of the 21st century.

Enhancing public health outcomes in developing countries: from good policies and best practices to better implementation.

PubMed

Woolcock, Michael

2018-06-01

In rich and poor countries alike, a core challenge is building the state's capability for policy implementation. Delivering high-quality public health and health care-affordably, reliably and at scale, for all-exemplifies this challenge, since doing so requires deftly integrating refined technical skills (surgery), broad logistics management (supply chains, facilities maintenance), adaptive problem solving (curative care), and resolving ideological differences (who pays? who provides?), even as the prevailing health problems themselves only become more diverse, complex, and expensive as countries become more prosperous. However, the current state of state capability in developing countries is demonstrably alarming, with the strains and demands only likely to intensify in the coming decades. Prevailing "best practice" strategies for building implementation capability-copying and scaling putative successes from abroad-are too often part of the problem, while individual training ("capacity building") and technological upgrades (e.g. new management information systems) remain necessary but deeply insufficient. An alternative approach is outlined, one centered on building implementation capability by working iteratively to solve problems nominated and prioritized by local actors.

The analysis of Taiwan's residential electricity demand under the electricity tariff policy

NASA Astrophysics Data System (ADS)

Chen, Po-Jui

In October 2013, the Taiwan Power Company (Taipower), the monopolized state utility service in Taiwan, implemented an electricity tariff adjustment policy to reduce residential electricity demand. Using bi-monthly billing data from 6,932 electricity consumers, this study examine how consumers respond to an increase in electricity prices. This study employs an empirical approach that takes advantage of quasi-random variation over a period of time when household bills were affected by a change in electricity price. The study found that this price increase caused a 1.78% decline in residential electricity consumption, implying a price elasticity of -0.19 for summer-season months and -0.15 for non-summer-season months. The demand for electricity is therefore relatively inelastic, likely because it is hard for people to change their electricity consumption behavior in the short-term. The results of this study highlight that demand-side management cannot be the only lever used to address Taiwan's forecasted decrease in electricity supply.

Methodical approaches to providing sustainable development of the transport industry management system based on self-organization

NASA Astrophysics Data System (ADS)

Belyantseva, Oksana; Panenkov, Andrey; Safonova, Nataliya

2017-10-01

Current conditions of the cognitive economy formation demand to take into account the leading role of information, knowledge and human capital in the development of the transport industry management system. The article substantiates the conceptual approach to the self-organization of a management system on the basis of innovative changes. Human capital is the key aspect of self-organization, so the directions of improving the workforce quality are justified. Basing on the information-innovative genesis of the process of self-organization, the authors justified the necessity of preventing asymmetric information. For this pupose the actions against the resistance to innovations were proposed. The implementation of certain measures contributes to the effective development of the transport management system.

Prediction-based manufacturing center self-adaptive demand side energy optimization in cyber physical systems

NASA Astrophysics Data System (ADS)

Sun, Xinyao; Wang, Xue; Wu, Jiangwei; Liu, Youda

2014-05-01

Cyber physical systems(CPS) recently emerge as a new technology which can provide promising approaches to demand side management(DSM), an important capability in industrial power systems. Meanwhile, the manufacturing center is a typical industrial power subsystem with dozens of high energy consumption devices which have complex physical dynamics. DSM, integrated with CPS, is an effective methodology for solving energy optimization problems in manufacturing center. This paper presents a prediction-based manufacturing center self-adaptive energy optimization method for demand side management in cyber physical systems. To gain prior knowledge of DSM operating results, a sparse Bayesian learning based componential forecasting method is introduced to predict 24-hour electric load levels for specific industrial areas in China. From this data, a pricing strategy is designed based on short-term load forecasting results. To minimize total energy costs while guaranteeing manufacturing center service quality, an adaptive demand side energy optimization algorithm is presented. The proposed scheme is tested in a machining center energy optimization experiment. An AMI sensing system is then used to measure the demand side energy consumption of the manufacturing center. Based on the data collected from the sensing system, the load prediction-based energy optimization scheme is implemented. By employing both the PSO and the CPSO method, the problem of DSM in the manufacturing center is solved. The results of the experiment show the self-adaptive CPSO energy optimization method enhances optimization by 5% compared with the traditional PSO optimization method.

What stresses remote area nurses? Current knowledge and future action.

PubMed

Lenthall, Sue; Wakerman, John; Opie, Tess; Dollard, Maureen; Dunn, Sandra; Knight, Sabina; Macleod, Martha; Watson, Colin

2009-08-01

Review and synthesise the literature identifying the stresses experienced by remote area nurses (RANs). Identify interventions implemented to address identified stresses. Explore the use of the job demands-resources (JD-R) model. A comprehensive literature review was conducted using the meta-databases Ovid and Informit. Remote Australian primary health care centres. The reported demands experienced by RANs can be grouped into four themes: (i) the remote context; (ii) workload and extended scope of practice; (iii) poor management; and (iv) violence in the workplace and community. In this high-demand, low-resource context, the JD-R model of occupational stress is particularly pertinent to examining occupational stress among RANs. The demands on RANs, such as the isolated geographical context, are immutable. However, there are key areas where resources can be enhanced to better meet the high level of need. These are: (i) adequate and appropriate education, training and orientation; (ii) appropriate funding of remote health services; and (iii) improved management practices and systems. There is a lack of empirical evidence relating to stresses experienced by RANs. The literature identifies some of the stresses experienced by RANs as unique to the remote context, while some are related to high demands coupled with a deficit of appropriate resources. Use of models, such as the JD-R model of occupational stress, might assist in identifying key areas where resources can be enhanced to better meet the high level of need and reduce RANs' levels of stress.

2017 Guidelines for the management of arterial hypertension in primary health care in Portuguese-speaking countries.

PubMed

Oliveira, Gláucia Maria Moraes de; Mendes, Miguel; Malachias, Marcus Vinícius Bolívar; Morais, João; Filho, Osni Moreira; Coelho, Armando Serra; Capingana, Daniel Pires; Azevedo, Vanda; Soares, Irenita; Menete, Alda; Ferreira, Beatriz; Soares, Miryan Bandeira Dos Prazeres Cassandra; Fernandes, Mário

2017-11-01

The World Health Organization goal's to reduce mortality due to chronic non-communicable diseases by 2% per year demands a huge effort from member countries. This challenge for health professionals requires global political action on implementation of social measures, with cost-effective population interventions to reduce chronic non-communicable diseases and their risk factors. Systemic arterial hypertension is highly prevalent in Portuguese-speaking countries, and is a major risk factor for complications such as stroke, acute myocardial infarction and chronic kidney disease, rivaling dyslipidemia and obesity in importance for the development of atherosclerotic disease. Joint actions to implement primary prevention measures can reduce outcomes related to hypertensive disease, especially ischemic heart disease and stroke. It is essential to ensure the implementation of guidelines for the management of systemic hypertension via a continuous process involving educational actions, lifestyle changes and guaranteed access to pharmacological treatment. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Implementation and Operation of Computer-Based Education

DTIC Science & Technology

1980-08-01

subject matter areas are used to categorize the activity at a center. Information about the composition of the staff is typically given less attention ...may divide the content, but do all parts of courseware development themselves. 12 o One staff member may make the decisions about design, content...areas of weakness which demand the manager’s attention or supplementary training. 14 FRACTIONAL APPOINTMENTS The subject of fractional appointments

Sink or Swim: Adapting to the Hydrologic Impacts of Climate Change

NASA Astrophysics Data System (ADS)

Gleick, P. H.

2014-12-01

Climate changes lead to a wide range of societal and environmental impacts; indeed, strong evidence has accrued that such impacts are already occurring, as summarized by the newest National Climate Assessment and other analyses. Among the most important will be alterations in the hydrologic cycle, changes in water supply and demand, and impacts on existing water-related infrastructure. Because of the complexity of our water systems, adaptation responses will be equally complex. This problem has made it difficult for water managers and planners to develop and implement adaptation strategies. This talk will address three ways to think about water-related adaptation approaches to climate change: (1) strategies that are already being implemented to address population and economic changes without climate change; (2) whether these first-line strategies are appropriate for additional impacts that might result from climatic changes; and (3) new approaches that might be necessary for new, non-linear, or threshold impacts. An effort will also be made to differentiate between adaptation strategies that influence the hydrologic cycle directly (e.g., cloud seeding), those that influence supply management (e.g., construction of additional reservoirs or water-distribution systems), and those that affect water demand (e.g., removal of outdoor landscaping, installation of efficient irrigation systems).

A novel minimum cost maximum power algorithm for future smart home energy management.

PubMed

Singaravelan, A; Kowsalya, M

2017-11-01

With the latest development of smart grid technology, the energy management system can be efficiently implemented at consumer premises. In this paper, an energy management system with wireless communication and smart meter are designed for scheduling the electric home appliances efficiently with an aim of reducing the cost and peak demand. For an efficient scheduling scheme, the appliances are classified into two types: uninterruptible and interruptible appliances. The problem formulation was constructed based on the practical constraints that make the proposed algorithm cope up with the real-time situation. The formulated problem was identified as Mixed Integer Linear Programming (MILP) problem, so this problem was solved by a step-wise approach. This paper proposes a novel Minimum Cost Maximum Power (MCMP) algorithm to solve the formulated problem. The proposed algorithm was simulated with input data available in the existing method. For validating the proposed MCMP algorithm, results were compared with the existing method. The compared results prove that the proposed algorithm efficiently reduces the consumer electricity consumption cost and peak demand to optimum level with 100% task completion without sacrificing the consumer comfort.

Environmental management plan (EMP) for Melamchi water supply project, Nepal.

PubMed

Khadka, Ram B; Khanal, Anil B

2008-11-01

More than 1.5 million people live in the Kathmandu valley. The valley is facing an extreme shortage of water supply. At the same time the demand is escalating rapidly. To address this issue of scarcity of water, the government of Nepal has proposed a project of inter-basin transfer of water from Melamchi River located 40 km north-east of the Kathmandu valley. The project will cover two districts and three municipalities and will potentially have significant impacts on the environment. In accordance with the Environmental Protection Regulation of Nepal (1997), the Melamchi Water Supply Project (MWSP) has undergone an EIA during the feasibility study stage of the proposed project. The recommendations contained in the EIA were integrated into the project design for implementation in 2006. This paper summarizes the background of MWSP, the environmental concerns described in the EIA and the status of Environmental Management Plan (EMP) developed to address environmental compliance and other issues involving participation and support of the local people. This paper also provides some lessons to learn on the modalities of addressing the demands and grievances of the local people concerning environmental management.

A comparison of the legal frameworks supporting water management in Europe and China.

PubMed

Yang, X; Griffiths, I M

2010-01-01

This paper has compared the legal frameworks supporting water management in Europe and China, with special focus on integrated river basin management (IRBM) to identify synergies and opportunities in policymaking and implementation. The research shows that China has committed to the efficient management of water resources through various policy tools during the current period. This commitment, however, has often been interrupted and distorted by politics, resulting in the neglect of socioeconomic and environmental priorities. The European legal framework supporting water management underwent a complex and lengthy development, but with the adoption of the Water Framework Directive provides a policy model on which to develop an integrated and sustainable approach to river basin management, elements of which may help to meet the demands of the emerging 21st century Chinese society on these critical natural resources.

Management Knowledge and Skills Required in the Health Care System of the Federation Bosnia and Herzegovina

PubMed Central

Slipicevic, Osman; Masic, Izet

2012-01-01

Extremely complex health care organizations, by their structure and organization, operate in a constantly changing business environment, and such situation implies and requires complex and demanding health management. Therefore, in order to manage health organizations in a competent manner, health managers must possess various managerial skills and be familiar with problems in health care. Research, identification, analysis, and assessment of health management education and training needs are basic preconditions for the development and implementation of adequate programs to meet those needs. Along with other specific activities, this research helped to determine the nature, profile, and level of top-priority needs for education. The need for knowledge of certain areas in health management, as well as the need for mastering concrete managerial competencies has been recognized as top-priorities requiring additional improvement and upgrading. PMID:23922519

Hospital quality: a product of good management as much as good treatment.

PubMed

Hyde, Andy; Frafjord, Anders

2013-01-01

In Norway, as in most countries, the demands placed on hospitals to reduce costs and improve the quality of services are intense. Although many say that improving quality reduces costs, few can prove it. Futhermore, how many people can show that improving quality improves patient satisfaction. Diakonhjemmet hospital in Norway has designed and implemented a hospital management system based on lean principles and the PDCA (Plan-Do-Check-Act) quality circle introduced by WE Deming (Deming 2000). The results are quite impressive with improvements in quality and patient satisfaction. The hospital also runs at a profit.

Prototype system of secure VOD

NASA Astrophysics Data System (ADS)

Minemura, Harumi; Yamaguchi, Tomohisa

1997-12-01

Secure digital contents delivery systems are to realize copyright protection and charging mechanism, and aim at secure delivery service of digital contents. Encrypted contents delivery and history (log) management are means to accomplish this purpose. Our final target is to realize a video-on-demand (VOD) system that can prevent illegal usage of video data and manage user history data to achieve a secure video delivery system on the Internet or Intranet. By now, mainly targeting client-server systems connected with enterprise LAN, we have implemented and evaluated a prototype system based on the investigation into the delivery method of encrypted video contents.

The Implementation and Evaluation of the Patient Admission Prediction Tool: Assessing Its Impact on Decision-Making Strategies and Patient Flow Outcomes in 2 Australian Hospitals.

PubMed

Crilly, Julia L; Boyle, Justin; Jessup, Melanie; Wallis, Marianne; Lind, James; Green, David; FitzGerald, Gerry

2015-01-01

To evaluate the implementation of a Patient Admission Prediction Tool (PAPT) in terms of patient flow outcomes and decision-making strategies. The PAPT was implemented in 2 Australian public teaching hospitals during October-December 2010 (hospital A) and October-December 2011 (hospital B). A multisite prospective, comparative (before and after) design was used. Patient flow outcomes measured included access block and hospital occupancy. Daily and weekly data were collected from patient flow reports and routinely collected emergency department information by the site champion and researchers. Daily decision-making strategies ranged from business as usual to use of overcensus beds. Weekly strategies included advanced approval to use of overcensus beds and prebooking nursing staff. These strategies resulted in improved weekend discharges to manage incoming demand for the following week. Following the introduction of the PAPT and workflow guidelines, patient access and hospital occupancy levels could be maintained despite increases in patient presentations (hospital A). The use of a PAPT, embedded in patient flow management processes and championed by a manager, can benefit bed and staff management. Further research that incorporates wider evaluation of the use of the tool at other sites is warranted.

Implementing practice management strategies to improve patient care: the EPIC project.

PubMed

Attwell, David; Rogers-Warnock, Leslie; Nemis-White, Joanna

2012-01-01

Healthcare gaps, the difference between usual care and best care, are evident in Canada, particularly with respect to our aging, ailing population. Primary care practitioners are challenged to identify, prevent and close care gaps in their practice environment given the competing demands of informed, litigious patients with complex medical needs, ever-evolving scientific evidence with new treatment recommendations across many disciplines and an enhanced emphasis on quality and accountability in healthcare. Patient-centred health and disease management partnerships using measurement, feedback and communication of practice patterns and outcomes have been shown to narrow care gaps. Practice management strategies such as the use of patient registries and recall systems have also been used to help practitioners better understand, follow and proactively manage populations of patients in their practice. The Enhancing Practice to Improve Care project was initiated to determine the impact of a patient-centred health and disease management partnership using practice management strategies to improve patient care and outcomes for patients with chronic kidney disease (CKD). Forty-four general practices from four regions of British Columbia participated and, indeed, demonstrated that care and outcomes for patients with CKD could be improved via the implementation of practice management strategies in a patient-centred partnership measurement model of health and disease management.

Transitions of Care Model Inclusive of Unplanned Care Improves the Patient Experience

PubMed Central

Cox, Jon; Teague, Stephanie; Beck, Eric

2016-01-01

A major emphasis in health care is creating an experience whereby patients receive the right care at the right time from the right provider in the right setting at the right cost. Over the past several decades, there has been considerable effort in the area of medical management, with prior authorization, gatekeeper utilization management regimens, and other techniques designed to guide patients and caregivers into desired treatment pathways. Alternatively, the concept of demand management may be employed to achieve these desired outcomes by giving patients meaningful, expanded choices beyond traditional acute-care settings. The implementation of a novel, patient-centered, unplanned care delivery model is described along with illustrative case studies. PMID:28725828

Reducing stock-outs of essential tuberculosis medicines: a system dynamics modelling approach to supply chain management.

PubMed

Bam, L; McLaren, Z M; Coetzee, E; von Leipzig, K H

2017-10-01

The under-performance of supply chains presents a significant hindrance to disease control in developing countries. Stock-outs of essential medicines lead to treatment interruption which can force changes in patient drug regimens, drive drug resistance and increase mortality. This study is one of few to quantitatively evaluate the effectiveness of supply chain policies in reducing shortages and costs. This study develops a systems dynamics simulation model of the downstream supply chain for amikacin, a second-line tuberculosis drug using 10 years of South African data. We evaluate current supply chain performance in terms of reliability, responsiveness and agility, following the widely-used Supply Chain Operation Reference framework. We simulate 141 scenarios that represent different combinations of supplier characteristics, inventory management strategies and demand forecasting methods to identify the Pareto optimal set of management policies that jointly minimize the number of shortages and total cost. Despite long supplier lead times and unpredictable demand, the amikacin supply chain is 98% reliable and agile enough to accommodate a 20% increase in demand without a shortage. However, this is accomplished by overstocking amikacin by 167%, which incurs high holding costs. The responsiveness of suppliers is low: only 57% of orders are delivered to the central provincial drug depot within one month. We identify three Pareto optimal safety stock management policies. Short supplier lead time can produce Pareto optimal outcomes even in the absence of other optimal policies. This study produces concrete, actionable guidelines to cost-effectively reduce stock-outs by implementing optimal supply chain policies. Preferentially selecting drug suppliers with short lead times accommodates unexpected changes in demand. Optimal supply chain management should be an essential component of national policy to reduce the mortality rate. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Scheduling Future Water Supply Investments Under Uncertainty

NASA Astrophysics Data System (ADS)

Huskova, I.; Matrosov, E. S.; Harou, J. J.; Kasprzyk, J. R.; Reed, P. M.

2014-12-01

Uncertain hydrological impacts of climate change, population growth and institutional changes pose a major challenge to planning of water supply systems. Planners seek optimal portfolios of supply and demand management schemes but also when to activate assets whilst considering many system goals and plausible futures. Incorporation of scheduling into the planning under uncertainty problem strongly increases its complexity. We investigate some approaches to scheduling with many-objective heuristic search. We apply a multi-scenario many-objective scheduling approach to the Thames River basin water supply system planning problem in the UK. Decisions include which new supply and demand schemes to implement, at what capacity and when. The impact of different system uncertainties on scheme implementation schedules are explored, i.e. how the choice of future scenarios affects the search process and its outcomes. The activation of schemes is influenced by the occurrence of extreme hydrological events in the ensemble of plausible scenarios and other factors. The approach and results are compared with a previous study where only the portfolio problem is addressed (without scheduling).

Predicting influent biochemical oxygen demand: Balancing energy demand and risk management.

PubMed

Zhu, Jun-Jie; Kang, Lulu; Anderson, Paul R

2018-01-01

Ready access to comprehensive influent information can help water reclamation plant (WRP) operators implement better real-time process controls, provide operational reliability and reduce energy consumption. The five-day biochemical oxygen demand (BOD 5 ), a critical parameter for WRP process control, is expensive and difficult to measure using hard-sensors. An alternative approach based on a soft-sensor methodology shows promise, but can be problematic when used to predict high BOD 5 values. Underestimating high BOD 5 concentrations for process control could result in an insufficient amount of aeration, increasing the risk of an effluent violation. To address this issue, we tested a hierarchical hybrid soft-sensor approach involving multiple linear regression, artificial neural networks (ANN), and compromise programming. While this hybrid approach results in a slight decrease in overall prediction accuracy relative to the approach based on ANN only, the underestimation percentage is substantially lower (37% vs. 61%) for predictions of carbonaceous BOD 5 (CBOD 5 ) concentrations higher than the long-term average value. The hybrid approach is also flexible and can be adjusted depending on the relative importance between energy savings and managing the risk of an effluent violation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Implementing Extreme Programming in Distributed Software Project Teams: Strategies and Challenges

NASA Astrophysics Data System (ADS)

Maruping, Likoebe M.

Agile software development methods and distributed forms of organizing teamwork are two team process innovations that are gaining prominence in today's demanding software development environment. Individually, each of these innovations has yielded gains in the practice of software development. Agile methods have enabled software project teams to meet the challenges of an ever turbulent business environment through enhanced flexibility and responsiveness to emergent customer needs. Distributed software project teams have enabled organizations to access highly specialized expertise across geographic locations. Although much progress has been made in understanding how to more effectively manage agile development teams and how to manage distributed software development teams, managers have little guidance on how to leverage these two potent innovations in combination. In this chapter, I outline some of the strategies and challenges associated with implementing agile methods in distributed software project teams. These are discussed in the context of a study of a large-scale software project in the United States that lasted four months.

Prioritizing critical success factors for reverse logistics implementation using fuzzy-TOPSIS methodology

NASA Astrophysics Data System (ADS)

Agrawal, Saurabh; Singh, Rajesh K.; Murtaza, Qasim

2016-03-01

Electronics industry is one of the fastest growing industries in the world. In India also, there are high turnovers and growing demand of electronics product especially after post liberalization in early nineties. These products generate e-waste which has become big environmental issue. Industries can handle these e-waste and product returns efficiently by developing reverse logistics (RL) system. A thorough study of critical success factors (CSFs) and their ordered implementation is essential for successful RL implementation. The aim of the study is to review the CSFs, and to prioritize them for RL implementation in Indian electronics industry. Twelve CSFs were identified through literature review, and discussion with the experts from the Indian electronics industry. Fuzzy-Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach is proposed for prioritizing these CSFs. Perusal of literature indicates that fuzzy-TOPSIS has not been applied earlier for prioritization of CSFs in Indian electronics industry. Five Indian electronics companies were selected for evaluation of this methodology. Results indicate that most of the identified factors are crucial for the RL implementation. Top management awareness, resource management, economic factors, and contracts terms and conditions are top four prioritized factor, and process capabilities and skilled workers is the least prioritized factor. The findings will be useful for successful RL implementation in Indian electronics industry.

Mind the gap! Lessons from science-based stakeholder dialogue in climate-adapted management of wetlands.

PubMed

Grygoruk, Mateusz; Rannow, Sven

2017-01-15

Effective stakeholder involvement is crucial for the management of protected areas, especially when new challenges like adaptation to climate change need to be addressed. Under these circumstances, science-based stakeholder involvement is required. However, there is often a gap between the information produced by science and the need for information from stakeholders. Along with the design and implementation of adaptive management strategies and policies, efforts must be taken to adjust messages about conservation and adaptation issues, to make them easier to understand, relevant and acceptable for stakeholders. In this paper, the experience of closing the gap between scientific information and the user needs of stakeholders in the Biebrza Valley is documented. The requirements of efficient stakeholder dialogue and the raising of awareness are then indicated. We conclude that many attempts to raise awareness of environmental conservation require improvements. Messages often need to be adjusted for different stakeholders and their various perception levels to efficiently anticipate the potential impacts of the changing climate on ecosystem management. We also revealed that the autonomous adaptation measures implemented by stakeholders to mitigate impacts of climatic change often contradict adaptive management planned and implemented by environmental authorities. We conclude that there is a demand for boundary spanners that can build a bridge between complex scientific outputs and stakeholder needs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Resources planning for radiological incidents management

NASA Astrophysics Data System (ADS)

Hamid, Amy Hamijah binti Ab.; Rozan, Mohd Zaidi Abd; Ibrahim, Roliana; Deris, Safaai; Yunus, Muhd. Noor Muhd.

2017-01-01

Disastrous radiation and nuclear meltdown require an intricate scale of emergency health and social care capacity planning framework. In Malaysia, multiple agencies are responsible for implementing radiological and nuclear safety and security. This research project focused on the Radiological Trauma Triage (RTT) System. This system applies patient's classification based on their injury and level of radiation sickness. This classification prioritizes on the diagnostic and treatment of the casualties which include resources estimation of the medical delivery system supply and demand. Also, this system consists of the leading rescue agency organization and disaster coordinator, as well as the technical support and radiological medical response teams. This research implemented and developed the resources planning simulator for radiological incidents management. The objective of the simulator is to assist the authorities in planning their resources while managing the radiological incidents within the Internal Treatment Area (ITA), Reception Area Treatment (RAT) and Hospital Care Treatment (HCT) phases. The majority (75%) of the stakeholders and experts, who had been interviewed, witnessed and accepted that the simulator would be effective to resolve various types of disaster and resources management issues.

Project management practice and its effects on project success in Malaysian construction industry

NASA Astrophysics Data System (ADS)

Haron, N. A.; Devi, P.; Hassim, S.; Alias, A. H.; Tahir, M. M.; Harun, A. N.

2017-12-01

The rapid economic development has increased the demand for construction of infrastructure and facilities globally. Sustainable development and globalization are the new ‘Zeitgeist’ of the 21st century. In order to implement these projects successfully and to meet the functional aim of the projects within their lifetime, an efficient project management practice is needed. The aim of this study is to identify the critical success factors (CSFs) and the extent of use of project management practice which affects project success, especially during the implementation stage. Data were obtained from self-administered questionnaires with 232 respondents. A mixed method of data collection was adopted using semi-structured interview and questionnaire approach. The result of the analysis of data obtained showed that new and emerging criteria such as customer satisfaction, competency of the project team, and performance of subcontractors/suppliers are becoming measures of success in addition to the classic iron triangle’s view of time, cost and quality. An insight on the extent of use of different project management practice in the industry was also achieved from the study.

A Potentially Useful for Airborne Separation in 4D-Trajectory ATM Operations

NASA Technical Reports Server (NTRS)

Wing, David J.

2005-01-01

An aircraft equipped with Airborne Separation Assistance System functions and 4- dimensional trajectory management capabilities can have significant, potentially transforming, value to Air Traffic Management at the local and system levels. This paper discusses how certain vital characteristics envisioned in the Next Generation Air Transportation System enable some Air Traffic Management functions to be distributed to properly equipped aircraft, and it defines and illustrates this equipage level in a potential application. The new equipage level, perhaps the most capable of many levels permitted, enables an effective implementation of both near- and long-term 4-dimensional trajectory operations in complex airspace, with the aircraft providing the near-term tactical functions and conforming to the long-term trajectory attributes coordinated with ground-based Traffic Flow Management authorities. NASA s recent research and development of this proposed aircraft equipage for en-route and terminal-arrival operations is summarized. The role the equipage level may play in addressing key implementation challenges of reducing ground infrastructure cost, building in security and safety, and scaling to traffic demand is discussed.

Many-objective optimization and visual analytics reveal key trade-offs for London's water supply

NASA Astrophysics Data System (ADS)

Matrosov, Evgenii S.; Huskova, Ivana; Kasprzyk, Joseph R.; Harou, Julien J.; Lambert, Chris; Reed, Patrick M.

2015-12-01

In this study, we link a water resource management simulator to multi-objective search to reveal the key trade-offs inherent in planning a real-world water resource system. We consider new supplies and demand management (conservation) options while seeking to elucidate the trade-offs between the best portfolios of schemes to satisfy projected water demands. Alternative system designs are evaluated using performance measures that minimize capital and operating costs and energy use while maximizing resilience, engineering and environmental metrics, subject to supply reliability constraints. Our analysis shows many-objective evolutionary optimization coupled with state-of-the art visual analytics can help planners discover more diverse water supply system designs and better understand their inherent trade-offs. The approach is used to explore future water supply options for the Thames water resource system (including London's water supply). New supply options include a new reservoir, water transfers, artificial recharge, wastewater reuse and brackish groundwater desalination. Demand management options include leakage reduction, compulsory metering and seasonal tariffs. The Thames system's Pareto approximate portfolios cluster into distinct groups of water supply options; for example implementing a pipe refurbishment program leads to higher capital costs but greater reliability. This study highlights that traditional least-cost reliability constrained design of water supply systems masks asset combinations whose benefits only become apparent when more planning objectives are considered.

Crisis management systems: staff nurses demand more support from their supervisors.

PubMed

Tzeng, Huey-Ming; Yin, Chang-Yi

2008-08-01

This study illustrates the contributions of the necessity, comprehensiveness, and difference (between necessity and comprehensiveness) levels of crisis management systems to participants' general satisfaction with their working institutions' nursing-related crisis management activities. Crisis management systems include strategic, technical/structural, assessment, public communication, and psychological/cultural aspects. An effective institutional crisis management system might help to decrease the number of incidents related to medical disputes or to prevent a crisis from worsening and becoming disastrous. A cross-sectional survey was administered during a nursing conference held in Taipei, Taiwan, on June 27, 2005. Two hundred ninety questionnaires were distributed, and 121 were retrieved (response rate, 41.7%; nursing administrators and staff). Univariate and multivariate analyses were performed. Ordinal logistic regression analyses show that being a public hospital managed by the government and having more difference on the strategic aspect between the necessity and comprehensiveness levels contribute to lower satisfaction with nursing-related crisis management activities (Nagelkerke R(2) = .441). In addition, staff nurses perceive higher necessity levels on all five aspects compared to nursing administrators. This study provides important insights into how the policies and activities of a medical institution's crisis management system can be prioritized and implemented. It is also important for students in nursing programs and for currently employed nurses to learn how to manage disputes related to nursing practice, so that early resolution can be achieved and crises can be avoided. These results suggest that staff nurses demand more support from their supervisors.

First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care.

PubMed

Håkanson, Cecilia; Cronfalk, Berit Seiger; Henriksen, Eva; Norberg, Astrid; Ternestedt, Britt-Marie; Sandberg, Jonas

2014-01-01

The aim of this study was to investigate first-line nursing home managers' views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested.

23 CFR 450.320 - Congestion management process in transportation management areas.

Code of Federal Regulations, 2010 CFR

2010-04-01

... travel demand reduction and operational management strategies. (b) The development of a congestion... appropriate analysis of reasonable (including multimodal) travel demand reduction and operational management... the analysis demonstrates that travel demand reduction and operational management strategies cannot...

Maternity staff perspectives regarding resource demands of breastfeeding supportive practices in accordance with the Baby-Friendly Hospital Initiative accreditation: a Q methodology approach.

PubMed

Huang, Chiu-Mieh; Hung, Wei-Shu; Lai, Jung-Nien; Kao, Yu-Hsiu; Wang, Ching-Ling; Guo, Jong-Long

2016-06-01

To explore the resource demands of implementing the Baby-Friendly Hospital Initiative among maternity staff. Implementing the Baby-Friendly Hospital Initiative is the most recognized global strategy for ensuring that hospital routines support breastfeeding. The maternity services of Baby-Friendly Hospital Initiative accredited hospitals are evaluated according to the Ten Steps to Successful Breastfeeding. Q methodology was applied to investigate the perspectives of 60 maternity staff in Northern Taiwan. Data were collected from May - December 2014. An online Q-sort platform was designed for the participants to perform sorting. The Q-sorts were subjected to factor analysis by using PQ Method software. Factors were extracted using principal component analysis with a varimax rotation. A combination of eigenvalues and a scree plot were employed to determine the number of retained factors. Four factors retained in the final model accounted for 56% of the total variance: (1) emphasis on implementing an institutional policy; (2) emphasis on providing supportive practices for breastfeeding mothers; (3) emphasis on establishing continual breastfeeding support; and (4) emphasis on managing breastfeeding supportive practices concerning a designated time period. The participants that were associated with Factors 1 and 3 emphasized the necessity of allocating resources to Steps 1, 2 and 10 of the Ten Steps. The participants associated with Factors 2 and 4 emphasized allocating resources to Steps 2-5 and 7. This study revealed the various perspectives of maternity staff regarding the resource demands of implementing the Baby-Friendly Hospital Initiative. These perspectives may serve as a reference for decision-makers in prioritizing resource allocation. © 2016 John Wiley & Sons Ltd.

Process Reengineering for Quality Improvement in ICU Based on Taylor's Management Theory.

PubMed

Tao, Ziqi

2015-06-01

Using methods including questionnaire-based surveys and control analysis, we analyzed the improvements in the efficiency of ICU rescue, service quality, and patients' satisfaction, in Xuzhou Central Hospital after the implementation of fine management, with an attempt to further introduce the concept of fine management and implement the brand construction. Originating in Taylor's "Theory of Scientific Management" (1982), fine management uses programmed, standardized, digitalized, and informational approaches to ensure each unit of an organization is running with great accuracy, high efficiency, strong coordination, and at sustained duration (Wang et al., Fine Management, 2007). The nature of fine management is a process that breaks up the strategy and goal, and executes it. Strategic planning takes place at every part of the process. Fine management demonstrates that everybody has a role to play in the management process, every area must be examined through the management process, and everything has to be managed (Zhang et al., The Experience of Hospital Nursing Precise Management, 2006). In other words, this kind of management theory demands all people to be involved in the entire process (Liu and Chen, Med Inf, 2007). As public hospital reform is becoming more widespread, it becomes imperative to "build a unified and efficient public hospital management system" and "improve the quality of medical services" (Guidelines on the Pilot Reform of Public Hospitals, 2010). The execution of fine management is of importance in optimizing the medical process, improving medical services and building a prestigious hospital brand.

Web-based learning for continuing nursing education of emergency unit staff.

PubMed

Paavilainen, Eija; Salminen-Tuomaala, Mari

2010-01-01

The authors describe a Web-based continuing education course focusing on patient counseling in an emergency department. Course materials were developed based on data collected from the department's patients and their family members and on earlier findings on counseling. Web-based education is an appropriate method for continuing education in a specific hospital department. This puts special demands for nurse managers in arranging, designing, and implementing the education together with educators.

Architecture for nuclear energy in the 21st century

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

Arthu, E.D.; Cunningham, P.T.; Wagner, R.L. Jr.

1999-02-21

Global and regional scenarios for future energy demand have been assessed from the perspectives of nuclear materials management. From these the authors propose creation of a nuclear fuel cycle architecture which maximizes inherent protection of plutonium and other nuclear materials. The concept also provides technical and institutional flexibility for transition into other fuel cycle systems, particularly those involving breeder reactors. The system, its implementation timeline, and overall impact are described in the paper.

Web-GIS based information management system to Bureau of Law Enforcement for Urban Managementenforcement for urban management

NASA Astrophysics Data System (ADS)

Sun, Hai; Wang, Cheng; Ren, Bo

2007-06-01

Daily works of Law Enforcement Bureau are crucial in the urban management. However, with the development of the city, the information and data which are relative to Law Enforcement Bureau's daily work are increasing and updating. The increasing data result in that some traditional work is limited and inefficient in daily work. Analyzing the demands and obstacles of Law Enforcement Bureau, the paper proposes a new method to solve these problems. A web-GIS based information management system was produced for Bureau of Law Enforcement for Urban Management of Foshan. First part of the paper provides an overview of the system. Second part introduces the architecture of system and data organization. In the third part, the paper describes the design and implement of functional modules detailedly. In the end, this paper is concluded and proposes some strategic recommendations for the further development of the system. This paper focuses on the architecture and implementation of the system, solves the developing issues based on ArcServer, and introduces a new concept to the local government to solve the current problems. Practical application of this system showed that it played very important role in the Law Enforcement Bureau's work.

Water-energy-food security nexus: the road map

NASA Astrophysics Data System (ADS)

Hamdy, Atef

2015-04-01

The world's growing population and increased prosperity will increase global demand for energy, as well as food and water supplies in the coming decades. In the arid and semi arid regions as in most of the world water and energy have historically been managed separately, with little consideration of cross sectoral interactions, yet in reality, water and energy are closely interconnected. By addressing water and energy together planners can identify crucial interactions, conflicting demands and potential synergies. For many countries around the world it is needed to establish a road map on: (i) how to implement nexus policies to increase efficiency of natural resources management? (ii) how to bridge science with policy and business? (iii) how governments be inspired by business? (iv) how can be business be inspired by science? (v) how can we learn from each other and how collaborate to address the challenges ahead? Such road map should seek to bring together stakeholders involved in the nexus implementation approach over the coming years to develop nexus tools for decision making to quantify water energy food resources on both national and regional level. However, experiences gained and learned lessons indicate clearly that numerous countries are facing several barriers in putting in action their nexus road map due to the lack of integrated resource management, lack of capacity for research development, lack of knowledge sharing across sectors, and not enough interaction between policy makers and scientists. Those are major challenges to be faced to achieve the water, energy and food security nexus. Furthermore, such goal cannot be reached without building and strengthening the synergy between education, research and innovation for sustainable resource management. Those issues beside others will be fully discussed in this paper. Keywords: water-energy-food security; nexus

Towards an Improved Represenation of Reservoirs and Water Management in a Land Surface-Hydrology Model

NASA Astrophysics Data System (ADS)

Yassin, F.; Anis, M. R.; Razavi, S.; Wheater, H. S.

2017-12-01

Water management through reservoirs, diversions, and irrigation have significantly changed river flow regimes and basin-wide energy and water balance cycles. Failure to represent these effects limits the performance of land surface-hydrology models not only for streamflow prediction but also for the estimation of soil moisture, evapotranspiration, and feedbacks to the atmosphere. Despite recent research to improve the representation of water management in land surface models, there remains a need to develop improved modeling approaches that work in complex and highly regulated basins such as the 406,000 km2 Saskatchewan River Basin (SaskRB). A particular challenge for regional and global application is a lack of local information on reservoir operational management. To this end, we implemented a reservoir operation, water abstraction, and irrigation algorithm in the MESH land surface-hydrology model and tested it over the SaskRB. MESH is Environment Canada's Land Surface-hydrology modeling system that couples Canadian Land Surface Scheme (CLASS) with hydrological routing model. The implemented reservoir algorithm uses an inflow-outflow relationship that accounts for the physical characteristics of reservoirs (e.g., storage-area-elevation relationships) and includes simplified operational characteristics based on local information (e.g., monthly target volume and release under limited, normal, and flood storage zone). The irrigation algorithm uses the difference between actual and potential evapotranspiration to estimate irrigation water demand. This irrigation demand is supplied from the neighboring reservoirs/diversion in the river system. We calibrated the model enabled with the new reservoir and irrigation modules in a multi-objective optimization setting. Results showed that the reservoir and irrigation modules significantly improved the MESH model performance in generating streamflow and evapotranspiration across the SaskRB and that this our approach provides a basis for improved large scale hydrological modelling.

High-Efficiency Food Production in a Renewable Energy Based Micro-Grid Power System

NASA Technical Reports Server (NTRS)

Bubenheim, David; Meiners, Dennis

2016-01-01

Controlled Environment Agriculture (CEA) systems can be used to produce high-quality, desirable food year round, and the fresh produce can positively contribute to the health and well being of residents in communities with difficult supply logistics. While CEA has many positive outcomes for a remote community, the associated high electric demands have prohibited widespread implementation in what is typically already a fully subscribed power generation and distribution system. Recent advances in CEA technologies as well as renewable power generation, storage, and micro-grid management are increasing system efficiency and expanding the possibilities for enhancing community supporting infrastructure without increasing demands for outside supplied fuels. We will present examples of how new lighting, nutrient delivery, and energy management and control systems can enable significant increases in food production efficiency while maintaining high yields in CEA. Examples from Alaskan communities where initial incorporation of renewable power generation, energy storage and grid management techniques have already reduced diesel fuel consumption for electric generation by more than 40% and expanded grid capacity will be presented. We will discuss how renewable power generation, efficient grid management to extract maximum community service per kW, and novel energy storage approaches can expand the food production, water supply, waste treatment, sanitation and other community support services without traditional increases of consumable fuels supplied from outside the community. These capabilities offer communities with a range of choices to enhance their communities. The examples represent a synergy of technology advancement efforts to develop sustainable community support systems for future space-based human habitats and practical implementation of infrastructure components to increase efficiency and enhance health and well being in remote communities today and tomorrow.

High-Efficiency Food Production in a Renewable Energy Based Micro-Grid

NASA Technical Reports Server (NTRS)

Bubenheim, David L.

2017-01-01

Controlled Environment Agriculture (CEA) systems can be used to produce high-quality, desirable food year round, and the fresh produce can positively contribute to the health and well being of residents in communities with difficult supply logistics. While CEA has many positive outcomes for a remote community, the associated high electric demands have prohibited widespread implementation in what is typically already a fully subscribed power generation and distribution system. Recent advances in CEA technologies as well as renewable power generation, storage, and micro-grid management are increasing system efficiency and expanding the possibilities for enhancing community supporting infrastructure without increasing demands for outside supplied fuels. We will present examples of how new lighting, nutrient delivery, and energy management and control systems can enable significant increases in food production efficiency while maintaining high yields in CEA.Examples from Alaskan communities where initial incorporation of renewable power generation, energy storage and grid management techniques have already reduced diesel fuel consumption for electric generation by more than 40 and expanded grid capacity will be presented. We will discuss how renewable power generation, efficient grid management to extract maximum community service per kW, and novel energy storage approaches can expand the food production, water supply, waste treatment, sanitation and other community support services without traditional increases of consumable fuels supplied from outside the community. These capabilities offer communities with a range of choices to enhance their communities. The examples represent a synergy of technology advancement efforts to develop sustainable community support systems for future space-based human habitats and practical implementation of infrastructure components to increase efficiency and enhance health and well-being in remote communities today and tomorrow.

Evaluation of an intervention to improve the management of allergens in school food services in the city of Barcelona.

PubMed

Fontcuberta-Famadas, M; Serral, G; López, M J; Balfagón, P; García-Cid, E; Caballé-Gavaldà, L

2018-02-15

An intervention to promote the development of an allergen control plan (ACP) and preventive measures for the management of allergens in school food services was implemented in all schools of Barcelona city over a three-year period (2013-2015) by the public health services. The present study aimed to assess changes regarding the management of food allergens in school food services in Barcelona after an intervention conducted by the public health services of the city. School meal operators of a random sample of 117 schools were assessed before and after the intervention using a structured questionnaire. The questionnaire collected general information on the students and their demand for special menus, and included 17 closed questions regarding the implementation of specific preventive measures for the management of allergens. Based on these 17 questions, a food safety score was calculated for each school. The improvement in these scores was evaluated. The results showed positive increments in the percentage of implementation of 12 of the 17 preventive measures assessed. The percentage of school food services with an implemented ACP increased by 49%. Schools with external and internal food supplies increased their scores by 16.5% and 19.6%, respectively. The greatest improvements were observed in smaller food services and in schools located in districts with low gross household incomes. The intervention was effective in improving school food services' management of allergens and in reducing the differences found among food services in the pre-intervention survey. We must also focus efforts on reducing socio-economic inequalities linked to the management of allergens. Copyright © 2018 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

Consumers’ experiences of back pain in rural Western Australia: access to information and services, and self-management behaviours

PubMed Central

2012-01-01

Background Coordinated, interdisciplinary services, supported by self-management underpin effective management for chronic low back pain (CLBP). However, a combination of system, provider and consumer-based barriers exist which limit the implementation of such models into practice, particularly in rural areas where unique access issues exist. In order to improve health service delivery for consumers with CLBP, policymakers and service providers require a more in depth understanding of these issues. The objective of this qualitative study was to explore barriers experienced by consumers in rural settings in Western Australia (WA) to accessing information and services and implementing effective self-management behaviours for CLBP. Methods Fourteen consumers with a history of CLBP from three rural sites in WA participated. Maximum variation sampling was employed to ensure a range of experiences were captured. An interviewer, blinded to quantitative pain history data, conducted semi-structured telephone interviews using a standardised schedule to explore individuals’ access to information and services for CLBP, and self-management behaviours. Interviews were digitally recorded and transcribed verbatim. Inductive analysis techniques were used to derive and refine key themes. Results Five key themes were identified that affected individuals’ experiences of managing CLBP in a rural setting, including: 1) poor access to information and services in rural settings; 2) inadequate knowledge and skills among local practitioners; 3) feelings of isolation and frustration; 4) psychological burden associated with CLBP; and 5) competing lifestyle demands hindering effective self-management for CLBP. Conclusions Consumers in rural WA experienced difficulties in knowing where to access relevant information for CLBP and expressed frustration with the lack of service delivery options to access interdisciplinary and specialist services for CLBP. Competing lifestyle demands such as work and family commitments were cited as key barriers to adopting regular self-management practices. Consumer expectations for improved health service coordination and a workforce skilled in pain management are relevant to future service planning, particularly in the contexts of workforce capacity, community health services, and enablers to effective service delivery in primary care. PMID:23057669

Quality management systems for your in vitro fertilization clinic's laboratory: Why bother?

PubMed

Olofsson, Jan I; Banker, Manish R; Sjoblom, Late Peter

2013-01-01

Several countries have in recent years introduced prescribed requirements for treatment and monitoring of outcomes, as well as a licensing or accreditation requirement for in vitro fertilization (IVF) clinics and their laboratories. It is commonplace for Assisted Reproductive Technology (ART) laboratories to be required to have a quality control system. However, more effective Total Quality Management systems are now being implemented by an increasing number of ART clinics. In India, it is now a requirement to have a quality management system in order to be accredited and to help meet customer demand for improved delivery of ART services. This review contains the proceedings a quality management session at the Indian Fertility Experts Meet (IFEM) 2010 and focuses on the creation of a patient-oriented best-in-class IVF laboratory.

Quality management systems for your in vitro fertilization clinic's laboratory: Why bother?

PubMed Central

Olofsson, Jan I; Banker, Manish R; Sjoblom, Late Peter

2013-01-01

Several countries have in recent years introduced prescribed requirements for treatment and monitoring of outcomes, as well as a licensing or accreditation requirement for in vitro fertilization (IVF) clinics and their laboratories. It is commonplace for Assisted Reproductive Technology (ART) laboratories to be required to have a quality control system. However, more effective Total Quality Management systems are now being implemented by an increasing number of ART clinics. In India, it is now a requirement to have a quality management system in order to be accredited and to help meet customer demand for improved delivery of ART services. This review contains the proceedings a quality management session at the Indian Fertility Experts Meet (IFEM) 2010 and focuses on the creation of a patient-oriented best-in-class IVF laboratory. PMID:23869142

Clinical-outcome-based demand management in health services.

PubMed

Brogan, C; Lawrence, D; Mayhew, L

2008-01-01

THE PROBLEM OF MANAGING DEMAND: Most healthcare systems have 'third-party payers' who face the problem of keeping within budgets despite pressures to increase resources due to the ageing population, new technologies and patient demands to lower thresholds for care. This paper uses the UK National Health Service as a case study to suggest techniques for system-based demand management, which aims to control demand and costs whilst maintaining the cost-effectiveness of the system. The technique for managing demand in primary, elective and urgent care consists of managing treatment thresholds for appropriate care, using a whole-systems approach and costing the care elements in the system. It is important to analyse activity in relation to capacity and demand. Examples of using these techniques in practice are given. The practical effects of using such techniques need evaluation. If these techniques are not used, managing demand and limiting healthcare expenditure will be at the expense of clinical outcomes and unmet need, which will perpetuate financial crises.

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

Fachechi, Alessio; Mainetti, Luca; Palano, Laura

The continuously rising demand for electricity has prompted governments and industries to research more effective energy management systems. The Internet of Things paradigm is a valuable add-on for controlling and managing the energy appliances such as Plug-in Electrical Vehicles (PEV) charging stations. In this paper, we present a Demand Response implementation for PEV charging stations able to use Wireless Sensor Network technologies based on the Constrained Application Protocol (CoAP). We developed a self-service kiosk system by which the user can autonomously swipe his/her credit card and choose the charging station to enable. When a user plugs his/her vehicle to themore » station, s/he subscribes his availability to share a portion of its energy. When the grid requests a contribution from the PEVs, the kiosk sends a CoAP message to the available stations and the energy flow is inverted (Vehicle-to-Grid). At the end of the charging process, the user's credit card gets charged with a discounted bill.« less

How treating the patient with diabetes can enhance your practice: recommendations for practice management.

PubMed

Levin, Roger P

2003-10-01

The ability of dental practices to remain productive and profitable over time depends on their capacity to serve patients comprehensively. The increasing diversity in the patient population demands that practices customize services to ensure exceptional care for all patients. This diversity is particularly prevalent in patient subpopulations with unique medical conditions and treatment needs, such as patients with diabetes. Proper and effective management of patients with diabetes requires that the practice evaluate all aspects of patient interaction. Systems need to be customized so that all procedures and patient communication scripts are implemented consistently to meet the distinct needs of patients with diabetes. A significant return on investment in customized systems can be realized if the practice implements effective marketing strategies to both attract this population of patients and brand the practice as a unique and specialized service provider.

New food safety law: effectiveness on the ground.

PubMed

Drew, Christa A; Clydesdale, Fergus M

2015-01-01

The demand for safety in the US food supply from production to consumption necessitates a scientific, risk-based strategy for the management of microbiological, chemical, and physical hazards in food. The key to successful management is an increase in systematic collaboration and communication and in enforceable procedures with all domestic and international stakeholders. The enactment of the Food Safety Modernization Act (FSMA) aims to prevent or reduce large-scale food-borne illness outbreaks through stricter facility registration and records standards, mandatory prevention-based controls, increased facility inspections in the United States and internationally, mandatory recall authority, import controls, and increased consumer communication. The bill provisions are expected to cost $1.4 billion over the next four years. Effective implementation of the FSMA's 50 rules, reports, studies, and guidance documents in addition to an increased inspection burden requires further funding appropriations. Additional full-time inspectors and unprecedented foreign compliance is necessary for the full and effective implementation of the FSMA.

Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches.

PubMed

Langlois, Etienne V; Becerril Montekio, Victor; Young, Taryn; Song, Kayla; Alcalde-Rabanal, Jacqueline; Tran, Nhan

2016-03-17

There is an increasing interest worldwide to ensure evidence-informed health policymaking as a means to improve health systems performance. There is a need to engage policymakers in collaborative approaches to generate and use knowledge in real world settings. To address this gap, we implemented two interventions based on iterative exchanges between researchers and policymakers/implementers. This article aims to reflect on the implementation and impact of these multi-site evidence-to-policy approaches implemented in low-resource settings. The first approach was implemented in Mexico and Nicaragua and focused on implementation research facilitated by communities of practice (CoP) among maternal health stakeholders. We conducted a process evaluation of the CoPs and assessed the professionals' abilities to acquire, analyse, adapt and apply research. The second approach, called the Policy BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills (Policy BUDDIES), was implemented in South Africa and Cameroon. The intervention put forth a 'buddying' process to enhance demand and use of systematic reviews by sub-national policymakers. The Policy BUDDIES initiative was assessed using a mixed-methods realist evaluation design. In Mexico, the implementation research supported by CoPs triggered monitoring by local health organizations of the quality of maternal healthcare programs. Health programme personnel involved in CoPs in Mexico and Nicaragua reported improved capacities to identify and use evidence in solving implementation problems. In South Africa, Policy BUDDIES informed a policy framework for medication adherence for chronic diseases, including both HIV and non-communicable diseases. Policymakers engaged in the buddying process reported an enhanced recognition of the value of research, and greater demand for policy-relevant knowledge. The collaborative evidence-to-policy approaches underline the importance of iterations and continuity in the engagement of researchers and policymakers/programme managers, in order to account for swift evolutions in health policy planning and implementation. In developing and supporting evidence-to-policy interventions, due consideration should be given to fit-for-purpose approaches, as different needs in policymaking cycles require adapted processes and knowledge. Greater consideration should be provided to approaches embedding the use of research in real-world policymaking, better suited to the complex adaptive nature of health systems.

Design of demand side response model in energy internet demonstration park

NASA Astrophysics Data System (ADS)

Zhang, Q.; Liu, D. N.

2017-08-01

The implementation of demand side response can bring a lot of benefits to the power system, users and society, but there are still many problems in the actual operation. Firstly, this paper analyses the current situation and problems of demand side response. On this basis, this paper analyses the advantages of implementing demand side response in the energy Internet demonstration park. Finally, the paper designs three kinds of feasible demand side response modes in the energy Internet demonstration park.

Food retailer practices, attitudes and beliefs about the supply of healthy foods.

PubMed

Andreyeva, Tatiana; Middleton, Ann E; Long, Michael W; Luedicke, Joerg; Schwartz, Marlene B

2011-06-01

Non-supermarket food retailers can be a promising channel for increasing the availability of healthy foods in underserved communities. The present paper reports on retailer practices, attitudes and beliefs about the supply of healthy foods before and after the introduction of new subsidies for healthy foods by the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in October 2009. We designed and conducted in-person standardized interviews with store owners and managers to assess perceptions of demand and profits for different foods, supply networks, barriers to stocking healthy foods and their changes following implementation of the new WIC packages. Non-supermarket retailers in five towns of Connecticut, USA (n 68 in 2009 and n 58 in 2010). Owners and managers of WIC-authorized and non-WIC convenience stores and non-chain grocery stores. Retailers identified customer demand as the primary factor in stocking decisions. They reported observing a significantly weaker demand for healthy foods compared with unhealthy foods, although it improved for certain foods with the new WIC subsidies. Less healthy foods were also perceived as more profitable. Supplier networks varied by product from convenient manufacturer delivery for salty snacks to self-supply for produce. WIC retailers were able to quickly adapt and supply healthy foods required under the new WIC programme guidelines. Retailers other than supermarkets currently perceive little demand for healthy foods, but new WIC subsidies have the power to change these perceptions. Supply barriers seem secondary in the limited offerings of healthy foods by stores and could be overcome when policy changes generate new demand for healthy foods.

Towards Hybrid Online On-Demand Querying of Realtime Data with Stateful Complex Event Processing

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

Zhou, Qunzhi; Simmhan, Yogesh; Prasanna, Viktor K.

Emerging Big Data applications in areas like e-commerce and energy industry require both online and on-demand queries to be performed over vast and fast data arriving as streams. These present novel challenges to Big Data management systems. Complex Event Processing (CEP) is recognized as a high performance online query scheme which in particular deals with the velocity aspect of the 3-V’s of Big Data. However, traditional CEP systems do not consider data variety and lack the capability to embed ad hoc queries over the volume of data streams. In this paper, we propose H2O, a stateful complex event processing framework,more » to support hybrid online and on-demand queries over realtime data. We propose a semantically enriched event and query model to address data variety. A formal query algebra is developed to precisely capture the stateful and containment semantics of online and on-demand queries. We describe techniques to achieve the interactive query processing over realtime data featured by efficient online querying, dynamic stream data persistence and on-demand access. The system architecture is presented and the current implementation status reported.« less

Coupling biophysical processes and water rights to simulate spatially distributed water use in an intensively managed hydrologic system

NASA Astrophysics Data System (ADS)

Han, Bangshuai; Benner, Shawn G.; Bolte, John P.; Vache, Kellie B.; Flores, Alejandro N.

2017-07-01

Humans have significantly altered the redistribution of water in intensively managed hydrologic systems, shifting the spatiotemporal patterns of surface water. Evaluating water availability requires integration of hydrologic processes and associated human influences. In this study, we summarize the development and evaluation of an extensible hydrologic model that explicitly integrates water rights to spatially distribute irrigation waters in a semi-arid agricultural region in the western US, using the Envision integrated modeling platform. The model captures both human and biophysical systems, particularly the diversion of water from the Boise River, which is the main water source that supports irrigated agriculture in this region. In agricultural areas, water demand is estimated as a function of crop type and local environmental conditions. Surface water to meet crop demand is diverted from the stream reaches, constrained by the amount of water available in the stream, the water-rights-appropriated amount, and the priority dates associated with particular places of use. Results, measured by flow rates at gaged stream and canal locations within the study area, suggest that the impacts of irrigation activities on the magnitude and timing of flows through this intensively managed system are well captured. The multi-year averaged diverted water from the Boise River matches observations well, reflecting the appropriation of water according to the water rights database. Because of the spatially explicit implementation of surface water diversion, the model can help diagnose places and times where water resources are likely insufficient to meet agricultural water demands, and inform future water management decisions.

Distributed Earth observation data integration and on-demand services based on a collaborative framework of geospatial data service gateway

NASA Astrophysics Data System (ADS)

Xie, Jibo; Li, Guoqing

2015-04-01

Earth observation (EO) data obtained by air-borne or space-borne sensors has the characteristics of heterogeneity and geographical distribution of storage. These data sources belong to different organizations or agencies whose data management and storage methods are quite different and geographically distributed. Different data sources provide different data publish platforms or portals. With more Remote sensing sensors used for Earth Observation (EO) missions, different space agencies have distributed archived massive EO data. The distribution of EO data archives and system heterogeneity makes it difficult to efficiently use geospatial data for many EO applications, such as hazard mitigation. To solve the interoperable problems of different EO data systems, an advanced architecture of distributed geospatial data infrastructure is introduced to solve the complexity of distributed and heterogeneous EO data integration and on-demand processing in this paper. The concept and architecture of geospatial data service gateway (GDSG) is proposed to build connection with heterogeneous EO data sources by which EO data can be retrieved and accessed with unified interfaces. The GDSG consists of a set of tools and service to encapsulate heterogeneous geospatial data sources into homogenous service modules. The GDSG modules includes EO metadata harvesters and translators, adaptors to different type of data system, unified data query and access interfaces, EO data cache management, and gateway GUI, etc. The GDSG framework is used to implement interoperability and synchronization between distributed EO data sources with heterogeneous architecture. An on-demand distributed EO data platform is developed to validate the GDSG architecture and implementation techniques. Several distributed EO data achieves are used for test. Flood and earthquake serves as two scenarios for the use cases of distributed EO data integration and interoperability.

First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care

PubMed Central

Håkanson, Cecilia; Cronfalk, Berit Seiger; Henriksen, Eva; Norberg, Astrid; Ternestedt, Britt-Marie; Sandberg, Jonas

2015-01-01

The aim of this study was to investigate first-line nursing home managers’ views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested. PMID:25628769

Change management in an environment of ongoing primary health care system reform: A case study of Australian primary health care services.

PubMed

Javanparast, Sara; Maddern, Janny; Baum, Fran; Freeman, Toby; Lawless, Angela; Labonté, Ronald; Sanders, David

2018-01-01

Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers. As part of a 5-year project, we interviewed PHC practitioners and managers of services in 7 Australian PHC services. Our findings revealed a policy shift away from the principles of comprehensive PHC including health promotion and action on social determinants of health to one-to-one disease management during the course of study. Analysis of the process of change shows that overall, rapid, and top-down radical reforms of policies and directions were the main characteristic of changes with minimal communication with practitioners and service managers. The study showed that services with community-controlled model of governance had more autonomy to use an emergent model of change and to maintain their comprehensive PHC services. Change is an inevitable feature of PHC systems continually trying to respond to health care demand and cost pressures. The implementation of change in complex settings such as PHC requires appropriate change management strategies to ensure that the proposed reforms are understood, accepted, and implemented successfully. Copyright © 2017 John Wiley & Sons, Ltd.

Intranet and village community: optimization of public service based on electronic government at the local level

NASA Astrophysics Data System (ADS)

Pradana, G. W.; Fanida, E. H.; Niswah, F.

2018-01-01

The demand for good governance is directed towards the realization of efficiency, effectiveness, and clean government. The move is demonstrated through national and regional levels to develop and implement electronic government concepts. Through the development of electronic government is done structuring management systems and work processes in the government environment by optimizing the utilization of information technology. One of the real forms of electronic government (e-Gov) implementation at the local level is the Intranet Sub-District program in Sukodono Sub-District, Sidoarjo. Intranet Sub-District is an innovation whose purpose is to realize the availability of information on the utilization of management, distribution, and storage of official scripts, and also the optimal delivery of information and communication in the implementation of guidance and supervision of local administration. The type of this paper is descriptive with a qualitative approach and focus on the implementation of the Intranet District Program in Sukodono District, Sidoarjo. The findings of the study are the limited number of human resources who have mastered ICT, the uneven network, the adequacy of institutional needs and the existence of budget support from the authorized institution and the information system has not accommodated all the service needs.

Improving the cost effectiveness of financial incentives in managing travel demand management (TDM).

DOT National Transportation Integrated Search

2013-10-01

Providing financial incentives to commuters to use alternative modes is a common element of managing transportation demand. Although these incentives have become common during the past two decades as elements of transportation demand management (TDM)...

Caching Servers for ATLAS

NASA Astrophysics Data System (ADS)

Gardner, R. W.; Hanushevsky, A.; Vukotic, I.; Yang, W.

2017-10-01

As many LHC Tier-3 and some Tier-2 centers look toward streamlining operations, they are considering autonomously managed storage elements as part of the solution. These storage elements are essentially file caching servers. They can operate as whole file or data block level caches. Several implementations exist. In this paper we explore using XRootD caching servers that can operate in either mode. They can also operate autonomously (i.e. demand driven), be centrally managed (i.e. a Rucio managed cache), or operate in both modes. We explore the pros and cons of various configurations as well as practical requirements for caching to be effective. While we focus on XRootD caches, the analysis should apply to other kinds of caches as well.

Experiences of Rehabilitation Professionals with the Implementation of a Back School for Patients with Chronic Low Back Pain: A Qualitative Study.

PubMed

Peters, Stefan; Faller, Hermann; Pfeifer, Klaus; Meng, Karin

2016-01-01

A standardized curriculum back school (CBS) has been recommended for further dissemination in medical rehabilitation in Germany. However, implementation of self-management education programs into practice is challenging. In low back pain care, individual factors of professionals could be decisive regarding implementation fidelity. The study aim was to explore attitudes and experiences of professionals who conducted the back school. Qualitative interviews were led with 45 rehabilitation professionals. The data were examined using thematic analysis. Three central themes were identified: (a) "back school as a common thread," (b) "theory versus practice," and (c) "participation and patient-centeredness." The CBS and its manual were frequently described positively because they provide structure. However, specified time was mentioned critically and there were heterogeneous perceptions regarding flexibility in conducting the CBS. Theory and practice in the CBS were discussed concerning amount, distribution, and conjunction. Participation and patient-centeredness were mainly mentioned in terms of amount and heterogeneity of participation as well as the demand for competences of professionals. Factors were detected that may either positively or negatively influence the implementation fidelity of self-management education programs. The results are explorative and provide potential explanatory mechanisms for behavior and acceptance of rehabilitation professionals regarding the implementation of biopsychosocial back schools.

Management of ATM-based networks supporting multimedia medical information systems

NASA Astrophysics Data System (ADS)

Whitman, Robert A.; Blaine, G. James; Fritz, Kevin; Goodgold, Ken; Heisinger, Patrick

1997-05-01

Medical information systems are acquiring the ability to collect and deliver many different types of medical information. In support of the increased network demands necessitated by these expanded capabilities, asynchronous transfer mode (ATM) based networks are being deployed in medical care systems. While ATM supplies a much greater line rate than currently deployed networks, the management and standards surrounding ATM are yet to mature. This paper explores the management and control issues surrounding an ATM network supporting medical information systems, and examines how management impacts network performance and robustness. A multivendor ATM network at the BJC Health System/Washington University and the applications using the network are discussed. Performance information for specific applications is presented and analyzed. Network management's influence on application reliability is outlined. The information collected is used to show how ATM network standards and management tools influence network reliability and performance. Performance of current applications using the ATM network is discussed. Special attention is given to issues encountered in implementation of hypertext transfer protocol over ATM internet protocol (IP) communications. A classical IP ATM implementation yields greater than twenty percent higher network performance over LANE. Maximum performance for a host's suite of applications can be obtained by establishing multiple individually engineered IP links through its ATM network connection.

Near Real-Time Monitoring of Global Evapotranspiration and its Application to Water Resource Management

NASA Astrophysics Data System (ADS)

Halverson, G. H.; Fisher, J.; Jewell, L. A.; Moore, G.; Verma, M.; McDonald, T.; Kim, S.; Muniz, A.

2016-12-01

Water scarcity and its impact on agriculture is a pressing world concern. At the heart of this crisis is the balance of water exchange between the land and the atmosphere. The ability to monitor evapotranspiration provides a solution by enabling sustainable irrigation practices. The Priestley-Taylor Jet Propulsion Laboratory model of evapotranspiration has been implemented to meet this need as a daily MODIS product with 1 to 5 km resolution. An automated data pipeline for this model implementation provides daily data with global coverage and near real-time latency using the Geospatial Data Abstraction Library. An interactive map providing on-demand statistical analysis enables water resource managers to monitor rates of water loss. To demonstrate the application of remotely-sensed evapotranspiration to water resource management, a partnership has been arranged with the New Mexico Office of the State Engineer (NMOSE). The online water research management tool was developed to meet the specifications of NMOSE using the Leaflet, GeoServer, and Django frameworks. NMOSE will utilize this tool to monitor drought and fire risk and manage irrigation. Through this test-case, it is hoped that real-time, user-friendly remote sensing tools will be adopted globally to make resource management decisions informed by the NASA Earth Observation System.

The Low-Level Radioactive Waste Management Office: Thirty Years of Experience in Canada - 13308

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

Benitez, Liliana; Gardiner, Mark J.; Zelmer, Robert L.

2013-07-01

This paper reviews thirty years of progress by the Low-Level Radioactive Waste Management Office (LLRWMO) in developing and implementing low-level radioactive waste (LLRW) remediation projects and environmentally safe co-existence strategies. It reports on the present status and the future of the national historic waste program in Canada. There are over two million cubic metres of historic LLRW in Canada. Historic LLRW is broadly defined as LLRW that was managed in the past in a manner that is no longer considered acceptable and for which the original owner cannot reasonably be held accountable. In many cases, the original owner can notmore » be identified or no longer exists. The LLRWMO was established in 1982 as Canada's agent to carry out the responsibilities of the federal government for the management of historic LLRW. The LLRWMO is operated by Atomic Energy of Canada Limited (AECL) through a cost-recovery agreement with Natural Resources Canada (NRCan), the federal department that provides the funding and establishes national policy for radioactive waste management in Canada. The LLRWMO expertise includes project managers, environmental remediation specialists, radiation surveyors, communications staff and administrative support staff. The LLRWMO in providing all aspects of project oversight and implementation contracts additional resources supplementing core staff capacity as project/program demands require. (authors)« less

Implementation and evaluation of LMS mobile application: scele mobile based on user-centered design

NASA Astrophysics Data System (ADS)

Banimahendra, R. D.; Santoso, H. B.

2018-03-01

The development of mobile technology is now increasing rapidly, demanding all activities including learning should be done on mobile devices. It shows that the implementation of mobile application as a learning medium needs to be done. This study describes the process of developing and evaluating the Moodle-based mobile Learning Management System (LMS) application called Student Centered e-Learning Environment (SCeLE). This study discusses the process of defining features, implementing features into the application, and evaluating the application. We define the features using user research and literature study, then we implement the application with user-centered design basis, at the last phase we evaluated the application using usability testing and system usability score (SUS). The purpose of this study is to determine the extent to which this application can help the users doing their tasks and provide recommendation for the next research and development.

Procuring load curtailment from local customers under uncertainty.

PubMed

Mijatović, Aleksandar; Moriarty, John; Vogrinc, Jure

2017-08-13

Demand side response (DSR) provides a flexible approach to managing constrained power network assets. This is valuable if future asset utilization is uncertain. However there may be uncertainty over the process of procurement of DSR from customers. In this context we combine probabilistic modelling, simulation and optimization to identify economically optimal procurement policies from heterogeneous customers local to the asset, under chance constraints on the adequacy of the procured DSR. Mathematically this gives rise to a search over permutations, and we provide an illustrative example implementation and case study.This article is part of the themed issue 'Energy management: flexibility, risk and optimization'. © 2017 The Author(s).

Reserve valuation in electric power systems

NASA Astrophysics Data System (ADS)

Ruiz, Pablo Ariel

Operational reliability is provided in part by scheduling capacity in excess of the load forecast. This reserve capacity balances the uncertain power demand with the supply in real time and provides for equipment outages. Traditionally, reserve scheduling has been ensured by enforcing reserve requirements in the operations planning. An alternate approach is to employ a stochastic formulation, which allows the explicit modeling of the sources of uncertainty. This thesis compares stochastic and reserve methods and evaluates the benefits of a combined approach for the efficient management of uncertainty in the unit commitment problem. Numerical studies show that the unit commitment solutions obtained for the combined approach are robust and superior with respect to the traditional approach. These robust solutions are especially valuable in areas with a high proportion of wind power, as their built-in flexibility allows the dispatch of practically all the available wind power while minimizing the costs of operation. The scheduled reserve has an economic value since it reduces the outage costs. In several electricity markets, reserve demand functions have been implemented to take into account the value of reserve in the market clearing process. These often take the form of a step-down function at the reserve requirement level, and as such they may not appropriately represent the reserve value. The value of reserve is impacted by the reliability, dynamic and stochastic characteristics of system components, the system operation policies, and the economic aspects such as the risk preferences of the demand. In this thesis, these aspects are taken into account to approximate the reserve value and construct reserve demand functions. Illustrative examples show that the demand functions constructed have similarities with those implemented in some markets.

Contribution of the Multi Attribute Value Theory to conflict resolution in groundwater management. Application to the Mancha Oriental groundwater system, Spain

NASA Astrophysics Data System (ADS)

Apperl, B.; Andreu, J.; Karjalainen, T. P.; Pulido-Velazquez, M.

2014-09-01

The implementation of the EU Water Framework Directive demands participatory water resource management approaches. Decision making in groundwater quantity and quality management is complex because of the existence of many independent actors, heterogeneous stakeholder interests, multiple objectives, different potential policies, and uncertain outcomes. Conflicting stakeholder interests have been often identified as an impediment to the realization and success of water regulations and policies. The management of complex groundwater systems requires clarifying stakeholders' positions (identifying stakeholders preferences and values), improving transparency with respect to outcomes of alternatives, and moving the discussion from the selection of alternatives towards definition of fundamental objectives (value-thinking approach), what facilitates negotiation. The aims of the study are to analyse the potential of the multi attribute value theory for conflict resolution in groundwater management and to evaluate the benefit of stakeholder incorporation in the different stages of the planning process to find an overall satisfying solution for groundwater management. The research was conducted in the Mancha Oriental groundwater system (Spain), subject to an intensive use of groundwater for irrigation. A complex set of objectives and attributes were defined, and the management alternatives were created by a combination of different fundamental actions, considering different implementation stages and future changes in water resources availability. Interviews were conducted with representative stakeholder groups using an interactive platform, showing simultaneously the consequences of changes of preferences to the alternative ranking. Results show that the acceptation of alternatives depends strongly on the combination of measures and the implementation stages. Uncertainties of the results were notable but did not influence heavily on the alternative ranking. The expected reduction of future groundwater resources by climate change increases the conflict potential. The implementation of the method to a very complex case study, with many conflicting objectives and alternatives and uncertain outcomes, including future scenarios under water limiting conditions, illustrate the potential of the method for supporting management decisions.

Contribution of the multi-attribute value theory to conflict resolution in groundwater management - application to the Mancha Oriental groundwater system, Spain

NASA Astrophysics Data System (ADS)

Apperl, B.; Pulido-Velazquez, M.; Andreu, J.; Karjalainen, T. P.

2015-03-01

The implementation of the EU Water Framework Directive demands participatory water resource management approaches. Decision making in groundwater quantity and quality management is complex because of the existence of many independent actors, heterogeneous stakeholder interests, multiple objectives, different potential policies, and uncertain outcomes. Conflicting stakeholder interests have often been identified as an impediment to the realisation and success of water regulations and policies. The management of complex groundwater systems requires the clarification of stakeholders' positions (identifying stakeholder preferences and values), improving transparency with respect to outcomes of alternatives, and moving the discussion from the selection of alternatives towards the definition of fundamental objectives (value-thinking approach), which facilitates negotiation. The aims of the study are to analyse the potential of the multi-attribute value theory for conflict resolution in groundwater management and to evaluate the benefit of stakeholder incorporation into the different stages of the planning process, to find an overall satisfying solution for groundwater management. The research was conducted in the Mancha Oriental groundwater system (Spain), subject to intensive use of groundwater for irrigation. A complex set of objectives and attributes was defined, and the management alternatives were created by a combination of different fundamental actions, considering different implementation stages and future changes in water resource availability. Interviews were conducted with representative stakeholder groups using an interactive platform, showing simultaneously the consequences of changes in preferences to the alternative ranking. Results show that the approval of alternatives depends strongly on the combination of measures and the implementation stages. Uncertainties in the results were notable, but did not influence the alternative ranking heavily. The expected reduction in future groundwater resources by climate change increases the conflict potential. The implementation of the method in a very complex case study, with many conflicting objectives and alternatives and uncertain outcomes, including future scenarios under water limiting conditions, illustrates the potential of the method for supporting management decisions.

Implementation of a Quality Improvement Process Aimed to Deliver Higher-Value Physical Therapy for Patients With Low Back Pain: Case Report.

PubMed

Karlen, Emily; McCathie, Becky

2015-12-01

The current state of health care demands higher-value care. Due to many barriers, clinicians routinely do not implement evidence-based care even though it is known to improve quality and reduce cost of care. The purpose of this case report is to describe a theory-based, multitactic implementation of a quality improvement process aimed to deliver higher-value physical therapy for patients with low back pain. Patients were treated from January 2010 through December 2014 in 1 of 32 outpatient physical therapy clinics within an academic health care system. Data were examined from 47,755 patients (mean age=50.3 years) entering outpatient physical therapy for management of nonspecific low back pain, with or without radicular pain. Development and implementation tactics were constructed from adult learning and change management theory to enhance adherence to best practice care among 130 physical therapists. A quality improvement team implemented 4 tactics: establish care delivery expectations, facilitate peer-led clinical and operational teams, foster a learning environment focused on meeting a population's needs, and continuously collect and analyze outcomes data. Physical therapy utilization and change in functional disability were measured to assess relative cost and quality of care. Secondarily, charge data assessed change in physical therapists' application of evidence-based care. Implementation of a quality improvement process was measured by year-over-year improved clinical outcomes, decreased utilization, and increased adherence to evidence-based physical therapy, which was associated with higher-value care. When adult learning and change management theory are combined in quality improvement efforts, common barriers to implementing evidence-based care can be overcome, creating an environment supportive of delivering higher-value physical therapy for patients with low back pain. © 2015 American Physical Therapy Association.

Designing an Academic Project Management Program: A Collaboration between a University and a PMI Chapter

ERIC Educational Resources Information Center

Poston, Robin S.; Richardson, Sandra M.

2011-01-01

The demand for project management skills in industry is increasing resulting in a higher demand for project management educational programs. Universities are addressing industry demand by developing project management courses, degree offerings and certificate programs that focus on both technical and general project management skills. While…

Best Practices in Developing Proactive Supply Strategies for Air Force Low-Demand ServiceParts

DTIC Science & Technology

2010-01-01

research clients and sponsors. R ® is a registered trademark. © Copyright 2010 RAND Corporation Permission is given to duplicate this document for personal...RAND Corporation, MG-274-AF, 2005 • Nancy Y. Moore, Cynthia R . Cook, Clifford A. Grammich, and Charles Lindenblatt, Using a Spend Analysis to...poration, DB-434-AF, 2004 • Nancy Y. Moore, Laura H. Baldwin, Frank Camm, and Cynthia R . Cook, Implementing Best Purchasing and Supply Management Preface

Data management in clinical research: An overview

PubMed Central

Krishnankutty, Binny; Bellary, Shantala; Kumar, Naveen B.R.; Moodahadu, Latha S.

2012-01-01

Clinical Data Management (CDM) is a critical phase in clinical research, which leads to generation of high-quality, reliable, and statistically sound data from clinical trials. This helps to produce a drastic reduction in time from drug development to marketing. Team members of CDM are actively involved in all stages of clinical trial right from inception to completion. They should have adequate process knowledge that helps maintain the quality standards of CDM processes. Various procedures in CDM including Case Report Form (CRF) designing, CRF annotation, database designing, data-entry, data validation, discrepancy management, medical coding, data extraction, and database locking are assessed for quality at regular intervals during a trial. In the present scenario, there is an increased demand to improve the CDM standards to meet the regulatory requirements and stay ahead of the competition by means of faster commercialization of product. With the implementation of regulatory compliant data management tools, CDM team can meet these demands. Additionally, it is becoming mandatory for companies to submit the data electronically. CDM professionals should meet appropriate expectations and set standards for data quality and also have a drive to adapt to the rapidly changing technology. This article highlights the processes involved and provides the reader an overview of the tools and standards adopted as well as the roles and responsibilities in CDM. PMID:22529469

ICT Solutions for Highly-Customized Water Demand Management Strategies

NASA Astrophysics Data System (ADS)

Giuliani, M.; Cominola, A.; Castelletti, A.; Fraternali, P.; Guardiola, J.; Barba, J.; Pulido-Velazquez, M.; Rizzoli, A. E.

2016-12-01

The recent deployment of smart metering networks is opening new opportunities for advancing the design of residential water demand management strategies (WDMS) relying on improved understanding of water consumers' behaviors. Recent applications showed that retrieving information on users' consumption behaviors, along with their explanatory and/or causal factors, is key to spot potential areas where targeting water saving efforts, and to design user-tailored WDMS. In this study, we explore the potential of ICT-based solutions in supporting the design and implementation of highly customized WDMS. On one side, the collection of consumption data at high spatial and temporal resolutions requires big data analytics and machine learning techniques to extract typical consumption features from the metered population of water users. On the other side, ICT solutions and gamifications can be used as effective means for facilitating both users' engagement and the collection of socio-psychographic users' information. This latter allows interpreting and improving the extracted profiles, ultimately supporting the customization of WDMS, such as awareness campaigns or personalized recommendations. Our approach is implemented in the SmartH2O platform and demonstrated in a pilot application in Valencia, Spain. Results show how the analysis of the smart metered consumption data, combined with the information retrieved from an ICT gamified web user portal, successfully identify the typical consumption profiles of the metered users and supports the design of alternative WDMS targeting the different users' profiles.

A review of Integrated Vehicle Health Management tools for legacy platforms: Challenges and opportunities

NASA Astrophysics Data System (ADS)

Esperon-Miguez, Manuel; John, Philip; Jennions, Ian K.

2013-01-01

Integrated Vehicle Health Management (IVHM) comprises a set of tools, technologies and techniques for automated detection, diagnosis and prognosis of faults in order to support platforms more efficiently. Specific challenges are faced when IVHM tools are to be retrofitted into legacy vehicles since major modifications are much more challenging than with platforms whose design can still be modified. The topics covered in this Review Paper include the state of the art of IVHM tools and how their characteristics match the requirements of legacy aircraft, a summary of problems faced in the past trying to retrofit IVHM tools both from a technical and organisational perspective and the current level of implementation of IVHM in industry. Although the technology has not reached the level necessary to implement IVHM to its full potential on every kind of component, significant progress has been achieved on rotating equipment, structures or electronics. Attempts to retrofit some of these tools in the past faced both technical difficulties and opposition by some stakeholders, the later being responsible for the failure of technically sound projects in more than one occasion. Nevertheless, despite these difficulties, products and services based on IVHM technology have started to be offered by the manufacturers and, what is more important, demanded by the operators, providing guidance on what the industry would demand from IVHM on legacy aircraft.

Evaluating effects of travel demand management in a medium-sized urban area : the study of I-40 Greensboro-Winston-Salem corridor

DOT National Transportation Integrated Search

2001-08-01

Travel demand management (TDM) is a set of procedures that have been shown to alleviate unlimited use of automobiles. Demand is managed by limiting highway capacity to meet demand to travel by car and providing incentives or disincentives to increase...

The dynamic model on the impact of biodiesel blend mandate (B5) on Malaysian palm oil domestic demand: A preliminary finding

NASA Astrophysics Data System (ADS)

Abidin, Norhaslinda Zainal; Applanaidu, Shri-Dewi; Sapiri, Hasimah

2014-12-01

Over the last ten years, world biofuels production has increased dramatically. The biodiesel demand is driven by the increases in fossil fuel prices, government policy mandates, income from gross domestic product and population growth. In the European Union, biofuel consumption is mostly driven by blending mandates in both France and Germany. In the case of Malaysia, biodiesel has started to be exported since 2006. The B5 of 5% blend of palm oil based biodiesel into diesel in all government vehicles was implemented in February 2009 and it is expected to be implemented nationwide in the nearest time. How will the blend mandate will project growth in the domestic demand of palm oil in Malaysia? To analyze this issue, a system dynamics model was constructed to evaluate the impact of blend mandate implementation on the palm oil domestic demand influence. The base run of simulation analysis indicates that the trend of domestic demand will increase until 2030 in parallel with the implementation of 5 percent of biodiesel mandate. Finally, this study depicts that system dynamics is a useful tool to gain insight and to experiment with the impact of changes in blend mandate implementation on the future growth of Malaysian palm oil domestic demand sector.

Demand management: enabling patients to use medical care appropriately.

PubMed

Vickery, D M; Lynch, W D

1995-05-01

A rationale is presented for considering demand management as well as supply management (managed care) in the current debate on health care reform. Demand management is the support of individuals so that they may make rational health and medical decisions based on a consideration of benefits and risks. The concept of demand for medical services is examined within a theoretical framework of four components: morbidity, perceived need, patient preference, and nonhealth motives. Two components, perceived need and patient preference, are suggested to offer considerable potential for making utilization more appropriate and reducing costs. Current demand services and potential hazards related to their continued expansion are discussed.

Regulating services as measures of ecological resilience on DoD lands

USGS Publications Warehouse

Angermeier, Paul; Villamagna, Amy M.

2015-01-01

Knowledge of the capacity and flow of ecosystem services can help DoD land managers make decisions that enhance cost-effectiveness, minimize environmental damage, and maximize resources available for military missions. We demonstrated a methodology to quantify and map selected regulating services (RS), which helps land managers envision tradeoffs. Our objectives were to 1) estimate current capacity of and demand for selected RS within DoD lands, 2) examine the effects of future DoD land management and climate changes on the capacity and flow of these RS, and 3) project how land-use and climate changes in nearby lands affect future demand for RS. Our approach incorporates widely accepted models and equations, remote sensing, GIS analysis, and stakeholder involvement. Required data include land cover/use, soil type, precipitation, and air temperature. We integrated data into the a) Surface Curve Number Method and b) Revised Universal Soil Loss Equation to estimate capacity of sediment, nitrogen (N) and surface-water regulation. Capacities and flows of RS vary greatly across landscapes and are likely to vary as climate changes or development occurs. Analyses of RS capacity and flow can help managers and planners prioritize actions in the context of best management practices and compatible use buffers. Staff surveys indicated that our approach was informative and easy to use. Implementation may be most limited by on-installation personnel time.

Development of «Park-and-Ride» system as a tool for sustainable access control managing

NASA Astrophysics Data System (ADS)

Danilina, Nina; Vlasov, Denis

2017-10-01

Large cities, whereby people use private transport, are facing the same challenges related to traffic congestion, reliability of public transportation and parking demand. Managing urban traffic and transport has become the most relevant police in transport planning. The article deals with the potential for further implementation in Russian Federation of «Park-and- Ride» recognized as an essential part of the overall transport and parking offer and successful planning tool to reducing congestion for any urban area around the world. The studies have been carried out in Moscow acknowledged as the city core of Moscow agglomeration — the largest and most populous in Russia. The research aims to support for the development of «Park-and-Ride» system applying the methodical approach adapted by the authors for the study to make it relevant for cities. A three-steps access control is offered to reduce private cars use in the city center. The results of the studies shows that such traffic management tool can help successfully in balancing the traffic demand and supply and, consequently, in resolving transport congestion and the number of coherent social, urban and economic challenges addressed to the sustainable development of urban areas.

Challenges in Incorporating Climate Change Adaptation into Integrated Water Resources Management

NASA Astrophysics Data System (ADS)

Kirshen, P. H.; Cardwell, H.; Kartez, J.; Merrill, S.

2011-12-01

Over the last few decades, integrated water resources management (IWRM), under various names, has become the accepted philosophy for water management in the USA. While much is still to be learned about how to actually carry it out, implementation is slowly moving forward - spurred by both legislation and the demands of stakeholders. New challenges to IWRM have arisen because of climate change. Climate change has placed increased demands on the creativities of planners and engineers because they now must design systems that will function over decades of hydrologic uncertainties that dwarf any previous hydrologic or other uncertainties. Climate and socio-economic monitoring systems must also now be established to determine when the future climate has changed sufficiently to warrant undertaking adaptation. The requirements for taking some actions now and preserving options for future actions as well as the increased risk of social inequities in climate change impacts and adaptation are challenging experts in stakeholder participation. To meet these challenges, an integrated methodology is essential that builds upon scenario analysis, risk assessment, statistical decision theory, participatory planning, and consensus building. This integration will create cross-disciplinary boundaries for these disciplines to overcome.

Integrated versus fragmented implementation of complex innovations in acute health care.

PubMed

Woiceshyn, Jaana; Blades, Kenneth; Pendharkar, Sachin R

Increased demand and escalating costs necessitate innovation in health care. The challenge is to implement complex innovations-those that require coordinated use across the adopting organization to have the intended benefits. We wanted to understand why and how two of five similar hospitals associated with the same health care authority made more progress with implementing a complex inpatient discharge innovation whereas the other three experienced more difficulties in doing so. We conducted a qualitative comparative case study of the implementation process at five comparable urban hospitals adopting the same inpatient discharge innovation mandated by their health care authority. We analyzed documents and conducted 39 interviews of the health care authority and hospital executives and frontline managers across the five sites over a 1-year period while the implementation was ongoing. In two and a half years, two of the participating hospitals had made significant progress with implementing the innovation and had begun to realize benefits; they exemplified an integrated implementation mode. Three sites had made minimal progress, following a fragmented implementation mode. In the former mode, a semiautonomous health care organization developed a clear overall purpose and chose one umbrella initiative to implement it. The integrative initiative subsumed the rest and guided resource allocation and the practices of hospital executives, frontline managers, and staff who had bought into it. In contrast, in the fragmented implementation mode, the health care authority had several overlapping, competing innovations that overwhelmed the sites and impeded their implementation. Implementing a complex innovation across hospital sites required (a) early prioritization of one initiative as integrative, (b) the commitment of additional (traded off or new) human resources, (c) deliberate upfront planning and continual support for and evaluation of implementation, and (d) allowance for local customization within the general principles of standardization.

Market-Based Decision Guidance Framework for Power and Alternative Energy Collaboration

NASA Astrophysics Data System (ADS)

Altaleb, Hesham

With the introduction of power energy markets deregulation, innovations have transformed once a static network into a more flexible grid. Microgrids have also been deployed to serve various purposes (e.g., reliability, sustainability, etc.). With the rapid deployment of smart grid technologies, it has become possible to measure and record both, the quantity and time of the consumption of electrical power. In addition, capabilities for controlling distributed supply and demand have resulted in complex systems where inefficiencies are possible and where improvements can be made. Electric power like other volatile resources cannot be stored efficiently, therefore, managing such resource requires considerable attention. Such complex systems present a need for decisions that can streamline consumption, delay infrastructure investments, and reduce costs. When renewable power resources and the need for limiting harmful emissions are added to the equation, the search space for decisions becomes increasingly complex. As a result, the need for a comprehensive decision guidance system for electrical power resources consumption and productions becomes evident. In this dissertation, I formulate and implement a comprehensive framework that addresses different aspect of the electrical power generation and consumption using optimization models and utilizing collaboration concepts. Our solution presents a two-prong approach: managing interaction in real-time for the short-term immediate consumption of already allocated resources; and managing the operational planning for the long-run consumption. More specifically, in real-time, we present and implement a model of how to organize a secondary market for peak-demand allocation and describe the properties of the market that guarantees efficient execution and a method for the fair distribution of collaboration gains. We also propose and implement a primary market for peak demand bounds determination problem with the assumption that participants of this market have the ability to collaborate in real-time. Moreover, proposed in this dissertation is an extensible framework to facilitate C&I entities forming a consortium to collaborate on their electric power supply and demand. The collaborative framework includes the structure of market setting, bids, and market resolution that produces a schedule of how power components are controlled as well as the resulting payment. The market resolution must satisfy a number of desirable properties (i.e., feasibility, Nash equilibrium, Pareto optimality, and equal collaboration profitability) which are formally defined in the dissertation. Furthermore, to support the extensible framework components' library, power components such as utility contract, back-up power generator, renewable resource, and power consuming service are formally modeled. Finally, the validity of this framework is evaluated by a case study using simulated load scenarios to examine the ability of the framework to efficiently operate at the specified time intervals with minimal overhead cost.

Performance management of multiple access communication networks

NASA Astrophysics Data System (ADS)

Lee, Suk; Ray, Asok

1993-12-01

This paper focuses on conceptual design, development, and implementation of a performance management tool for computer communication networks to serve large-scale integrated systems. The objective is to improve the network performance in handling various types of messages by on-line adjustment of protocol parameters. The techniques of perturbation analysis of Discrete Event Dynamic Systems (DEDS), stochastic approximation (SA), and learning automata have been used in formulating the algorithm of performance management. The efficacy of the performance management tool has been demonstrated on a network testbed. The conceptual design presented in this paper offers a step forward to bridging the gap between management standards and users' demands for efficient network operations since most standards such as ISO (International Standards Organization) and IEEE address only the architecture, services, and interfaces for network management. The proposed concept of performance management can also be used as a general framework to assist design, operation, and management of various DEDS such as computer integrated manufacturing and battlefield C(sup 3) (Command, Control, and Communications).

A novel medical information management and decision model for uncertain demand optimization.

PubMed

Bi, Ya

2015-01-01

Accurately planning the procurement volume is an effective measure for controlling the medicine inventory cost. Due to uncertain demand it is difficult to make accurate decision on procurement volume. As to the biomedicine sensitive to time and season demand, the uncertain demand fitted by the fuzzy mathematics method is obviously better than general random distribution functions. To establish a novel medical information management and decision model for uncertain demand optimization. A novel optimal management and decision model under uncertain demand has been presented based on fuzzy mathematics and a new comprehensive improved particle swarm algorithm. The optimal management and decision model can effectively reduce the medicine inventory cost. The proposed improved particle swarm optimization is a simple and effective algorithm to improve the Fuzzy interference and hence effectively reduce the calculation complexity of the optimal management and decision model. Therefore the new model can be used for accurate decision on procurement volume under uncertain demand.

Factors associated with the implementation of programs for drug abuse prevention in schools

PubMed Central

Pereira, Ana Paula Dias; Paes, Ângela Tavares; Sanchez, Zila M

2016-01-01

ABSTRACT OBJECTIVE To analyze if characteristics of managers, schools, and curriculum are associated with the implementation of programs for drug abuse prevention in elementary and high schools. METHODS Cross-sectional study, with random sample of 263 school managers. Data were collected between 2012 and 2013 by a program that sends forms via internet. A closed self-filling questionnaire was applied online. Statistical analysis included Chi-square tests and logistic regression models. The outcome variable was the presence of program for drug abuse prevention inserted in the daily life and educational program of the school. The explanatory variables were divided into: demographic data of the manager; characteristics of the school and of the curriculum; health education; and drug use in the school. RESULTS We found that 42.5% (95%CI 36.1–49.1) of the evaluated schools had programs for drug abuse prevention. With the multiple logistic regression model, we observed that the more time the manager has worked with education, the chance of the school having a program increased at about 4.0%. Experimenting with innovative teaching techniques also increased at about six times the chance of the school developing a program for drug abuse prevention. The difficulties in the implementation of the programs were more present in state and municipal schools, when compared with private schools, due to, for instance: lack of teaching materials, lack of money, and competing demands for teaching other subjects. CONCLUSIONS The implementation of programs for drug abuse prevention in the city of Sao Paulo is associated with the experience of the manager in education and with the teaching strategies of the school. PMID:27509010

Identifying Functional Requirements for Flexible Airspace Management Concept Using Human-In-The-Loop Simulations

NASA Technical Reports Server (NTRS)

Lee, Paul U.; Bender, Kim; Pagan, Danielle

2011-01-01

Flexible Airspace Management (FAM) is a mid- term Next Generation Air Transportation System (NextGen) concept that allows dynamic changes to airspace configurations to meet the changes in the traffic demand. A series of human-in-the-loop (HITL) studies have identified procedures and decision support requirements needed to implement FAM. This paper outlines a suggested FAM procedure and associated decision support functionality based on these HITL studies. A description of both the tools used to support the HITLs and the planned NextGen technologies available in the mid-term are presented and compared. The mid-term implementation of several NextGen capabilities, specifically, upgrades to the Traffic Management Unit (TMU), the initial release of an en route automation system, the deployment of a digital data communication system, a more flexible voice communications network, and the introduction of a tool envisioned to manage and coordinate networked ground systems can support the implementation of the FAM concept. Because of the variability in the overall deployment schedule of the mid-term NextGen capabilities, the dependency of the individual NextGen capabilities are examined to determine their impact on a mid-term implementation of FAM. A cursory review of the different technologies suggests that new functionality slated for the new en route automation system is a critical enabling technology for FAM, as well as the functionality to manage and coordinate networked ground systems. Upgrades to the TMU are less critical but important nonetheless for FAM to be fully realized. Flexible voice communications network and digital data communication system could allow more flexible FAM operations but they are not as essential.

Building new WDM regulations for the Namibian tourism sector on factors influencing current water-management practices at the enterprise level

NASA Astrophysics Data System (ADS)

Schachtschneider, Klaudia

Namibia's aridity is forcing its water sector to resort to new water resource management approaches, including water demand management (WDM). Such a change in management approach is facilitated through the country's opportunity at independence to rewrite and adapt its old policies, including those for water and tourism. Legal support for WDM through the Water Act and other sector-specific Acts is crucial to plan the practical implementation of WDM throughout the different water use sectors of Namibia. In order to be able to put the policy into practice, it is imperative to understand which factors motivate people to adopt WDM initiatives. Within the Namibian tourism industry three main factors have been identified which influence the water-management approaches at tourist facilities. This paper discusses how the water and tourism decision makers can consider these factors when developing new regulations to introduce WDM in the tourism sector.

Total quality management in orthodontic practice.

PubMed

Atta, A E

1999-12-01

Quality is the buzz word for the new Millennium. Patients demand it, and we must serve it. Yet one must identify it. Quality is not imaging or public relations; it is a business process. This short article presents quality as a balance of three critical notions: core clinical competence, perceived values that our patients seek and want, and the cost of quality. Customer satisfaction is a variable that must be identified for each practice. In my practice, patients perceive quality as communication and time, be it treatment or waiting time. Time is a value and cost that must be managed effectively. Total quality management is a business function; it involves diagnosis, design, implementation, and measurement of the process, the people, and the service. Kazien is a function that reduces value services, eliminates waste, and manages time and cost in the process. Total quality management is a total commitment for continuous improvement.

Velocity control as a tool for optimal plume containment in the Equus Beds aquifer, Kansas

USGS Publications Warehouse

Heidari, M.; Sadeghipour, J.; Drici, O.

1987-01-01

A ground-water-management model was developed to investigate the best management options for the containment of an oil-field-brine plume in the Equus Beds aquifer in south-central Kansas. The main purpose of the management model was to find the optimal locations and minimum rates of pumpage of a set of plume-interception wells, to successfully reverse the velocity vectors at observation wells located along the plume front, and also to satisfy freshwater demands from supply wells. The effects of the calculated minimum withdrawals from the interception wells on the migration of contaminants throughout the ground-water system were evaluated utilizing a solute-transport model. This latter analysis was carried out to ensure the containment of the plume. Whereas application of the management model to the study area achieves the management objectives, the implementation of the results is believed to be impractical and expensive.

Characterization of mathematics instructional practises for prospective elementary teachers with varying levels of self-efficacy in classroom management and mathematics teaching

NASA Astrophysics Data System (ADS)

Lee, Carrie W.; Walkowiak, Temple A.; Nietfeld, John L.

2017-03-01

The purpose of this study was to investigate the relationship between prospective teachers' (PTs) instructional practises and their efficacy beliefs in classroom management and mathematics teaching. A sequential, explanatory mixed-methods design was employed. Results from efficacy surveys, implemented with 54 PTs were linked to a sample of teachers' instructional practises during the qualitative phase. In this phase, video-recorded lessons were analysed based on tasks, representations, discourse, and classroom management. Findings indicate that PTs with higher levels of mathematics teaching efficacy taught lessons characterised by tasks of higher cognitive demand, extended student explanations, student-to-student discourse, and explicit connections between representations. Classroom management efficacy seems to bear influence on the utilised grouping structures. These findings support explicit attention to PTs' mathematics teaching and classroom management efficacy throughout teacher preparation and a need for formative feedback to inform development of beliefs about teaching practises.

Contingency Management and Deliberative Decision-Making Processes.

PubMed

Regier, Paul S; Redish, A David

2015-01-01

Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation.

Contingency Management and Deliberative Decision-Making Processes

PubMed Central

Regier, Paul S.; Redish, A. David

2015-01-01

Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation. PMID:26082725

Water resources management. (Arabic version). World Bank policy paper

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

NONE

1993-10-01

A new approach, recognizing that water is a scarce natural resource-subject to many interdependencies in conveyance and use-should be adopted by the World Bank and its member countries. Chapter 2 discusses the management problems that have beset the sector in many countries and how these are being aggravated by increasing demands for water and rising costs of new supplies. Chapter 3 outlines the strategy for improving the management of water resources. Chapter 4 spells out the role of the World Bank in helping countries implement better approaches to water resources management. Five appendixes discuss in detail market failures and publicmore » policy; lessons learned about the relation among water, people, and the environment; privatization and user participation; Bank guidelines related to water resources; and Bank experience with investments in water resources.« less

Load shifting with the use of home energy management system implemented in FPGA

NASA Astrophysics Data System (ADS)

Bazydło, Grzegorz; Wermiński, Szymon

2017-08-01

The increases for power demand in the Electrical Power System (EPS) causes a significant increase of power in daily load curve and transmission line overload. The large variability in energy consumption in EPS combined with unpredictable weather events can lead to a situation in which to save the stability of the EPS, the power limits must be introduced or even industrial customers in a given area have to be disconnected, which causes financial losses. Nowadays, a Transmission System Operator is looking for additional solutions to reduce peak power, because existing approaches (mainly building new intervention power unit or tariff programs) are not satisfactory due to the high cost of services in combination with insufficient power reduction effect. The paper presents an approach to load shifting with the use of home Energy Management System (EMS) installed at small end-users. The home energy management algorithm, executed by EMS controller, is modeled using Unified Modeling Language (UML). Then, the UML model is translated into Verilog description, and is finally implemented in the Field Programmable Gate Arrays. The advantages of the proposed approach are the relatively low cost of reduction service, small loss of end-users' comfort, and the convenient maintenance of EMS. A practical example illustrating the proposed approach and calculation of potential gains from its implementation are also presented.

Design and implementation of GRID-based PACS in a hospital with multiple imaging departments

NASA Astrophysics Data System (ADS)

Yang, Yuanyuan; Jin, Jin; Sun, Jianyong; Zhang, Jianguo

2008-03-01

Usually, there were multiple clinical departments providing imaging-enabled healthcare services in enterprise healthcare environment, such as radiology, oncology, pathology, and cardiology, the picture archiving and communication system (PACS) is now required to support not only radiology-based image display, workflow and data flow management, but also to have more specific expertise imaging processing and management tools for other departments providing imaging-guided diagnosis and therapy, and there were urgent demand to integrate the multiple PACSs together to provide patient-oriented imaging services for enterprise collaborative healthcare. In this paper, we give the design method and implementation strategy of developing grid-based PACS (Grid-PACS) for a hospital with multiple imaging departments or centers. The Grid-PACS functions as a middleware between the traditional PACS archiving servers and workstations or image viewing clients and provide DICOM image communication and WADO services to the end users. The images can be stored in distributed multiple archiving servers, but can be managed with central mode. The grid-based PACS has auto image backup and disaster recovery services and can provide best image retrieval path to the image requesters based on the optimal algorithms. The designed grid-based PACS has been implemented in Shanghai Huadong Hospital and been running for two years smoothly.

Water resource management: an Indian perspective.

PubMed

Khadse, G K; Labhasetwar, P K; Wate, S R

2012-10-01

Water is precious natural resource for sustaining life and environment. Effective and sustainable management of water resources is vital for ensuring sustainable development. In view of the vital importance of water for human and animal life, for maintaining ecological balance and for economic and developmental activities of all kinds, and considering its increasing scarcity, the planning and management of water resource and its optimal, economical and equitable use has become a matter of the utmost urgency. Management of water resources in India is of paramount importance to sustain one billion plus population. Water management is a composite area with linkage to various sectors of Indian economy including the agricultural, industrial, domestic and household, power, environment, fisheries and transportation sector. The water resources management practices should be based on increasing the water supply and managing the water demand under the stressed water availability conditions. For maintaining the quality of freshwater, water quality management strategies are required to be evolved and implemented. Decision support systems are required to be developed for planning and management of the water resources project. There is interplay of various factors that govern access and utilization of water resources and in light of the increasing demand for water it becomes important to look for holistic and people-centered approaches for water management. Clearly, drinking water is too fundamental and serious an issue to be left to one institution alone. It needs the combined initiative and action of all, if at all we are serious in socioeconomic development. Safe drinking water can be assured, provided we set our mind to address it. The present article deals with the review of various options for sustainable water resource management in India.

Pediatric sepsis.

PubMed

Mathias, Brittany; Mira, Juan C; Larson, Shawn D

2016-06-01

Sepsis is the leading cause of pediatric death worldwide. In the United States alone, there are 72 000 children hospitalized for sepsis annually with a reported mortality rate of 25% and an economic cost estimated to be $4.8 billion. However, it is only recently that the definition and management of pediatric sepsis has been recognized as being distinct from adult sepsis. The definition of pediatric sepsis is currently in a state of evolution, and there is a large disconnect between the clinical and research definitions of sepsis which impacts the application of research findings into clinical practice. Despite this, it is the speed of diagnosis and the timely implementation of current treatment guidelines that has been shown to improve outcomes. However, adherence to treatment guidelines is currently low and it is only through the implementation of protocols that improved care and outcomes have been demonstrated. The current management of pediatric sepsis is largely based on adaptations from adult sepsis treatment; however, distinct physiology demands more prospective pediatric trials to tailor management to the pediatric population. Adherence to current and emerging practice guidelines will require that protocolized care pathways become a commonplace.

Factors affecting speech pathologists' implementation of stroke management guidelines: a thematic analysis.

PubMed

Miao, Melissa; Power, Emma; O'Halloran, Robyn

2015-01-01

Although clinical practice guidelines can facilitate evidence-based practice and improve the health outcomes of stroke patients, they continue to be underutilised. There is limited research into the reasons for this, especially in speech pathology. This study provides the first in-depth, qualitative examination of the barriers and facilitators that speech pathologists perceive and experience when implementing guidelines. A maximum variation sample of eight speech pathologists participated in a semi-structured interview concerning the implementation of the National Stroke Foundation's Clinical Guidelines for Stroke Management 2010. Interviews were transcribed, thematically analysed and member checked before overall themes were identified. Three main themes and ten subthemes were identified. The first main theme, making implementation explicit, reflected the necessity of accessing and understanding guideline recommendations, and focussing specifically on implementation in context. In the second theme, demand versus ability to change, the size of changes required was compared with available resources and collaboration. The final theme, Speech pathologist motivation to implement guidelines, demonstrated the influence of individual perception of the guidelines and personal commitment to improved practice. Factors affecting implementation are complex, and are not exclusively barriers or facilitators. Some potential implementation strategies are suggested. Further research is recommended. In most Western nations, stroke remains the single greatest cause of disability, including communication and swallowing disabilities. Although adherence to stroke clinical practice guidelines improves stroke patient outcomes, guidelines continue to be underutilised, and the reasons for this are not well understood. This is the first in-depth qualitative study identifying the complex barriers and facilitators to guideline implementation as experienced by speech pathologists in stroke care. Suggested implementation strategies include local monitoring of guideline implementation (e.g. team meetings, audits), increasing collaboration on implementation projects (e.g. managerial involvement, networking), and seeking speech pathologist input into guideline development.

Getting the goods without the bads : freight transportation demand management strategies to reduce urban impacts.

DOT National Transportation Integrated Search

2013-09-01

This project identifies and evaluatesstrategies to reduce the social costs associated with goods movement in urban areas by managing : transportation demand. Information about various freight transportation demand management (TDM) strategies was gath...

What does it take to set goals for self-management in primary care? A qualitative study.

PubMed

Lenzen, Stephanie Anna; van Dongen, Jerôme Jean Jacques; Daniëls, Ramon; van Bokhoven, Marloes Amantia; van der Weijden, Trudy; Beurskens, Anna

2016-12-01

There is an increasing number of patients with a chronic illness demanding primary care services. This demands for effective self-management support, including collaborative goal setting. Despite the fact that primary care professionals seem to have difficulties implementing goal setting, little information is available about the factors influencing the complexity of this process in primary care. The aim of this study was to contribute to an understanding of the complexity of self-management goal setting in primary care by exploring experts' and primary care professionals' experiences with self-management goal setting and viewpoints regarding influencing factors. A descriptive qualitative research methodology was adopted. Two focus groups and three individual interviews were conducted (total participants n = 17). Thematic content analysis was used to analyse the data. The findings were categorized into four main themes with subordinated subthemes. The themes focus around the complexity of setting non-medical goals and around professionals' skills and attitudes to negotiate and decide about goals with patients. Furthermore, patients' skills and attitudes for goal setting and the integration of goal setting in the time available were formulated as themes. Setting self-management goals in primary care, especially in family medicine, might require a shift from a medical perspective to a biopsychosocial perspective, with an increasing role set aside for the professional to coach the patient in expressing his self-management goals and to take responsibility for these goals. © The Author 2016. Published by Oxford University Press.

[Rehabilitee-management-categories (RMK)--results of the development phase and of the first clinical implementation in alcohol rehabilitation centres].

PubMed

Spyra, K; Köhn, S; Ammelburg, N; Schmidt, C; Missel, P; Lindenmeyer, J

2011-10-01

Due to the introduction of lump sum reimbursement systems for acute-care settings (DRGs), patient classification systems have been developed in Germany during the last 15 years to adapt a case-based lump sum system to the field of medical rehabilitation. The concept of Rehabilitee-Management-Categories (RMK), developed by the Charité - Universitätsmedizin Berlin, classifies rehabilitees primarily by their relevant impairments of activity and participation, as these factors mainly determine treatment needs and resources required in rehabilitation. It can, inter alia, be used to optimize the demand-related allocation of treatment services in the rehabilitation centres as well as lead to more transparency in the allocation process. RMK results are reported on the example of inpatient rehabilitation of alcohol dependence. Utilizing internationally established assessments, an RMK-assessment was developed that allows the assessment of rehab treatment needs of patients undergoing alcohol dependence rehabilitation. The RMK-assessment was completed by n=731 rehabilitees. Latent class analysis was applied to find groups of cases. To facilitate the RMK-patient classification a software-based algorithm was developed and implemented in 12 rehabilitation centres (implementation study). To validate the results of the first study phase, the data collected during implementation (n=1,533) was again analyzed using latent class analysis. Combined standardized and qualitative user surveys were conducted at the end of the implementation study. On the basis of 15 needs-related patient characteristics, 4 comparable case groups (AL-1 to AL-4) each were identified in 2 independent samples, groups that differed significantly in their degree of dependence-related, psychological and social impairment. The user survey confirmed the basic clinical plausibility of the 4 different case groups as well as the feasibility of the instruments applied in a rehabilitation setting. The RMK-concept offers a new approach for a demand-related patient classification in medical rehabilitation. The RMK-instruments allow a standardized initial assessment of impairment and treatment needs in alcohol rehabilitation and can hence be used for objective comparisons between rehabilitation centres. The results of the RMK-assessment provide relevant information about demand-related treatment requirements, which is a matter of great interest in the context of limited resources. Appropriate treatment requirements for the 4 RMK-case groups will be defined and verified in the next step of the RMK-concept. A financial evaluation of the RMK is possible in principal, will however require more extensive development, not least in order to model and evaluate the health-economic implications involved. © Georg Thieme Verlag KG Stuttgart · New York.

Environmental Management Model for Road Maintenance Operation Involving Community Participation

NASA Astrophysics Data System (ADS)

Triyono, A. R. H.; Setyawan, A.; Sobriyah; Setiono, P.

2017-07-01

Public expectations of Central Java, which is very high on demand fulfillment, especially road infrastructure as outlined in the number of complaints and community expectations tweeter, Short Mail Massage (SMS), e-mail and public reports from various media, Highways Department of Central Java province requires development model of environmental management in the implementation of a routine way by involving the community in order to fulfill the conditions of a representative, may serve road users safely and comfortably. This study used survey method with SEM analysis and SWOT with Latent Independent Variable (X), namely; Public Participation in the regulation, development, construction and supervision of road (PSM); Public behavior in the utilization of the road (PMJ) Provincial Road Service (PJP); Safety in the Provincial Road (KJP); Integrated Management System (SMT) and latent dependent variable (Y) routine maintenance of the provincial road that is integrated with the environmental management system and involve the participation of the community (MML). The result showed the implementation of routine maintenance of road conditions in Central Java province has yet to implement an environmental management by involving the community; Therefore developed environmental management model with the results of H1: Community Participation (PSM) has positive influence on the Model of Environmental Management (MML); H2: Behavior Society in Jalan Utilization (PMJ) positive effect on Model Environmental Management (MML); H3: Provincial Road Service (PJP) positive effect on Model Environmental Management (MML); H4: Safety in the Provincial Road (KJP) positive effect on Model Environmental Management (MML); H5: Integrated Management System (SMT) has positive influence on the Model of Environmental Management (MML). From the analysis obtained formulation model describing the relationship / influence of the independent variables PSM, PMJ, PJP, KJP, and SMT on the dependent variable MML as follows: MML = 0.13 + 0.07 PSM PJP PMJ + 0.09 + 0.19 + 0.48 KJP SMT + e

Over-the-horizon, connected home/office (OCHO): situation management of environmental, medical, and security conditions at remote premises via broadband wireless access

NASA Astrophysics Data System (ADS)

Hortos, William S.

2010-04-01

Broadband wireless access standards, together with advances in the development of commercial sensing and actuator devices, enable the feasibility of a consumer service for a multi-sensor system that monitors the conditions within a residence or office: the environment/infrastructure, patient-occupant health, and physical security. The proposed service is a broadband reimplementation and combination of existing services to allow on-demand reports on and management of the conditions by remote subscribers. The flow of on-demand reports to subscribers and to specialists contracted to mitigate out-of-tolerance conditions is the foreground process. Service subscribers for an over-the-horizon connected home/office (OCHO) monitoring system are the occupant of the premises and agencies, contracted by the service provider, to mitigate or resolve any observed out-of-tolerance condition(s) at the premises. Collectively, these parties are the foreground users of the OCHO system; the implemented wireless standards allow the foreground users to be mobile as they request situation reports on demand from the subsystems on remote conditions that comprise OCHO via wireless devices. An OCHO subscriber, i.e., a foreground user, may select the level of detail found in on-demand reports, i.e., the amount of information displayed in the report of monitored conditions at the premises. This is one context of system operations. While foreground reports are sent only periodically to subscribers, the information generated by the monitored conditions at the premises is continuous and is transferred to a background configuration of servers on which databases reside. These databases are each used, generally, in non-real time, for the assessment and management of situations defined by attributes like those being monitored in the foreground by OCHO. This is the second context of system operations. Context awareness and management of conditions at the premises by a second group of analysts and decision makers who extract information from the OCHO data in the databases form the foundation of the situation management problem.

Challenges and lessons learned in conducting comparative-effectiveness trials.

PubMed

Herrick, Linda M; Locke, G Richard; Zinsmeister, Alan R; Talley, Nicholas J

2012-05-01

The current health-care environment is demanding evidence-based medicine that relies on clinical trials as the basis for decisions. Clinician investigators are more often finding that they are personally responsible for coordinating large, multisite trials. We present strategies for successful implementation and management of multisite clinical trials and knowledge gained through an international, multisite randomized clinical trial. Topics include team composition, regulatory requirements, study organization and governance, communication strategies, recruitment and retention efforts, budget, technology transfer, and publication.

Challenges and Lessons Learned in Conducting Comparative-Effectiveness Trials

PubMed Central

Herrick, Linda M.; Locke, G. Richard; Zinsmeister, Alan R.; Talley, Nicholas J.

2014-01-01

The current health-care environment is demanding evidence-based medicine that relies on clinical trials as the basis for decisions. Clinician investigators are more often finding that they are personally responsible for coordinating large, multisite trials. We present strategies for successful implementation and management of multisite clinical trials and knowledge gained through an international, multisite randomized clinical trial. Topics include team composition, regulatory requirements, study organization and governance, communication strategies, recruitment and retention efforts, budget, technology transfer, and publication. PMID:22552235

The simulation of 3D structure of groundwater system based on Java/Java3D

NASA Astrophysics Data System (ADS)

Yang, Xiaodong; Cui, Weihong; Wang, Peifa; Huang, Yongqi

2007-06-01

With the singular development of Internet technique and 3DGIS as well as VR and the imminence demand of 3D visualization from Groundwater information management field, how to display, roam, anatomize and analyze of 3D structure of Groundwater system on Internet have become a research hotspot in hydrogeology field. We simulated the 3D Groundwater resource structure of Taiyuan basin and implemented displaying, roaming, anatomizing and analyzing functions on Internet by Java 3D.

Design and Implementation of a Telephone Triage/Advice Service: An Instrument of Demand Management at USA Medical Department Activity-Heidelberg.

DTIC Science & Technology

1997-06-01

situations. The USAMH population includes 32,793 family members, many who are young spouses with small children . A recent study of USAMH emergency room...software is based on the work of Shiela Q. Wheeler, considered a pioneer in triage nursing and author of Telephone Triage: Theory . Practice and Protocol...personnel at USAMH established personnel levels at the Table of Distribution and Allowances ( TDA ) level with no overhires authorized. The working group

Load research manual. Volume 2: Fundamentals of implementing load research procedures

NASA Astrophysics Data System (ADS)

1980-11-01

This manual will assist electric utilities and state regulatory authorities in investigating customer electricity demand as part of cost-of-service studies, rate design, marketing research, system design, load forecasting, rate reform analysis, and load management research. Load research procedures are described in detail. Research programs at three utilities are compared: Carolina Power and Light Company, Long Island Lighting Company, and Southern California Edison Company. A load research bibliography and glossaries of load research and statistical terms are also included.

Programming models for energy-aware systems

NASA Astrophysics Data System (ADS)

Zhu, Haitao

Energy efficiency is an important goal of modern computing, with direct impact on system operational cost, reliability, usability and environmental sustainability. This dissertation describes the design and implementation of two innovative programming languages for constructing energy-aware systems. First, it introduces ET, a strongly typed programming language to promote and facilitate energy-aware programming, with a novel type system design called Energy Types. Energy Types is built upon a key insight into today's energy-efficient systems and applications: despite the popular perception that energy and power can only be described in joules and watts, real-world energy management is often based on discrete phases and modes, which in turn can be reasoned about by type systems very effectively. A phase characterizes a distinct pattern of program workload, and a mode represents an energy state the program is expected to execute in. Energy Types is designed to reason about energy phases and energy modes, bringing programmers into the optimization of energy management. Second, the dissertation develops Eco, an energy-aware programming language centering around sustainability. A sustainable program built from Eco is able to adaptively adjusts its own behaviors to stay on a given energy budget, avoiding both deficit that would lead to battery drain or CPU overheating, and surplus that could have been used to improve the quality of the program output. Sustainability is viewed as a form of supply and demand matching, and a sustainable program consistently maintains the equilibrium between supply and demand. ET is implemented as a prototyped compiler for smartphone programming on Android, and Eco is implemented as a minimal extension to Java. Programming practices and benchmarking experiments in these two new languages showed that ET can lead to significant energy savings for Android Apps and Eco can efficiently promote battery awareness and temperature awareness in real-world Java programs.

Managing the demands of the preregistration mental health nursing programme: The views of students with mental health conditions.

PubMed

Ramluggun, Pras; Lacy, Mary; Cadle, Martha; Anjoyeb, Mahmood

2018-05-30

An increasing number of students with a pre-existing mental health condition are enrolling on preregistration mental health nursing programmes. The challenges faced by these students in managing the demands of the programme have not been fully explored. Mental health and well-being is an integral part of providing a healthy university in which students can flourish. The purpose of the study was to explore how students with an underlying mental health issue manage the demands of the mental health nursing programme. The outcomes of the study are aimed at informing inclusive teaching and learning and current student support provision. Ethics approval was given. Students from two universities in South East England who met the criterion of having a pre-existing mental health condition when enrolling on the mental health preregistration nursing programme were invited to take part. Nine students took part in the study. Using an interpretative descriptive design, 1:1 face-to-face, audio-taped, semistructured interviews were undertaken. The data were analysed using a framework approach, and this revealed four main themes: timing of disclosure; managing lived experience in learning environments; students' coping mechanisms, and experience of support. Recommendations for practice was that approved education institutes (AEIs) should ensure they have a robust, inclusive practice by implementing strategies to develop these students' resilience, and enhance their learning and the current support provisions. This will ensure the barriers to disclosing their mental health conditions are recognized and minimized to enable these students to fully contribute to their own learning and teaching experience. © 2018 Australian College of Mental Health Nurses Inc.

Adopting and implementing nutrition guidelines in recreational facilities: tensions between public health and corporate profitability.

PubMed

Olstad, Dana Lee; Raine, Kim D; McCargar, Linda J

2013-05-01

Little is known about how public entities can partner with industry to achieve public health goals. We investigated industry's perspective of factors that influenced their adoption and implementation of voluntary, government-issued nutrition guidelines (Alberta Nutrition Guidelines for Children and Youth, ANGCY) in recreational facilities. In-depth semi-structured interviews were conducted. Data were analysed using directed content analysis. Food services in recreational facilities. Seven managers from industry participated; five from companies that had adopted and implemented the ANGCY (adopters) in recreational facilities and two from companies that had not (non-adopters). Industry views nutrition guidelines through the lens of profitability. Non-adopters were unwilling to implement the ANGCY for fear of sacrificing short-term profitability, whereas adopters adhered to them in an attempt to position themselves for long-term profitability. Adopters faced barriers including few resources, no training, complex guidelines, low availability of and demand for ANGCY-compliant products, competitive pressures and substantial declines in revenue. Managers believed widespread voluntary adoption of the ANGCY was unlikely without government incentives and/or a mandate, as the environmental context for voluntary action was poor. All managers supported government-mandated implementation of the ANGCY to level the playing field upon which companies compete. Public-private partnerships in recreational facilities can embrace public health goals in the short term, provided industry perceives potential for long-term financial gain. Widespread uptake of voluntary nutrition guidelines in this setting is unlikely, however, as market mechanisms do not encourage industry to sell and promote healthier options. Government legislation may therefore be warranted.

Solving the worldwide emergency department crowding problem - what can we learn from an Israeli ED?

PubMed

Pines, Jesse M; Bernstein, Steven L

2015-01-01

ED crowding is a prevalent and important issue facing hospitals in Israel and around the world, including North and South America, Europe, Australia, Asia and Africa. ED crowding is associated with poorer quality of care and poorer health outcomes, along with extended waits for care. Crowding is caused by a periodic mismatch between the supply of ED and hospital resources and the demand for patient care. In a recent article in the Israel Journal of Health Policy Research, Bashkin et al. present an Ishikawa diagram describing several factors related to longer length of stay (LOS), and higher levels of ED crowding, including management, process, environmental, human factors, and resource issues. Several solutions exist to reduce ED crowding, which involve addressing several of the issues identified by Bashkin et al. This includes reducing the demand for and variation in care, and better matching the supply of resources to demands in care in real time. However, what is needed to reduce crowding is an institutional imperative from senior leadership, implemented by engaged ED and hospital leadership with multi-disciplinary cross-unit collaboration, sufficient resources to implement effective interventions, access to data, and a sustained commitment over time. This may move the culture of a hospital to facilitate improved flow within and across units and ultimately improve quality and safety over the long-term.

Stuck in the middle: The emotional labours of case managers in the personal injury compensation system.

PubMed

Newnam, Sharon; Petersen, Alan; Keleher, Helen; Collie, Alex; Vogel, Adam; McClure, Rod

2016-10-17

Case managers within injury compensation systems are confronted with various emotional demands. Employing the concept of emotional labour, this paper explores distinctive aspects of these demands. The findings are drawn from focus groups with 21 Australian case managers. Case managers work was characterised by extra-role commitments, emotional control, stress and balancing tensions arising from differing stakeholder expectations about outcomes related to compensation and return to work. By examining the experiences of case managers, the findings add to the literature on the emotional labour of front line service workers, especially with respect to the demands involved in managing the conflicting demands of work.

Green and blue water demand from large-scale land acquisitions in Africa

PubMed Central

Johansson, Emma Li; Fader, Marianela; Seaquist, Jonathan W.; Nicholas, Kimberly A.

2016-01-01

In the last decade, more than 22 million ha of land have been contracted to large-scale land acquisitions in Africa, leading to increased pressures, competition, and conflicts over freshwater resources. Currently, 3% of contracted land is in production, for which we model site-specific water demands to indicate where freshwater appropriation might pose high socioenvironmental challenges. We use the dynamic global vegetation model Lund–Potsdam–Jena managed Land to simulate green (precipitation stored in soils and consumed by plants through evapotranspiration) and blue (extracted from rivers, lakes, aquifers, and dams) water demand and crop yields for seven irrigation scenarios, and compare these data with two baseline scenarios of staple crops representing previous water demand. We find that most land acquisitions are planted with crops that demand large volumes of water (>9,000 m3⋅ha−1) like sugarcane, jatropha, and eucalyptus, and that staple crops have lower water requirements (<7,000 m3⋅ha−1). Blue water demand varies with irrigation system, crop choice, and climate. Even if the most efficient irrigation systems were implemented, 18% of the land acquisitions, totaling 91,000 ha, would still require more than 50% of water from blue water sources. These hotspots indicate areas at risk for transgressing regional constraints for freshwater use as a result of overconsumption of blue water, where socioenvironmental systems might face increased conflicts and tensions over water resources. PMID:27671634

[ABC supplies classification: a managment tool of costs in nursing].

PubMed

Lourenço, Karina Gomes; Castilho, Valéria

2006-01-01

The implementation of costs management systems has been extremely helpful to healthcare area owing to their efficacy in cutting expenditures as well as improving service quality. The ABC classification is an applied strategy to stocktaking and control. The research, which consists of an exploratory/descriptive quantitative analysis, has been carried out in order to identify, in a year time period, the demand for supplies at Universidade de Sao Paulo's Hospital. Of 1938 classified materials, 67 itens had been classified that they correspond to the materials with bigger costs for the hospital. 31.3% of these A-Class supplies catalogued items are the nursing materials, more used for the nursing team.

A high performance hierarchical storage management system for the Canadian tier-1 centre at TRIUMF

NASA Astrophysics Data System (ADS)

Deatrich, D. C.; Liu, S. X.; Tafirout, R.

2010-04-01

We describe in this paper the design and implementation of Tapeguy, a high performance non-proprietary Hierarchical Storage Management (HSM) system which is interfaced to dCache for efficient tertiary storage operations. The system has been successfully implemented at the Canadian Tier-1 Centre at TRIUMF. The ATLAS experiment will collect a large amount of data (approximately 3.5 Petabytes each year). An efficient HSM system will play a crucial role in the success of the ATLAS Computing Model which is driven by intensive large-scale data analysis activities that will be performed on the Worldwide LHC Computing Grid infrastructure continuously. Tapeguy is Perl-based. It controls and manages data and tape libraries. Its architecture is scalable and includes Dataset Writing control, a Read-back Queuing mechanism and I/O tape drive load balancing as well as on-demand allocation of resources. A central MySQL database records metadata information for every file and transaction (for audit and performance evaluation), as well as an inventory of library elements. Tapeguy Dataset Writing was implemented to group files which are close in time and of similar type. Optional dataset path control dynamically allocates tape families and assign tapes to it. Tape flushing is based on various strategies: time, threshold or external callbacks mechanisms. Tapeguy Read-back Queuing reorders all read requests by using an elevator algorithm, avoiding unnecessary tape loading and unloading. Implementation of priorities will guarantee file delivery to all clients in a timely manner.

VA's expansion of supportive housing: successes and challenges on the path toward Housing First.

PubMed

Austin, Erika Laine; Pollio, David E; Holmes, Sally; Schumacher, Joseph; White, Bert; Lukas, Carol Vandeusen; Kertesz, Stefan

2014-05-01

The U.S. Department of Veterans Affairs (VA) is transitioning to a Housing First approach to placement of veterans in permanent supportive housing through the use of rental vouchers, an ambitious organizational transformation. This qualitative study examined the experiences of eight VA facilities undertaking this endeavor in 2012. A multidisciplinary team interviewed facility leadership, midlevel managers, and frontline staff (N=95 individuals) at eight VA facilities representing four U.S. regions. The team used a semistructured interview protocol and the constant comparative method to explore how individuals throughout the organizations experienced and responded to the challenges of transitioning to a Housing First approach. Frontline staff faced challenges in rapidly housing homeless veterans because of difficult rental markets, the need to coordinate with local public housing authorities, and a lack of available funds for move-in costs. Staff sought to balance their time spent on housing activities with intensive case management of highly vulnerable veterans. Finding low-demand sheltering options (that is, no expectations regarding sobriety or treatment participation, as in the Housing First model) for veterans waiting for housing presented a significant challenge to implementation of Housing First. Facility leadership supported Housing First implementation through resource allocation, performance monitoring, and reliance on midlevel managers to understand and meet the challenges of implementation. The findings highlight the considerable practical challenges and innovative solutions arising from a large-scale effort to implement Housing First, with particular attention to the experiences of individuals at all levels within an organization.

Unpacking the 'information barrier': comparing perspectives on information as a barrier to climate change adaptation in the interior mountain West.

PubMed

Archie, Kelli M; Dilling, Lisa; Milford, Jana B; Pampel, Fred C

2014-01-15

Inadequate information has been repeatedly identified as a barrier to climate change adaptation planning and implementation. However less is known about how information functions as a barrier, and to what degree it prevents adaptation compared to other perceived barriers. In addition, the role of institutional context in mediating the demand for information in the context of adaptation has been less well studied. This paper helps to clarify the role that information plays in adaptation planning for two sectors of public employees working at similar scales, in similar locations, with similar challenges. We conducted surveys and semi-structured interviews to investigate the demand for information in support of adaptation implementation and planning from US federal public lands managers and municipal officials in the US interior West. We found that federal managers and municipal officials both consulted information frequently for decision making, and while both groups indicated that lack of information at relevant scales was a barrier to adaptation planning, this was seen as a much stronger barrier for federal managers than for communities. Uncertainty of information was raised as an issue, but results were mixed on whether or not this acted as a strong barrier. While peer-reviewed publications were seen as the "best available science," and correlated with adaptation planning, they were not accessed directly as frequently as other sources of information, including colleagues, the internet and reports. The strong connection between communities and adjacent federal lands may provide an opportunity for networking that could facilitate the flow of information relevant for adaptation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Pre-implementation studies of a workforce planning tool for nurse staffing and human resource management in university hospitals.

PubMed

van Oostveen, Catharina J; Ubbink, Dirk T; Mens, Marian A; Pompe, Edwin A; Vermeulen, Hester

2016-03-01

To investigate the reliability, validity and feasibility of the RAFAELA workforce planning system (including the Oulu patient classification system - OPCq), before deciding on implementation in Dutch hospitals. The complexity of care, budgetary restraints and demand for high-quality patient care have ignited the need for transparent hospital workforce planning. Nurses from 12 wards of two university hospitals were trained to test the reliability of the OPCq by investigating the absolute agreement of nursing care intensity (NCI) measurements among nurses. Validity was tested by assessing whether optimal NCI/nurse ratio, as calculated by a regression analysis in RAFAELA, was realistic. System feasibility was investigated through a questionnaire among all nurses involved. Almost 67 000 NCI measurements were performed between December 2013 and June 2014. Agreement using the OPCq varied between 38% and 91%. For only 1 in 12 wards was the optimal NCI area calculated judged as valid. Although the majority of respondents was positive about the applicability and user-friendliness, RAFAELA was not accepted as useful workforce planning system. Nurses' performance using the RAFAELA system did not warrant its implementation. Hospital managers should first focus on enlarging the readiness of nurses regarding the implementation of a workforce planning system. © 2015 John Wiley & Sons Ltd.

Managing and Communicating Operational Workflow: Designing and Implementing an Electronic Outpatient Whiteboard.

PubMed

Steitz, Bryan D; Weinberg, Stuart T; Danciu, Ioana; Unertl, Kim M

2016-01-01

Healthcare team members in emergency department contexts have used electronic whiteboard solutions to help manage operational workflow for many years. Ambulatory clinic settings have highly complex operational workflow, but are still limited in electronic assistance to communicate and coordinate work activities. To describe and discuss the design, implementation, use, and ongoing evolution of a coordination and collaboration tool supporting ambulatory clinic operational workflow at Vanderbilt University Medical Center (VUMC). The outpatient whiteboard tool was initially designed to support healthcare work related to an electronic chemotherapy order-entry application. After a highly successful initial implementation in an oncology context, a high demand emerged across the organization for the outpatient whiteboard implementation. Over the past 10 years, developers have followed an iterative user-centered design process to evolve the tool. The electronic outpatient whiteboard system supports 194 separate whiteboards and is accessed by over 2800 distinct users on a typical day. Clinics can configure their whiteboards to support unique workflow elements. Since initial release, features such as immunization clinical decision support have been integrated into the system, based on requests from end users. The success of the electronic outpatient whiteboard demonstrates the usefulness of an operational workflow tool within the ambulatory clinic setting. Operational workflow tools can play a significant role in supporting coordination, collaboration, and teamwork in ambulatory healthcare settings.

Implementing nurse-initiated and managed antiretroviral treatment (NIMART) in South Africa: a qualitative process evaluation of the STRETCH trial.

PubMed

Georgeu, Daniella; Colvin, Christopher J; Lewin, Simon; Fairall, Lara; Bachmann, Max O; Uebel, Kerry; Zwarenstein, Merrick; Draper, Beverly; Bateman, Eric D

2012-07-16

Task-shifting is promoted widely as a mechanism for expanding antiretroviral treatment (ART) access. However, the evidence for nurse-initiated and managed ART (NIMART) in Africa is limited, and little is known about the key barriers and enablers to implementing NIMART programmes on a large scale. The STRETCH (Streamlining Tasks and Roles to Expand Treatment and Care for HIV) programme was a complex educational and organisational intervention implemented in the Free State Province of South Africa to enable nurses providing primary HIV/AIDS care to expand their roles and include aspects of care and treatment usually provided by physicians. STRETCH used a phased implementation approach and ART treatment guidelines tailored specifically to nurses. The effects of STRETCH on pre-ART mortality, ART provision, and the quality of HIV/ART care were evaluated through a randomised controlled trial. This study was conducted alongside the trial to develop a contextualised understanding of factors affecting the implementation of the programme. This study was a qualitative process evaluation using in-depth interviews and focus group discussions with patients, health workers, health managers, and other key informants as well as observation in clinics. Research questions focused on perceptions of STRETCH, changes in health provider roles, attitudes and patient relationships, and impact of the implementation context on trial outcomes. Data were analysed collaboratively by the research team using thematic analysis. NIMART appears to be highly acceptable among nurses, patients, and physicians. Managers and nurses expressed confidence in their ability to deliver ART successfully. This confidence developed slowly and unevenly, through a phased and well-supported approach that guided nurses through training, re-prescription, and initiation. The research also shows that NIMART changes the working and referral relationships between health staff, demands significant training and support, and faces workload and capacity constraints, and logistical and infrastructural challenges. Large-scale NIMART appears to be feasible and acceptable in the primary level public sector health services in South Africa. Successful implementation requires a comprehensive approach with: an incremental and well supported approach to implementation; clinical guidelines tailored to nurses; and significant health services reorganisation to accommodate the knock-on effects of shifts in practice.

Flood Risk Management Policy in Scotland: Research Questions Past, Present and Future

NASA Astrophysics Data System (ADS)

Wilkinson, Mark; Hastings, Emily; MacDonald, Jannette

2016-04-01

Scotland's Centre of Expertise for Waters (CREW) delivers accessible research and expert opinion to support the Scottish Government and its delivery partners in the development and implementation of water policy. It was established in 2011 by the Scottish Government (Rural and Environmental Science and Analytical Services) in recognition of a gap in the provision of short term advice and research to policy (development and implementation). Key policy areas include the Water Framework Directive, Floods Directive, Drinking Water Directive, Habitats Directive and Scotland's Hydro Nation Strategy. CREW is unique in its demand-driven and free service for policy makers and practitioners, managing the engagement between scientists, policy makers and practitioners to work effectively across this interface. The users of CREW are the Scottish Government, Scottish Environment Protection Agency, Scottish Natural Heritage and Scottish Water. CREW has funded around 100 projects relating to water policy since its inception in 2011. Of these, a significant number relate to flood risk management policy. Based on a review of work to date, this poster will give an overview of these projects and a forward look at the challenges that remain. From learning from community led flood risk management to surface water flood forecasting for urban communities, links will be made between sustainable and traditional flood risk management while considering the perceptions of stakeholders to flood risk management. How can we deliver fully integrated flood risk management options? How policy makers, scientists and land managers can better work together will also be explored.

Implementation of Inventory Management System (IMS) case study on XYZ online store business unit

NASA Astrophysics Data System (ADS)

Bagus Yosan, R.; Kholil, Muhammad; Hanum, Bhetriza

2018-03-01

XYZ baby and child shop is a new player in the business of selling toys and baby gears. Consumers target for XYZ toy shop is segmentation of middle and upper financial ability buyers. XYZ toy store sells imported toys and baby products with high quality products, using international grade production materials and ISO production certificates: 9002. With this conceptual, establishment XYZ business line is as a provider (seller) toys and baby equipment premium brand; then the scope of the product sold must meet all expectations of market demands. Meet the expectations of market demand is not easy; because by fulfilling all expectations, then the impact is the high stock of goods that must be available. The high stock of goods will directly impact on the needs of a large storage area of goods and reduce money. Based on the previous description, the formulation of the problem in this research is: "What inventory management strategy can be applied to improve the productivity of Lean Manufacturing business unit of XYZ online store?"

RIS integrated IMAC system

NASA Astrophysics Data System (ADS)

Angelhed, Jan-Erik; Carlsson, Goeran; Gustavsson, Staffan; Karlsson, Anders; Larsson, Lars E. G.; Svensson, Sune; Tylen, Ulf

1998-07-01

An Image Management And Communication (IMAC) system adapted to the X-ray department at Sahlgrenska University Hospital has been developed using standard components. Two user demands have been considered primary: Rapid access to (display of) images and an efficient worklist management. To fulfil these demands a connection between the IMAC system and the existing Radiological Information System (RIS) has been implemented. The functional modules are: check of information consistency in data exported from image sources, a (logically) central storage of image data, viewing facility for high speed-, large volume-, clinical work, and an efficient interface to the RIS. Also, an image related database extension has been made to the RIS. The IMAC system has a strictly modular design with a simple structure. The image archive and short term storage are logically the same and acts as a huge disk. Through NFS all image data is available to all the connected workstations. All patient selection for viewing is through worklists, which are created by selection criteria in the RIS, by the use of barcodes, or, in singular cases, by entering the patient ID by hand.

Developing Gis-Based Demand-Responsive Transit System in Tehran City

NASA Astrophysics Data System (ADS)

Faroqi, H.; Sadeghi-Niaraki, A.

2015-12-01

Create, maintain and development of public transport network in metropolitan are important problems in the field of urban transport management. In public transport, maximize the efficient use of public fleet capacity has been considered. Concepts and technologies of GIS have provided suitable way for management and optimization of the public transports systems. In demand-responsive public transportation system, firstly fellow traveller groups have been established for applicants based on spatial concepts and tools of GIS, second for each group according to its' members and their paths, a public vehicle has been allocated to them then based on dynamic routing, the fellow passenger group has been gathered from their origins and has been moved to their destinations through optimal route. The suggested system has been implemented based on network data and commuting trips statistics of 1 to 6 districts in Tehran city. Evaluation performed on the results show the 34% increase using of Taxi capacity, 13% increase using of Van capacity and 10% increase using of Bus capacity in comparison between current public transport system and suggested public transportation system has been improved.

A cumulative energy demand indicator (CED), life cycle based, for industrial waste management decision making.

PubMed

Puig, Rita; Fullana-I-Palmer, Pere; Baquero, Grau; Riba, Jordi-Roger; Bala, Alba

2013-12-01

Life cycle thinking is a good approach to be used for environmental decision-support, although the complexity of the Life Cycle Assessment (LCA) studies sometimes prevents their wide use. The purpose of this paper is to show how LCA methodology can be simplified to be more useful for certain applications. In order to improve waste management in Catalonia (Spain), a Cumulative Energy Demand indicator (LCA-based) has been used to obtain four mathematical models to help the government in the decision of preventing or allowing a specific waste from going out of the borders. The conceptual equations and all the subsequent developments and assumptions made to obtain the simplified models are presented. One of the four models is discussed in detail, presenting the final simplified equation to be subsequently used by the government in decision making. The resulting model has been found to be scientifically robust, simple to implement and, above all, fulfilling its purpose: the limitation of waste transport out of Catalonia unless the waste recovery operations are significantly better and justify this transport. Copyright © 2013. Published by Elsevier Ltd.

Demand generation and social mobilisation for integrated community case management (iCCM) and child health: Lessons learned from successful programmes in Niger and Mozambique.

PubMed

Sharkey, Alyssa B; Martin, Sandrine; Cerveau, Teresa; Wetzler, Erica; Berzal, Rocio

2014-12-01

We present the approaches used in and outcomes resulting from integrated community case management (iCCM) programmes in Niger and Mozambique with a strong focus on demand generation and social mobilisation. We use a case study approach to describe the programme and contextual elements of the Niger and Mozambique programmes. Awareness and utilisation of iCCM services and key family practices increased following the implementation of the Niger and Mozambique iCCM and child survival programmes, as did care-seeking within 24 hours and care-seeking from appropriate, trained providers in Mozambique. These approaches incorporated interpersonal communication activities and community empowerment/participation for collective change, partnerships and networks among key stakeholder groups within communities, media campaigns and advocacy efforts with local and national leaders. iCCM programmes that train and equip community health workers and successfully engage and empower community members to adopt new behaviours, have appropriate expectations and to trust community health workers' ability to assess and treat illnesses can lead to improved care-seeking and utilisation, and community ownership for iCCM.

Strategic Sourcing of R&D: The Determinants of Success

NASA Astrophysics Data System (ADS)

Brook, Jacques W.; Plugge, Albert

The outsourcing of the R&D function is an emerging practice of corporate firms. In their attempt to reduce the increasing cost of research and technology development, firms are strategically outsourcing the R&D function or repositioning their internal R&D organisation. By doing so, they are able to benefit from other technology sources around the world. So far, there is only limited research on how firms develop their R&D sourcing strategies and how these strategies are implemented. This study aims to identify which determinants contribute to the success of R&D sourcing strategies. The results of our empirical research indicate that a clear vision of how to manage innovation strategically on a corporate level is a determinant of an effective R&D strategy. Moreover, our findings revealed that the R&D sourcing strategy influences a firm's sourcing capabilities. These sourcing capabilities need to be developed to manage the demand as well as the supply of R&D services. The alignment between the demand capabilities and the supply capabilities contributes to the success of R&D sourcing.

An event-version-based spatio-temporal modeling approach and its application in the cadastral management

NASA Astrophysics Data System (ADS)

Li, Yangdong; Han, Zhen; Liao, Zhongping

2009-10-01

Spatiality, temporality, legality, accuracy and continuality are characteristic of cadastral information, and the cadastral management demands that the cadastral data should be accurate, integrated and updated timely. It's a good idea to build an effective GIS management system to manage the cadastral data which are characterized by spatiality and temporality. Because no sound spatio-temporal data models have been adopted, however, the spatio-temporal characteristics of cadastral data are not well expressed in the existing cadastral management systems. An event-version-based spatio-temporal modeling approach is first proposed from the angle of event and version. Then with the help of it, an event-version-based spatio-temporal cadastral data model is built to represent spatio-temporal cadastral data. At last, the previous model is used in the design and implementation of a spatio-temporal cadastral management system. The result of the application of the system shows that the event-version-based spatio-temporal data model is very suitable for the representation and organization of cadastral data.

School and the Concussed Youth – Recommendations for Concussion Education and Management

PubMed Central

Sady, Maegan D.; Vaughan, Christopher G.; Gioia, Gerard A.

2011-01-01

Synopsis School learning and performance is arguably the critical centerpiece of child and adolescent development, and there can be significant temporary upset in cognitive processing after a mild traumatic brain injury, also called a concussion. This injury results in a cascade of neurochemical abnormalities, and in the wake of this dysfunction, both physical activity and cognitive activity become sources of additional neurometabolic demand on the brain and may cause symptoms to re-emerge or worsen. This paper provides a foundation for post-injury management of cognitive activity, particularly in the school setting, including design and implementation of school-wide concussion education and management programs. Definitions of cognitive over-exertion and cognitive rest are provided, with guidelines for managing cognitive load in individuals based on their symptom profile and neurocognitive performance. On a broader scale, guidance for the development of comprehensive concussion education and management programs in schools is provided. Proactive management could facilitate recovery by ensuring less cognitive exertion and stress during the recovery period. PMID:22050944

The challenge of electronic waste (e-waste) management in developing countries.

PubMed

Osibanjo, O; Nnorom, I C

2007-12-01

Information and telecommunications technology (ICT) and computer Internet networking has penetrated nearly every aspect of modern life, and is positively affecting human life even in the most remote areas of the developing countries. The rapid growth in ICT has led to an improvement in the capacity of computers but simultaneously to a decrease in the products lifetime as a result of which increasingly large quantities of waste electrical and electronic equipment (e-waste) are generated annually. ICT development in most developing countries, particularly in Africa, depends more on secondhand or refurbished EEEs most of which are imported without confirmatory testing for functionality. As a result large quantities of e-waste are presently being managed in these countries. The challenges facing the developing countries in e-waste management include: an absence of infrastructure for appropriate waste management, an absence of legislation dealing specifically with e-waste, an absence of any framework for end-of-life (EoL) product take-back or implementation of extended producer responsibility (EPR). This study examines these issues as they relate to practices in developing countries with emphasis on the prevailing situation in Nigeria. Effective management of e-waste in the developing countries demands the implementation of EPR, the establishment of product reuse through remanufacturing and the introduction of efficient recycling facilities. The implementation of a global system for the standardization and certification/labelling of secondhand appliances intended for export to developing countries will be required to control the export of electronic recyclables (e-scarp) in the name of secondhand appliances.

Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries

PubMed Central

Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

2015-01-01

Objectives Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. Methods An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. Results How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. Conclusions The development of hospital leaders’ skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. PMID:26683885

Job crafting in changing organizations: Antecedents and implications for exhaustion and performance.

PubMed

Petrou, Paraskevas; Demerouti, Evangelia; Schaufeli, Wilmar B

2015-10-01

The present study addressed employee job crafting behaviors (i.e., seeking resources, seeking challenges, and reducing demands) in the context of organizational change. We examined predictors of job crafting both at the organizational level (i.e., perceived impact of the implemented changes on the working life of employees) and the individual level (i.e., employee willingness to follow the changes). Job crafting behaviors were expected to predict task performance and exhaustion. Two-wave longitudinal data from 580 police officers undergoing organizational changes were analyzed with structural equation modeling. Findings showed that the degree to which changes influence employees' daily work was linked to reducing demands and exhaustion, whereas employee willingness to change was linked to seeking resources and seeking challenges. Furthermore, while seeking resources and seeking challenges were associated with high task performance and low exhaustion respectively, reducing demands seemed to predict exhaustion positively. Our findings suggest that job crafting can act as a strategy of employees to respond to organizational change. While seeking resources and seeking challenges enhance employee adjustment and should be encouraged by managers, reducing demands seems to have unfavorable implications for employees. (c) 2015 APA, all rights reserved).

Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries.

PubMed

Burnett, Susan; Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

2016-04-01

Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. The development of hospital leaders' skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. © The Author(s) 2015.

Integrated water resources modelling for assessing sustainable water governance

NASA Astrophysics Data System (ADS)

Skoulikaris, Charalampos; Ganoulis, Jacques; Tsoukalas, Ioannis; Makropoulos, Christos; Gkatzogianni, Eleni; Michas, Spyros

2015-04-01

Climatic variations and resulting future uncertainties, increasing anthropogenic pressures, changes in political boundaries, ineffective or dysfunctional governance of natural resources and environmental degradation are some of the most fundamental challenges with which worldwide initiatives fostering the "think globally, act locally" concept are concerned. Different initiatives target the protection of the environment through sustainable development; Integrated Water Resources Management (IWRM) and Transboundary Water Resources Management (TWRM) in the case of internationally shared waters are frameworks that have gained wide political acceptance at international level and form part of water resources management planning and implementation on a global scale. Both concepts contribute in promoting economic efficiency, social equity and environmental sustainability. Inspired by these holistic management approaches, the present work describes an effort that uses integrated water resources modelling for the development of an integrated, coherent and flexible water governance tool. This work in which a sequence of computer based models and tools are linked together, aims at the evaluation of the sustainable operation of projects generating renewable energy from water as well as the sustainability of agricultural demands and environmental security in terms of environmental flow under various climatic and operational conditions. More specifically, catchment hydrological modelling is coupled with dams' simulation models and thereafter with models dedicated to water resources management and planning,while the bridging of models is conducted through geographic information systems and custom programming tools. For the case of Mesta/Nestos river basin different priority rules in the dams' operational schedule (e.g. priority given to power production as opposed to irrigation needs and vice versa), as well as different irrigation demands, e.g. current water demands as opposed to those defined in the River Basin Management Plan (RBMP), are thoroughly examined in order to ascertain the river's capability to cover multi water demands and the potential of further infrastructure development. Due to the transboundary nature of the river basin in question, different scenarios quantify the maximum water volumes that could be further exploited in the upper part of the basin in order to avoid adverse consequences to the downstream regional economy, power productivity and environmental flow, and in terms of water governance to satisfy the need to balance water use between socio-economic activities and ecosystems.

Health care in China: improvement, challenges, and reform.

PubMed

Wang, Chen; Rao, Keqin; Wu, Sinan; Liu, Qian

2013-02-01

Over the past 2 decades, significant progress has been made in improving the health-care system and people's health conditions in China. Following rapid economic growth and social development, China's health-care system is facing new challenges, such as increased health-care demands and expenditure, inefficient use of health-care resources, unsatisfying implementation of disease management guidelines, and inadequate health-care insurance. Facing these challenges, the Chinese government carried out a national health-care reform in 2009. A series of policies were developed and implemented to improve the health-care insurance system, the medical care system, the public health service system, the pharmaceutical supply system, and the health-care institution management system in China. Although these measures have shown promising results, further efforts are needed to achieve the ultimate goal of providing affordable and high-quality care for both urban and rural residents in China. This article not only covers the improvement, challenges, and reform of health care in general in China, but also highlights the status of respiratory medicine-related issues.

Thermal analysis and management of lithium-titanate batteries

NASA Astrophysics Data System (ADS)

Giuliano, Michael R.; Advani, Suresh G.; Prasad, Ajay K.

2011-08-01

Battery electric vehicles and hybrid electric vehicles demand batteries that can store large amounts of energy in addition to accommodating large charge and discharge currents without compromising battery life. Lithium-titanate batteries have recently become an attractive option for this application. High current thresholds allow these cells to be charged quickly as well as supply the power needed to drive such vehicles. These large currents generate substantial amounts of waste heat due to loss mechanisms arising from the cell's internal chemistry and ohmic resistance. During normal vehicle operation, an active cooling system must be implemented to maintain a safe cell temperature and improve battery performance and life. This paper outlines a method to conduct thermal analysis of lithium-titanate cells under laboratory conditions. Thermochromic liquid crystals were implemented to instantaneously measure the entire surface temperature field of the cell. The resulting temperature measurements were used to evaluate the effectiveness of an active cooling system developed and tested in our laboratory for the thermal management of lithium-titanate cells.

44 CFR 6.8 - Subpoena and other legal demands.

Code of Federal Regulations, 2010 CFR

2010-10-01

... other legal demands. Access to records in systems of records by subpoena or other legal process shall be... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Subpoena and other legal demands. 6.8 Section 6.8 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY...

Identification, assessment, and control of hazards in water supply: experiences from Water Safety Plan implementations in Germany.

PubMed

Mälzer, H-J; Staben, N; Hein, A; Merkel, W

2010-01-01

According to the recommendations of the World Health Organization (WHO) for Water Safety Plans (WSP), a Technical Risk Management was developed, which considers standard demands in drinking water treatment in Germany. It was already implemented at several drinking water treatment plants of different size and treatment processes in Germany. Hazards affecting water quality, continuity, and the reliability of supply from catchment to treatment and distribution could be identified by a systematic approach, and suitable control measures were defined. Experiences are presented by detailed examples covering methods, practical consequences, and further outcomes. The method and the benefits for the water suppliers are discussed and an outlook on the future role of WSPs in German water supply is given.

["Activity based costing" in radiology].

PubMed

Klose, K J; Böttcher, J

2002-05-01

The introduction of diagnosis related groups for reimbursement of hospital services in Germany (g-drg) demands for a reconsideration of utilization of radiological products and costs related to them. Traditional cost accounting as approach to internal, department related budgets are compared with the accounting method of activity based costing (ABC). The steps, which are necessary to implement ABC in radiology are developed. The introduction of a process-oriented cost analysis is feasible for radiology departments. ABC plays a central role in the set-up of decentralized controlling functions within this institutions. The implementation seems to be a strategic challenge for department managers to get more appropriate data for adequate enterprise decisions. The necessary steps of process analysis can be used for other purposes (Certification, digital migration) as well.

Global Tungsten Demand and Supply Forecast

NASA Astrophysics Data System (ADS)

Dvořáček, Jaroslav; Sousedíková, Radmila; Vrátný, Tomáš; Jureková, Zdenka

2017-03-01

An estimate of the world tungsten demand and supply until 2018 has been made. The figures were obtained by extrapolating from past trends of tungsten production from1905, and its demand from 1964. In addition, estimate suggestions of major production and investment companies were taken into account with regard to implementations of new projects for mining of tungsten or possible termination of its standing extraction. It can be assumed that tungsten supply will match demand by 2018. This suggestion is conditioned by successful implementation of new tungsten extraction projects, and full application of tungsten recycling methods.

Are economic evaluations and health technology assessments increasingly demanded in times of rationing health services? The case of the Argentine financial crisis.

PubMed

Rubinstein, Adolfo; Belizán, María; Discacciati, Vilda

2007-01-01

After 4 years of deepening recession, Argentina's economy plummeted after default in 2002. This crisis critically affected health expenditures and triggered acute rationing. Our objective was to explore health decision-makers' knowledge and attitudes about economic evaluations (EE) and whether health technology assessment (HTA) were increasingly used for decision making. A qualitative design based on semistructured interviews and focus groups was used to explore how decision makers belonging to different health sectors implement resource allocation decisions. Informants were mostly unaware of EE. The most important criteria mentioned to adopt a treatment were evidence of effectiveness, social/stakeholder demand, or resource availability. Despite general positive attitudes about EE, knowledge was rather limited. Although cost considerations were widely accepted by purchasers and managers, clinicians argued about these issues as interfering with the doctor-patient relationship. Other important perceived barriers to HTA use were lack of confidence in the transferability of studies conducted in developed countries and institutional fragmentation of the Argentine healthcare system. The new macroeconomic context was cited as a justification of implicit rationing measures. Although explicit priority setting was implemented by many purchasers and managers, HTA was not used to improve technical and/or allocative efficiency. The crisis seems to be a strong incentive to extend the use of HTA in Argentina, provided decision makers are aware as well as involved in the generation of local studies.

Optimal expansion of a drinking water infrastructure system with respect to carbon footprint, cost-effectiveness and water demand.

PubMed

Chang, Ni-Bin; Qi, Cheng; Yang, Y Jeffrey

2012-11-15

Urban water infrastructure expansion requires careful long-term planning to reduce the risk from climate change during periods of both economic boom and recession. As part of the adaptation management strategies, capacity expansion in concert with other management alternatives responding to the population dynamics, ecological conservation, and water management policies should be systematically examined to balance the water supply and demand temporally and spatially with different scales. To mitigate the climate change impact, this practical implementation often requires a multiobjective decision analysis that introduces economic efficiencies and carbon-footprint matrices simultaneously. The optimal expansion strategies for a typical water infrastructure system in South Florida demonstrate the essence of the new philosophy. Within our case study, the multiobjective modeling framework uniquely features an integrated evaluation of transboundary surface and groundwater resources and quantitatively assesses the interdependencies among drinking water supply, wastewater reuse, and irrigation water permit transfer as the management options expand throughout varying dimensions. With the aid of a multistage planning methodology over the partitioned time horizon, such a systems analysis has resulted in a full-scale screening and sequencing of multiple competing objectives across a suite of management strategies. These strategies that prioritize 20 options provide a possible expansion schedule over the next 20 years that improve water infrastructure resilience and at low life-cycle costs. The proposed method is transformative to other applications of similar water infrastructure systems elsewhere in the world. Copyright © 2012 Elsevier Ltd. All rights reserved.

IMPORTANCE OF INTEGRATED MANAGEMENT SYSTEM APPLIED IN HEALTH ESTABLISHMENTS IN ORDER TO RAISE TREATMENT QUALITY.

PubMed

Dodić, Biljana; Miljković, Tatjana; Bjelobrk, Marija; Cemerlic Ađić, Nada; Ađić, Filip; Dodić, Slobodan

2016-01-01

The term "management" is best characterized as "managing" economic or social processes to achieve objectives through a rational use of material and immaterial resources by applying the principles, functions, and management methods. This study has been aimed at evaluating the value of an integrated quality management system implemented at the Institute of Cardiovascular Diseases of Vojvodina to improve the quality of treatment. In the period from 2008 to 2010 about 40 employees from the Institute of Cardiovascular Diseases of Vojvodina attended various courses given by the lecturers of the Faculty of Technical Sciences, where the function and significance of the "International Standards Organization" were explained, after which standards of interest were implemented at the Institute of Cardiovascular Diseases of Vojvodina. The Department of Cardiology has introduced 11 cardiac procedures with 5 special instructions, 14 general procedures, and 7 specific procedures with 2 instructions. The Department of Cardiac Surgery has introduced 7 procedures to be implemented. The "Vojvodina score" model was put into practice for the perioperative evaluation of cardiac surgery risk. During 2014, the Institute of Cardiovascular Diseases ofVojvodina obtained accreditation for the period of 7 years. The integrated quality management system must be applied in order to achieve a high level of health care in the shortest possible time and with the least possible consumption of material and human resources. The application of this system in practice gives a realistic insight into the working processes and facilitates their functioning. It demands and requires constant monitoring of the system efficiency along with continuous changes and improvements of all elements of the working processes and functional units.

Management in general practice: the challenge of the new General Medical Services contract.

PubMed

Checkland, Kath

2004-10-01

Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Three general practices in England, chosen using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed by such a manager, the limits of his or her authority, and the management of performance in this role.

Management in general practice: the challenge of the new General Medical Services contract

PubMed Central

Checkland, Kath

2004-01-01

Background: Managers in general practice perform a variety of roles, from purely administrative to higher-level strategic planning. There has been little research investigating in detail how they perform these roles and the problems that they encounter. The new General Medical Services (GMS) contract contains new management challenges and it is not clear how practices will meet these. Aim: To improve understanding of the roles performed by managers in general practice and to consider the implications of this for the implementation of the new GMS contract. Design of study: In-depth qualitative case studies covering the period before and immediately after the vote in favour of the new GMS contract. Setting: Three general practices in England, chosen using purposeful sampling. Method: Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Results: Understanding about what constitutes the legitimate role of managers in general practice varies both within and between practices. Those practices in the study that employed a manager to work at a strategic level with input into the direction of the organisation demonstrated significant problems with this in practice. These included lack of clarity about what the legitimate role of the manager involved, problems relating to the authority of managers in the context of a partnership, and lack of time available to them to do higher-level work. In addition, general practitioners (GPs) were not confident about their ability to manage their managers' performance. Conclusion: The new GMS contract will place significant demands on practice management. These results suggest that it cannot be assumed that simply employing a manager with high-level skills will enable these demands to be met; there must first be clarity about what the manager should be doing, and attention must be directed at questions about the legitimacy enjoyed by such a manager, the limits of his or her authority, and the management of performance in this role. PMID:15469672

Modeling Sustainable Bioenergy Feedstock Production in the Alps

NASA Astrophysics Data System (ADS)

Kraxner, Florian; Leduc, Sylvain; Kindermann, Georg; Fuss, Sabine; Pietsch, Stephan; Lakyda, Ivan; Serrano Leon, Hernan; Shchepashchenko, Dmitry; Shvidenko, Anatoly

2016-04-01

Sustainability of bioenergy is often indicated by the neutrality of emissions at the conversion site while the feedstock production site is assumed to be carbon neutral. Recent research shows that sustainability of bioenergy systems starts with feedstock management. Even if sustainable forest management is applied, different management types can impact ecosystem services substantially. This study examines different sustainable forest management systems together with an optimal planning of green-field bioenergy plants in the Alps. Two models - the biophysical global forest model (G4M) and a techno-economic engineering model for optimizing renewable energy systems (BeWhere) are implemented. G4M is applied in a forward looking manner in order to provide information on the forest under different management scenarios: (1) managing the forest for maximizing the carbon sequestration; or (2) managing the forest for maximizing the harvestable wood amount for bioenergy production. The results from the forest modelling are then picked up by the engineering model BeWhere, which optimizes the bioenergy production in terms of energy demand (power and heat demand by population) and supply (wood harvesting potentials), feedstock harvesting and transport costs, the location and capacity of the bioenergy plant as well as the energy distribution logistics with respect to heat and electricity (e.g. considering existing grids for electricity or district heating etc.). First results highlight the importance of considering ecosystem services under different scenarios and in a geographically explicit manner. While aiming at producing the same amount of bioenergy under both forest management scenarios, it turns out that in scenario (1) a substantially larger area (distributed across the Alps) will need to be used for producing (and harvesting) the necessary amount of feedstock than under scenario (2). This result clearly shows that scenario (2) has to be seen as an "intensification scenario" under which more biomass feedstock can be produced and harvested, so that less area would be affected by harvesting and other management activities. Intensification through optimal forest management can lead to a substantial reduction of the area necessary for bioenergy feedstock supply. This in turn means that the "spared" area and the associated ecosystem services can be designated for conservation or other uses. This insight provides support to policy and decision makers in considering the optimal "mix" or "co-existence" of different ecosystem services and economic demands from a modern landscape management approach.

Time management behavior as a moderator for the job demand-control interaction.

PubMed

Peeters, Miranda A G; Rutte, Christel G

2005-01-01

The interaction effects of time management, work demands, and autonomy on burnout were investigated in a survey study of 123 elementary teachers. A 3-way interaction between time management, work demands, and autonomy was hypothesized: The combination of high work demands and low autonomy was predicted to lead to burnout for teachers low in time management and not, or to a lesser extent, for those high in time management. This hypothesis is confirmed for emotional exhaustion, the most predictive dimension of teacher burnout, and partly confirmed for the personal accomplishment dimension. Generalizability to other contactual occupations is discussed. ((c) 2005 APA, all rights reserved).

Data Mining for Understanding and Impriving Decision-Making Affecting Ground Delay Programs

NASA Technical Reports Server (NTRS)

Kulkarni, Deepak; Wang, Yao Xun; Sridhar, Banavar

2013-01-01

The continuous growth in the demand for air transportation results in an imbalance between airspace capacity and traffic demand. The airspace capacity of a region depends on the ability of the system to maintain safe separation between aircraft in the region. In addition to growing demand, the airspace capacity is severely limited by convective weather. During such conditions, traffic managers at the FAA's Air Traffic Control System Command Center (ATCSCC) and dispatchers at various Airlines' Operations Center (AOC) collaborate to mitigate the demand-capacity imbalance caused by weather. The end result is the implementation of a set of Traffic Flow Management (TFM) initiatives such as ground delay programs, reroute advisories, flow metering, and ground stops. Data Mining is the automated process of analyzing large sets of data and then extracting patterns in the data. Data mining tools are capable of predicting behaviors and future trends, allowing an organization to benefit from past experience in making knowledge-driven decisions. The work reported in this paper is focused on ground delay programs. Data mining algorithms have the potential to develop associations between weather patterns and the corresponding ground delay program responses. If successful, they can be used to improve and standardize TFM decision resulting in better predictability of traffic flows on days with reliable weather forecasts. The approach here seeks to develop a set of data mining and machine learning models and apply them to historical archives of weather observations and forecasts and TFM initiatives to determine the extent to which the theory can predict and explain the observed traffic flow behaviors.

Improving productivity and profitability of a bioanalytical business through sales and operation planning.

PubMed

Islam, Rafiqul

2013-07-01

Today's bioanalytical CROs face increasing global competition, highly variable demand, high fixed costs, pricing pressure, and increasing demand for quality and speed. Most bioanalytical laboratories have responded to these challenges by implementing automation and by implementing process improvement methodologies (e.g., Six Sigma). These solutions have not resulted in a significant improvement in productivity and profitability since none of them are able to predict the upturn or downturn in demand. High volatility of demand causes long lead times and high costs during peak demand and poor productivity during trough demand. Most bioanalytical laboratories lack the tools to align supply efficiently to meet changing demand. In this paper, sales and operation planning (S&OP) has been investigated as a tool to balance supply and demand. The S&OP process, when executed effectively, can be the single greatest determinant of profitability for a bioanalytical business.

Effectiveness and equity of the Tanzania National Voucher Scheme for mosquito nets over 10 years of implementation.

PubMed

Kramer, Karen; Mandike, Renata; Nathan, Rose; Mohamed, Ally; Lynch, Matthew; Brown, Nick; Mnzava, Ally; Rimisho, Wilhelmina; Lengeler, Christian

2017-06-15

The Tanzania National Voucher Scheme (TNVS) was a public private partnership managed by the Ministry of Health that provided pregnant women and infants with highly subsidized (long-lasting) insecticide-treated nets between 2004 and 2014. It was implemented in the context of the National Insecticide Treated Nets (NATNETS) Programme and was the main keep up strategy for vulnerable populations. The programme design was adjusted considerably over time to incorporate new evidence, shifting public health policies, and changing donor priorities. Three TNVS models can be distinguished: (1) the fixed discount; (2) the fixed top-up; (3) the hybrid voucher model. The changes improved equity and effectiveness, but also had a profound effect on how the programme was managed and implemented. The TNVS reached the majority of beneficiaries with vouchers, and significantly increased household ownership and use of LLINs. While two mass distribution campaigns implemented between 2009 and 2011 achieved universal coverage and equity, the TNVS ensured continuous protection of the vulnerable populations before, during and after the campaigns. The TNVS stimulated and maintained a large national retail network which managed the LLIN supply chain. The effectiveness of the TNVS was a function of several interdependent factors, including the supply chain of vouchers through the public health system; the supply chain of nets in the commercial sector; the demand for nets from voucher recipients; management and risk mitigation measures; and the influence of global and donor objectives. The TNVS was a highly innovative and globally influential programme, which stimulated the thinking around effectively and equitably distributing ITNs, and contributed directly to the evolution of global policy. It was a fundamental component of the NATNETS programme which protected a malaria-vulnerable population for over a decade.

An object-oriented, technology-adaptive information model

NASA Technical Reports Server (NTRS)

Anyiwo, Joshua C.

1995-01-01

The primary objective was to develop a computer information system for effectively presenting NASA's technologies to American industries, for appropriate commercialization. To this end a comprehensive information management model, applicable to a wide variety of situations, and immune to computer software/hardware technological gyrations, was developed. The model consists of four main elements: a DATA_STORE, a data PRODUCER/UPDATER_CLIENT and a data PRESENTATION_CLIENT, anchored to a central object-oriented SERVER engine. This server engine facilitates exchanges among the other model elements and safeguards the integrity of the DATA_STORE element. It is designed to support new technologies, as they become available, such as Object Linking and Embedding (OLE), on-demand audio-video data streaming with compression (such as is required for video conferencing), Worldwide Web (WWW) and other information services and browsing, fax-back data requests, presentation of information on CD-ROM, and regular in-house database management, regardless of the data model in place. The four components of this information model interact through a system of intelligent message agents which are customized to specific information exchange needs. This model is at the leading edge of modern information management models. It is independent of technological changes and can be implemented in a variety of ways to meet the specific needs of any communications situation. This summer a partial implementation of the model has been achieved. The structure of the DATA_STORE has been fully specified and successfully tested using Microsoft's FoxPro 2.6 database management system. Data PRODUCER/UPDATER and PRESENTATION architectures have been developed and also successfully implemented in FoxPro; and work has started on a full implementation of the SERVER engine. The model has also been successfully applied to a CD-ROM presentation of NASA's technologies in support of Langley Research Center's TAG efforts.

Implementing a video-based intervention to empower staff members in an autism care organization: a qualitative study.

PubMed

Hall, Alex; Finch, Tracy; Kolehmainen, Niina; James, Deborah

2016-10-21

Implementing good-quality health and social care requires empowerment of staff members within organizations delivering care. Video Interaction Guidance (VIG) is an intervention using positive video feedback to empower staff through reflection on practice. This qualitative study explored the implementation of VIG within an autism care organization in England, from the perspective of staff members undergoing training to deliver VIG. Semi-structured interviews were conducted with a purposive sample of 7 participants working within the organization (5 staff undergoing training to deliver VIG; 2 senior managers influencing co-ordination of training). Participants were asked about their views of VIG and its implementation. The topic guide was informed by Normalization Process Theory (NPT). Data were analysed inductively and emerging issues were related to NPT. Five broad themes were identified: (1) participants reported that they and other staff did not understand VIG until they became involved, initially believing it would highlight negative rather than positive practice; (2) enthusiastic feedback from staff who had been involved seemed to encourage other staff to become involved; (3) key implementation challenges included demands of daily work and securing managers' support; (4) ideas for future practice arising from empowerment through VIG seemed difficult to realise within an organizational culture reportedly unreceptive to creative ideas from staff; (5) individuals' emotional responses to implementation seemed beyond the reach of NPT, which focused more upon collective processes. Implementation of VIG may require recognition that it is not a 'quick fix'. Peer advocacy may be a fruitful implementation strategy. Senior managers may need to experience VIG to develop their understanding so that they can provide appropriate implementation support. NPT may lack specificity to explain how individual agency weaves with collective processes and social systems to embed innovation in routine practice. This exploratory study has provided broad insights into facilitators and barriers to the implementation of an intervention to empower staff within an autism care organization. Further research is needed into similar interventions, including a focus upon staff members' emotional responses and resources, and how such interventions may relate to the culture of the organization in which implementation occurs.

Applying workability in the Australian residential aged care context.

PubMed

Brooke, Elizabeth; Goodall, Joanne; Handrus, Maxwell; Mawren, Daveena

2013-06-01

The study is based on an innovative demonstration project which trialled the implementation of the Finnish 'workability' framework and research measures. It aimed, firstly, to test the applicability of the Workability Index (WAI) to the Australian residential aged care workforce, focusing on personal care assistants (PCAs), and secondly, to assess the effectiveness of actions aimed at improving workability. The facility manager implemented multidimensional 'actions' according to the workability framework. The Workability Survey (WAS) and WAI and intervention instruments were administered (n = 64). Completed responses to 'pre' and 'post' instruments formed matched pairs (n = 15). WAI scores increased significantly, by 3 points on average, after all 'actions' were implemented. The only significant 'action' was increasing the number of PCAs in high care. Workability provides a useful research workforce development instrument measuring interactions between aged care workers and organisational demands and the outcomes of 'actions'. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

Barriers to the implementation of green chemistry in the United States.

PubMed

Matus, Kira J M; Clark, William C; Anastas, Paul T; Zimmerman, Julie B

2012-10-16

This paper investigates the conditions under which firms are able to develop and implement innovations with sustainable development benefits. In particular, we examine "green chemistry" innovations in the United States. Via interviews with green chemistry leaders from industry, academia, nongovernmental institutions (NGOs), and government, we identified six major categories of challenges commonly confronted by innovators: (1) economic and financial, (2) regulatory, (3) technical, (4) organizational, (5) cultural, and (6) definition and metrics. Further analysis of these barriers shows that in the United States, two elements of these that are particular to the implementation of green chemistry innovations are the absence of clear definitions and metrics for use by researchers and decision makers, as well as the interdisciplinary demands of these innovations on researchers and management. Finally, we conclude with some of the strategies that have been successful thus far in overcoming these barriers, and the types of policies which could have positive impacts moving forward.

Capacity building in water demand management as a key component for attaining millennium development goals

NASA Astrophysics Data System (ADS)

Gumbo, Bekithemba; Forster, Laura; Arntzen, Jaap

Successful water demand management (WDM) implementation as a component of integrated water resource management (IWRM) can play a significant role in the alleviation of poverty through more efficient use of available water resources. The urban population in Southern African cities is characterised by so-called ‘water poor’ communities who typically expend a high percentage of their household income on poor quality water. Usually they have no access to an affordable alternative source. Although WDM as a component of IWRM is not a panacea for poverty, it can help alleviate poverty by facilitating water services management by municipal water supply agencies (MWSAs) in the region. WDM is a key strategy for achieving the millennium development goals (MDGs) and, as such, should be given due attention in the preparation of national IWRM and water efficiency plans. Various studies in the Southern African region have indicated that capacity building is necessary for nations to develop IWRM and water-use efficiency plans to meet the targets set out in the MDGs. WDM education and training of water professionals and end-users is particularly important in developing countries, which are resource and information-access poor. In response to these findings, The World Conservation Union (IUCN) and its consulting partners, the Training and Instructional Design Academy of South Africa (TIDASA), and Centre for Applied Research (CAR) designed, developed and presented a pilot WDM Guideline Training Module for MWSAs as part of Phase II of IUCN’s Southern Africa regional WDM project. Pilot training was conducted in July 2004 in Lusaka, Zambia for a group of 36 participants involved in municipal water supply from nine Southern African countries. This paper looks at the links between building the capacity of professionals, operational staff and other role-players in the municipal water supply chain to implement WDM as part of broader IWRM strategies, and the subsequent potential for poverty relief resulting from more effective, efficient and equitable use and allocation of municipal water supplies.

Closing Yield Gaps: How Sustainable Can We Be?

PubMed

Pradhan, Prajal; Fischer, Günther; van Velthuizen, Harrij; Reusser, Dominik E; Kropp, Juergen P

2015-01-01

Global food production needs to be increased by 60-110% between 2005 and 2050 to meet growing food and feed demand. Intensification and/or expansion of agriculture are the two main options available to meet the growing crop demands. Land conversion to expand cultivated land increases GHG emissions and impacts biodiversity and ecosystem services. Closing yield gaps to attain potential yields may be a viable option to increase the global crop production. Traditional methods of agricultural intensification often have negative externalities. Therefore, there is a need to explore location-specific methods of sustainable agricultural intensification. We identified regions where the achievement of potential crop calorie production on currently cultivated land will meet the present and future food demand based on scenario analyses considering population growth and changes in dietary habits. By closing yield gaps in the current irrigated and rain-fed cultivated land, about 24% and 80% more crop calories can respectively be produced compared to 2000. Most countries will reach food self-sufficiency or improve their current food self-sufficiency levels if potential crop production levels are achieved. As a novel approach, we defined specific input and agricultural management strategies required to achieve the potential production by overcoming biophysical and socioeconomic constraints causing yield gaps. The management strategies include: fertilizers, pesticides, advanced soil management, land improvement, management strategies coping with weather induced yield variability, and improving market accessibility. Finally, we estimated the required fertilizers (N, P2O5, and K2O) to attain the potential yields. Globally, N-fertilizer application needs to increase by 45-73%, P2O5-fertilizer by 22-46%, and K2O-fertilizer by 2-3 times compared to the year 2010 to attain potential crop production. The sustainability of such agricultural intensification largely depends on the way management strategies for closing yield gaps are chosen and implemented.

Closing Yield Gaps: How Sustainable Can We Be?

PubMed Central

Pradhan, Prajal; Fischer, Günther; van Velthuizen, Harrij; Reusser, Dominik E.; Kropp, Juergen P.

2015-01-01

Global food production needs to be increased by 60–110% between 2005 and 2050 to meet growing food and feed demand. Intensification and/or expansion of agriculture are the two main options available to meet the growing crop demands. Land conversion to expand cultivated land increases GHG emissions and impacts biodiversity and ecosystem services. Closing yield gaps to attain potential yields may be a viable option to increase the global crop production. Traditional methods of agricultural intensification often have negative externalities. Therefore, there is a need to explore location-specific methods of sustainable agricultural intensification. We identified regions where the achievement of potential crop calorie production on currently cultivated land will meet the present and future food demand based on scenario analyses considering population growth and changes in dietary habits. By closing yield gaps in the current irrigated and rain-fed cultivated land, about 24% and 80% more crop calories can respectively be produced compared to 2000. Most countries will reach food self-sufficiency or improve their current food self-sufficiency levels if potential crop production levels are achieved. As a novel approach, we defined specific input and agricultural management strategies required to achieve the potential production by overcoming biophysical and socioeconomic constraints causing yield gaps. The management strategies include: fertilizers, pesticides, advanced soil management, land improvement, management strategies coping with weather induced yield variability, and improving market accessibility. Finally, we estimated the required fertilizers (N, P2O5, and K2O) to attain the potential yields. Globally, N-fertilizer application needs to increase by 45–73%, P2O5-fertilizer by 22–46%, and K2O-fertilizer by 2–3 times compared to the year 2010 to attain potential crop production. The sustainability of such agricultural intensification largely depends on the way management strategies for closing yield gaps are chosen and implemented. PMID:26083456

Analyzing Uncertainty and Risk in the Management of Water Resources in the State Of Texas

NASA Astrophysics Data System (ADS)

Singh, A.; Hauffpauir, R.; Mishra, S.; Lavenue, M.

2010-12-01

The State of Texas updates its state water plan every five years to determine the water demand required to meet its growing population. The plan compiles forecasts of water deficits from state-wide regional water planning groups as well as the water supply strategies to address these deficits. To date, the plan has adopted a deterministic framework, where reference values (e.g., best estimates, worst-case scenario) are used for key factors such as population growth, demand for water, severity of drought, water availability, etc. These key factors can, however, be affected by multiple sources of uncertainties such as - the impact of climate on surface water and groundwater availability, uncertainty in population projections, changes in sectoral composition of the economy, variability in water usage, feasibility of the permitting process, cost of implementation, etc. The objective of this study was to develop a generalized and scalable methodology for addressing uncertainty and risk in water resources management both at the regional and the local water planning level. The study proposes a framework defining the elements of an end-to-end system model that captures the key components of demand, supply and planning modules along with their associated uncertainties. The framework preserves the fundamental elements of the well-established planning process in the State of Texas, promoting an incremental and stakeholder-driven approach to adding different levels of uncertainty (and risk) into the decision-making environment. The uncertainty in the water planning process is broken down into two primary categories: demand uncertainty and supply uncertainty. Uncertainty in Demand is related to the uncertainty in population projections and the per-capita usage rates. Uncertainty in Supply, in turn, is dominated by the uncertainty in future climate conditions. Climate is represented in terms of time series of precipitation, temperature and/or surface evaporation flux for some future time period of interest, which can be obtained as outputs of global climate models (GCMs). These are then linked with hydrologic and water-availability models (WAMs) to estimate water availability for the worst drought conditions under each future climate scenario. Combining the demand scenarios with the water availability scenarios yields multiple scenarios for water shortage (or surplus). Given multiple shortage/surplus scenarios, various water management strategies can be assessed to evaluate the reliability of meeting projected deficits. These reliabilities are then used within a multi-criteria decision-framework to assess trade-offs between various water management objectives, thus helping to make more robust decisions while planning for the water needs of the future.

Wildfire effects on hiking and biking demand in New Mexico: a travel cost study.

PubMed

Hesseln, Hayley; Loomis, John B; González-Cabán, Armando; Alexander, Susan

2003-12-01

We use a travel cost model to test the effects of wild and prescribed fire on visitation by hikers and mountain bikers in New Mexico. Our results indicate that net benefits for mountain bikers is $150 per trip and that they take an average of 6.2 trips per year. Hikers take 2.8 trips per year with individual net benefits per trip of $130. Both hikers' and mountain bikers' demand functions react adversely to prescribed burning. Net benefits for both groups fall as areas recover from prescribed burns. Because both visitation and annual recreation benefits decrease to these two types of visitors, this gives rise to multiple use costs associated with prescribed burning. With respect to wildfire, hikers and mountain bikers both exhibit decreased visitation as areas recover from wildfires, however, only hikers indicate an increase in per trip net benefits. Bikers' demand effectively drops to zero. These results differ from previous findings in the literature and have implications for efficient implementation of the National Fire Plan and whether prescribed burning is a cost effective tool for multiple use management of National Forests. Specifically, that fire and recreation managers cannot expect recreation users to react similarly to fire across recreation activities, or different geographic regions. What is cost effective in one region may not be so in another.

Optimal Operation of a Thermal Energy Storage Tank Using Linear Optimization

NASA Astrophysics Data System (ADS)

Civit Sabate, Carles

In this thesis, an optimization procedure for minimizing the operating costs of a Thermal Energy Storage (TES) tank is presented. The facility in which the optimization is based is the combined cooling, heating, and power (CCHP) plant at the University of California, Irvine. TES tanks provide the ability of decoupling the demand of chilled water from its generation, over the course of a day, from the refrigeration and air-conditioning plants. They can be used to perform demand-side management, and optimization techniques can help to approach their optimal use. The proposed optimization approach provides a fast and reliable methodology of finding the optimal use of the TES tank to reduce energy costs and provides a tool for future implementation of optimal control laws on the system. Advantages of the proposed methodology are studied using simulation with historical data.

Integrating market processes into utility resource planning

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

Kahn, E.P.

1992-11-01

Integrated resource planning has resulted in an abundance of alternatives for meeting existing and new demand for electricity services: (1) utility demand-side management (DSM) programs, (2) DSM bidding, (3) competitive bidding for private power supplies, (4) utility re-powering, and (5) new utility construction. Each alternative relies on a different degree of planning for implementation and, therefore, each alternative relies on markets to a greater or lesser degree. This paper shows how the interaction of planning processes and market forces results in resource allocations among the alternatives. The discussion focuses on three phenomena that are driving forces behind the unanticipated consequences'more » of contemporary integrated resource planning efforts. These forces are: (1) large-scale DSM efforts, (2) customer bypass, and (3) large-scale independent power projects. 22 refs., 3 figs., 2 tabs.« less

MROrchestrator: A Fine-Grained Resource Orchestration Framework for MapReduce Clusters

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

Sharma, Bikash; Prabhakar, Ramya; Kandemir, Mahmut

2012-01-01

Efficient resource management in data centers and clouds running large distributed data processing frameworks like MapReduce is crucial for enhancing the performance of hosted applications and boosting resource utilization. However, existing resource scheduling schemes in Hadoop MapReduce allocate resources at the granularity of fixed-size, static portions of nodes, called slots. In this work, we show that MapReduce jobs have widely varying demands for multiple resources, making the static and fixed-size slot-level resource allocation a poor choice both from the performance and resource utilization standpoints. Furthermore, lack of co-ordination in the management of mul- tiple resources across nodes prevents dynamic slotmore » reconfigura- tion, and leads to resource contention. Motivated by this, we propose MROrchestrator, a MapReduce resource Orchestrator framework, which can dynamically identify resource bottlenecks, and resolve them through fine-grained, co-ordinated, and on- demand resource allocations. We have implemented MROrches- trator on two 24-node native and virtualized Hadoop clusters. Experimental results with a suite of representative MapReduce benchmarks demonstrate up to 38% reduction in job completion times, and up to 25% increase in resource utilization. We further show how popular resource managers like NGM and Mesos when augmented with MROrchestrator can hike up their performance.« less

A Study of Energy Management Systems and its Failure Modes in Smart Grid Power Distribution

NASA Astrophysics Data System (ADS)

Musani, Aatif

The subject of this thesis is distribution level load management using a pricing signal in a smart grid infrastructure. The project relates to energy management in a spe-cialized distribution system known as the Future Renewable Electric Energy Delivery and Management (FREEDM) system. Energy management through demand response is one of the key applications of smart grid. Demand response today is envisioned as a method in which the price could be communicated to the consumers and they may shift their loads from high price periods to the low price periods. The development and deployment of the FREEDM system necessitates controls of energy and power at the point of end use. In this thesis, the main objective is to develop the control model of the Energy Management System (EMS). The energy and power management in the FREEDM system is digitally controlled therefore all signals containing system states are discrete. The EMS is modeled as a discrete closed loop transfer function in the z-domain. A breakdown of power and energy control devices such as EMS components may result in energy con-sumption error. This leads to one of the main focuses of the thesis which is to identify and study component failures of the designed control system. Moreover, H-infinity ro-bust control method is applied to ensure effectiveness of the control architecture. A focus of the study is cyber security attack, specifically bad data detection in price. Test cases are used to illustrate the performance of the EMS control design, the effect of failure modes and the application of robust control technique. The EMS was represented by a linear z-domain model. The transfer function be-tween the pricing signal and the demand response was designed and used as a test bed. EMS potential failure modes were identified and studied. Three bad data detection meth-odologies were implemented and a voting policy was used to declare bad data. The run-ning mean and standard deviation analysis method proves to be the best method to detect bad data. An H-infinity robust control technique was applied for the first time to design discrete EMS controller for the FREEDM system.

Management of change through force field analysis.

PubMed

Baulcomb, Jean Sandra

2003-07-01

Today's NHS is rapidly changing, placing more emphasis on the managerial responsibilities of ward managers. Managing change is seen as being skilled at creating, acquiring and transferring knowledge to reflect new knowledge and insights. Defining core concepts is often difficult and requires the drawing on models/theories of change for guidance. Guidance from Lewin's (1951) force field analysis demonstrates the complexities of the change process and how driving and resisting forces were incorporated within the planning and implementation phases. Findings outline the benefits of a small scale change for staff, patients and the organization when successfully used to introduce a change of shift pattern within a progressively busy haematology day unit, in order to meet service demands without additional funding. Conclusions have been drawn in relation to the process and recommendations for practice made to further enhance care delivery within the unit.

The challenges of training, support and assessment of healthcare support workers: A qualitative study of experiences in three English acute hospitals.

PubMed

Sarre, Sophie; Maben, Jill; Aldus, Clare; Schneider, Justine; Wharrad, Heather; Nicholson, Caroline; Arthur, Antony

2018-03-01

Ever-growing demands on care systems have increased reliance on healthcare support workers. In the UK, their training has been variable, but organisation-wide failures in care have prompted questions about how this crucial section of the workforce should be developed. Their training, support and assessment has become a policy priority. This paper examines: healthcare support workers' access to training, support and assessment; perceived gaps in training provision; and barriers and facilitators to implementation of relevant policies in acute care. We undertook a qualitative study of staff caring for older inpatients at ward, divisional or organisational-level in three acute National Health Service hospitals in England in 2014. 58 staff working with older people (30 healthcare support workers and 24 staff managing or working alongside them) and 4 healthcare support worker training leads. One-to-one semi-structured interviews included: views and experiences of training and support; translation of training into practice; training, support and assessment policies and difficulties of implementing them. Transcripts were analysed to identify themes. Induction training was valued, but did not fully prepare healthcare support workers for the realities of the ward. Implementation of hospital policies concerning supervision and formal assessment of competencies varied between and within hospitals, and was subject to availability of appropriate staff and competing demands on staff time. Gaps identified in training provision included: caring for people with cognitive impairment; managing the emotions of patients, families and themselves; and having difficult conversations. Access to ongoing training was affected by: lack of time; infrequent provision; attitudes of ward managers to additional support workforce training, and their need to balance this against patients' and other staff members' needs; and the use of e-learning as a default mode of training delivery. With the current and unprecedented policy focus on training, support and assessment of healthcare support workers, our study suggests improved training would be welcomed by them and their managers. Provision of training, support and assessment could be improved by organisational policy that promotes and protects healthcare support worker training; formalising the provision and availability of on-ward support; and training and IT support provided on a drop-in basis. Challenges in implementation are likely to be faced in all international settings where there is increased reliance on a support workforce. While recent policies in the UK offers scope to overcome some of these challenges there is a risk that some will be exacerbated. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Scenario analysis for integrated water resources planning and management under uncertainty in the Zayandehrud river basin

NASA Astrophysics Data System (ADS)

Safavi, Hamid R.; Golmohammadi, Mohammad H.; Sandoval-Solis, Samuel

2016-08-01

The goal of this study is to develop and analyze three scenarios in the Zayandehrud river basin in Iran using a model already built and calibrated by Safavi et al. (2015) that has results for the baseline scenario. Results from the baseline scenario show that water demands will be supplied at the cost of depletion of surface and ground water resources, making this scenario undesirable and unsustainable. Supply Management, Demand Management, and Meta (supply and demand management) scenarios are the selected scenarios in this study. They are to be developed and declared into the Zayandehrud model to assess and evaluate the imminent status of the basin. Certain strategies will be employed for this purpose to improve and rectify the current management policies. The five performance criteria of time-based and volumetric reliability, resilience, vulnerability, and maximum deficit will be employed in the process of scenario analysis and evaluation. The results obtained from the performance criteria will be summed up into a so-called 'Water Resources Sustainability Index' to facilitate comparison among the likely trade-offs. Uncertainties arising from historical data, management policies, rainfall-runoff model, demand priorities, and performance criteria are considered in the proposed conceptual framework and modeled by appropriate approaches. Results show that the Supply Management scenario can be used to improve upon the demand supply but that it has no tangible effects on the improvement of the resources in the study region. In this regard, the Demand Management scenario is found to be more effective than the water supply one although it still remains unacceptable. Results of the Meta scenario indicate that both the supply and demand management scenarios must be applied if the water resources are to be safeguarded against degradation and depletion. In other words, the supply management scenario is necessary but not adequate; rather, it must be coupled to the demand management scenario. Finally, it will be shown that applying the Meta scenario will improve the water resources from sustainably.

Ginger augmented chemotherapy: A novel multitarget nontoxic approach for cancer management.

PubMed

Saxena, Roopali; Rida, Padmashree C G; Kucuk, Omer; Aneja, Ritu

2016-06-01

Cancer, referred to as the 'disease of civilization', continues to haunt humanity due to its dreadful manifestations and limited success of therapeutic interventions such as chemotherapy in curing the disease. Although effective, chemotherapy has repeatedly demonstrated inadequacy in disease management due to its debilitating side effects arising from its deleterious nonspecific effects on normal healthy cells. In addition, development of chemoresistance due to mono-targeting often results in cessation of chemotherapy. This urgently demands development and implementation of multitargeted alternative therapies with mild or no side effects. One extremely promising strategy that yet remains untapped in the clinic is augmenting chemotherapy with dietary phytochemicals or extracts. Ginger, depository of numerous bioactive molecules, not only targets cancer cells but can also mitigate chemotherapy-associated side effects. Consequently, combination therapy involving ginger extract and chemotherapeutic agents may offer the advantage of being efficacious with reduced toxicity. Here we discuss the remarkable and often overlooked potential of ginger extract to manage cancer, the possibility of developing ginger-based combinational therapies, and the major roadblocks along with strategies to overcome them in clinical translation of such inventions. We are optimistic that clinical implementation of such combination regimens would be a much sought after modality in cancer management. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Monitoring and validation of decentralised water and wastewater systems for increased uptake.

PubMed

Sharma, A K; Cook, S; Chong, M N

2013-01-01

Decentralised water and wastewater systems are being implemented to meet growing demand for municipal services either in combination with centralised systems or as standalone systems. In Australia, there has been increased investment in decentralised water and wastewater systems in response to the capacity constraints of existing centralised systems, an extended period of below average rainfall, uncertainly in traditional water sources due to potential climate change impacts, and the need to reduce the environmental impact of urban development. The implementation of decentralised water systems as a mainstream practice at different development scales is impeded by the knowledge gaps on their actual performance in a range of development types and settings. As the wide-spread uptake of these approaches in modern cities is relatively new compared to centralised approaches, there is limited information available on their planning, design, implementation, reliability and robustness. This paper presents a number of case studies where monitoring studies are under way to validate the performance of decentralised water and wastewater systems. The results from these case studies show the yield and reliability of these decentralised systems, as well as the associated energy demand and ecological footprint. The outputs from these case studies, and other monitoring studies, are important in improving decentralised system design guidelines and developing industry wide management norms for the operation and maintenance of decentralised systems.

An exploration of the roles of nurse managers in evidence-based practice implementation.

PubMed

Wilkinson, Joyce E; Nutley, Sandra M; Davies, Huw T O

2011-12-01

Internationally, nurses face ongoing difficulties in making a reality of evidence-based practice. Existing studies suggest that nurse managers (NMs) should play a key role in leading and facilitating evidence-based practice, but the nature of this role has not yet been fully explored or articulated. This is one of the first studies to investigate the roles of NMs in evidence-based practice implementation. METHODOLOGY AND METHODS: Using a case study approach the study explores five propositions in relation to the NMs' potential evidence-based practice role and the extent to which their attitudes, knowledge, and skills support such a role. In doing so, it draws on interviews (n= 51), documentary analysis and observational data. Data analysis reveals that the role of NMs in facilitating evidence-based practice is under-articulated, largely passive and currently limited by competing demands. Progress in implementing evidence-based practice in the case study sites is largely explained by factors other than the role played by NMs. As such, the findings expose significant discrepancies between NMs' actual roles and those espoused in the literature as being necessary. Contextual factors are important and it is clear that the role of the contemporary NM places considerable emphasis on management and administration to the detriment of clinical practice concerns. The study reveals that NMs are only involved in evidence-based practice implementation in a passive role, not the full engagement described in the literature as being necessary. This study adds previously lacking detail of the roles of NMs. It elucidates why exhortations to NMs to become more involved in evidence-based practice implementation are ineffective without action to address the problems identified. Copyright ©2011 Sigma Theta Tau International.

Measuring and managing radiologist workload: application of lean and constraint theories and production planning principles to planning radiology services in a major tertiary hospital.

PubMed

MacDonald, Sharyn L S; Cowan, Ian A; Floyd, Richard; Mackintosh, Stuart; Graham, Rob; Jenkins, Emma; Hamilton, Richard

2013-10-01

We describe how techniques traditionally used in the manufacturing industry (lean management, the theory of constraints and production planning) can be applied to planning radiology services to reduce the impact of constraints such as limited radiologist hours, and to subsequently reduce delays in accessing imaging and in report turnaround. Targets for imaging and reporting were set aligned with clinical needs. Capacity was quantified for each modality and for radiologists and recorded in activity lists. Demand was quantified and forecasting commenced based on historical referral rates. To try and mitigate the impact of radiologists as a constraint, lean management processes were applied to radiologist workflows. A production planning process was implemented. Outpatient waiting times to access imaging steadily decreased. Report turnaround times improved with the percentage of overnight/on-call reports completed by a 1030 target time increased from approximately 30% to 80 to 90%. The percentage of emergency and inpatient reports completed within one hour increased from approximately 15% to approximately 50% with 80 to 90% available within 4 hours. The number of unreported cases on the radiologist work-list at the end of the working day reduced. The average weekly accuracy for demand forecasts for emergency and inpatient CT, MRI and plain film imaging was 91%, 83% and 92% respectively. For outpatient CT, MRI and plain film imaging the accuracy was 60%, 55% and 77% respectively. Reliable routine weekly and medium to longer term service planning is now possible. Tools from industry can be successfully applied to diagnostic imaging services to improve performance. They allow an accurate understanding of the demands on a service, capacity, and can reliably predict the impact of changes in demand or capacity on service delivery. © 2013 The Royal Australian and New Zealand College of Radiologists.

Infrastructure sufficiency in meeting water demand under climate-induced socio-hydrological transition in the urbanizing Capibaribe River basin - Brazil

NASA Astrophysics Data System (ADS)

Ribeiro Neto, A.; Scott, C. A.; Lima, E. A.; Montenegro, S. M. G. L.; Cirilo, J. A.

2014-09-01

Water availability for a range of human uses will increasingly be affected by climate change, especially in the arid and semiarid tropics. The main objective of this study is to evaluate the infrastructure sufficiency in meeting water demand under climate-induced socio-hydrological transition in the Capibaribe River basin (CRB). The basin has experienced spatial and sectoral (agriculture-to-urban) reconfiguration of water demands. Human settlements that were once dispersed, relying on intermittent sources of surface water, are now larger and more spatially concentrated, which increases water-scarcity effects. Based on the application of linked hydrologic and water-resources models using precipitation and temperature projections of the IPCC SRES (Special Report: Emissions Scenarios) A1B scenario, a reduction in rainfall of 26.0% translated to streamflow reduction of 60.0%. We used simulations from four members of the HadCM3 (UK Met Office Hadley Centre) perturbed physics ensemble, in which a single model structure is used and perturbations are introduced to the physical parameterization schemes in the model (Chou et al., 2012). We considered that the change of the water availability in the basin in the future scenarios must drive the water management and the development of adaptation strategies that will manage the water demand. Several adaptive responses are considered, including water-loss reductions, wastewater collection and reuse, and rainwater collection cisterns, which together have potential to reduce future water demand by 23.0%. This study demonstrates the vulnerabilities of the infrastructure system during socio-hydrological transition in response to hydroclimatic and demand variabilities in the CRB and also indicates the differential spatial impacts and vulnerability of multiple uses of water to changes over time. The simulations showed that the measures proposed and the water from interbasin transfer project of the São Francisco River had a positive impact over the water supply in the basin, mainly for human use. Industry and irrigation will suffer impact unless other measures are implemented for demand control.

A survey on barcode RFID and NFC

NASA Astrophysics Data System (ADS)

Thanapal, P.; Prabhu, J.; Jakhar, Mridula

2017-11-01

Over the recent years, many industries have started implementing new technologies for tracing and tracking their products. These technologies are a kind of blessing to their management system. The technology and management system has to work in parallel to avoid loopholes in the system. We can see so many technologies around us and the most difficult and important part is to choose best out of all these new technologies. The important point which we need to take care while choosing a technology for the system is to make sure the technology can integrate properly with the other parameters in the management system. The industry management system consists of many levels such as initial level, intermediate level, final level and tracking. Nowadays tracking a product from its initial stage is becoming a trend. To cope up with this upcoming trend and also with the company demand, integrating the product with Barcode, RFID tags, NFC tag or any other traceable technology. Many supply chain Management system are also adopting this techniques.

Advanced consequence management program: challenges and recent real-world implementations

NASA Astrophysics Data System (ADS)

Graser, Tom; Barber, K. S.; Williams, Bob; Saghir, Feras; Henry, Kurt A.

2002-08-01

The Enhanced Consequence Management, Planning and Support System (ENCOMPASS) was developed under DARPA's Advanced Consequence Management program to assist decision-makers operating in crisis situations such as terrorist attacks using conventional and unconventional weapons and natural disasters. ENCOMPASS provides the tools for first responders, incident commanders, and officials at all levels to share vital information and consequently, plan and execute a coordinated response to incidents of varying complexity and size. ENCOMPASS offers custom configuration of components with capabilities ranging from map-based situation assessment, situation-based response checklists, casualty tracking, and epidemiological surveillance. Developing and deploying such a comprehensive system posed significant challenges for DARPA program management, due to an inherently complex domain, a broad spectrum of customer sites and skill sets, an often inhospitable runtime environment, demanding development-to-deployment transition requirements, and a technically diverse and geographically distributed development team. This paper introduces ENCOMPASS and explores these challenges, followed by an outline of selected ENCOMPASS deployments, demonstrating how ENCOMPASS can enhance consequence management in a variety real world contexts.

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.

Life cycle of a data warehousing project in healthcare.

PubMed

Verma, R; Harper, J

2001-01-01

Hill Physicians Medical Group (and its medical management firm, PriMed Management) early on recognized the need for a data warehouse. Management demanded that data from many sources be integrated, cleansed, and formatted. As a first step, an operational data store (ODS) was built and populated with data from the main transactional system; encounter data were added. The ODS has served its purpose well and has whetted management's appetite for more information and faster, more reliable access, all in one location. PriMed hired Annams Systems Consulting (Annams) for this effort. A team was formed, made up of consultants from Annams and members of PriMed's information services (IS) team. The "classical" approach is being taken: enhancing the ODS, which is largely normalized in structure, and integrating data from various sources, along with enforcing business rules. The team is designing and implementing data marts and a "star schema" style of data modeling--a useful tool for management to evaluate results before investing further.

Web-based, self-management enhancing interventions with e-diaries and personalized feedback for persons with chronic illness: a tale of three studies.

PubMed

Nes, Andréa A G; Eide, Hilde; Kristjánsdóttir, Ólöf Birna; van Dulmen, Sandra

2013-12-01

Chronic illness places high demands on patients. Interventions supporting self-management and providing personalized feedback might help patients to gain new perspectives and enhance use of constructive self-management strategies. We developed three comparable web-based CBT-grounded interventions including e-diaries and feedback delivered through PDAs/smartphones. The feasibility and efficacy of these interventions have been investigated for patients with irritable bowel syndrome (in an RCT), chronic widespread pain (RCT) and type 2 diabetes (feasibility study). This is a descriptive study that summarizes the content, feasibility and efficacy of the interventions and discusses issues relevant for implementing this type of web-based therapeutic interventions in clinical practice. The web-based interventions appear feasible, acceptable and supportive. In a short and midterm time frame, the interventions promote self-management. Booster sessions may be needed for prolonged effects. Given the physical and mental symptoms of the patients under study and the nature of the intervention, providers who deliver the feedback need a health care background and training in this specific way of counseling. The results of the three studies suggest that personalized web-based interventions are effective and have the potential to support self-management in daily healthcare. Studies concerning clinical significance and implementation are needed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Implementing an EMIS: The right way and the wrong way

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

Mayer, G.J.; Schroeder, J.V.

1999-07-01

The information age has touched all corners of business and private life. Environmental managers are not exempt from its touch. Today's environmental manager has the difficult job of keeping the company in compliance as well as acting as environmental historian. Much more environmental information is available today than ever before. Compounding this problem is the fact that environmental functions were not exempt from corporate streamlining, belt tightening and budget cutting. Finally, with corporations increasingly considering environmental costs as a function that should be managed as actively as any other area of the business, the demand for systematic environmental information managementmore » tools is increasing rapidly. Today's environmental professional is faced with the need to manage more information with less available staff time, to do it faster, better and cheaper, and to have the information available at his/her fingertips. Deciding on the right Environmental Management Information System (EMIS) solution can be quite difficult. Numerous off-the-shelf solutions exist and customized system development is always an option. Implementation of an EMIS is generally a costly project, both in terms of dollars and in terms of manpower distractions and process changes. Therefore, getting it right the first time is critical. Like a construction project, when you turn on the switch, the equipment is expected to perform as planned and designed.« less

Adaptive Transmission Planning: Implementing a New Paradigm for Managing Economic Risks in Grid Expansion

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

Hobbs, Benjamin F.; Xu, Qingyu; Ho, Jonathan

The problem of whether, where, when, and what types of transmission facilities to build in terms of minimizing costs and maximizing net economic benefits has been a challenge for the power industry from the beginning-ever since Thomas Edison debated whether to create longer dc distribution lines (with their high losses) or build new power stations in expanding his urban markets. Today's planning decisions are far more complex, as grids cover the continent and new transmission, generation, and demand-side technologies emerge.

Pediatric Sepsis

PubMed Central

Mathias, Brittany; Mira, Juan; Larson, Shawn D.

2016-01-01

Purpose of Review Sepsis is the leading cause of pediatric death worldwide. In the United States alone, there are 72,000 children hospitalized for sepsis annually with a reported mortality rate of 25% and an economic cost estimated to be $4.8 billion. However, it is only recently that the definition and management of pediatric sepsis has been recognized as being distinct from adult sepsis. Recent Findings The definition of pediatric sepsis is currently in a state of evolution and there is a large disconnect between the clinical and research definitions of sepsis which impacts the application of research findings into clinical practice. Despite this, it is the speed of diagnosis and the timely implementation of current treatment guidelines that has been shown to improve outcomes. However, adherence to treatment guidelines is currently low and it is only through the implementation of protocols that improved care and outcomes have been demonstrated. Summary Current management of pediatric sepsis is largely based on adaptations from adult sepsis treatment; however, distinct physiology demands more prospective pediatric trials to tailor management to the pediatric population. Adherence to current and emerging practice guidelines will require that protocolized care pathways become commonplace. PMID:26983000

Applying Reflective Middleware Techniques to Optimize a QoS-enabled CORBA Component Model Implementation

NASA Technical Reports Server (NTRS)

Wang, Nanbor; Parameswaran, Kirthika; Kircher, Michael; Schmidt, Douglas

2003-01-01

Although existing CORBA specifications, such as Real-time CORBA and CORBA Messaging, address many end-to-end quality-of service (QoS) properties, they do not define strategies for configuring these properties into applications flexibly, transparently, and adaptively. Therefore, application developers must make these configuration decisions manually and explicitly, which is tedious, error-prone, and open sub-optimal. Although the recently adopted CORBA Component Model (CCM) does define a standard configuration framework for packaging and deploying software components, conventional CCM implementations focus on functionality rather than adaptive quality-of-service, which makes them unsuitable for next-generation applications with demanding QoS requirements. This paper presents three contributions to the study of middleware for QoS-enabled component-based applications. It outlines rejective middleware techniques designed to adaptively (1) select optimal communication mechanisms, (2) manage QoS properties of CORBA components in their contain- ers, and (3) (re)con$gure selected component executors dynamically. Based on our ongoing research on CORBA and the CCM, we believe the application of rejective techniques to component middleware will provide a dynamically adaptive and (re)configurable framework for COTS software that is well-suited for the QoS demands of next-generation applications.

Integrated versus fragmented implementation of complex innovations in acute health care

PubMed Central

Woiceshyn, Jaana; Blades, Kenneth; Pendharkar, Sachin R.

2017-01-01

Background: Increased demand and escalating costs necessitate innovation in health care. The challenge is to implement complex innovations—those that require coordinated use across the adopting organization to have the intended benefits. Purpose: We wanted to understand why and how two of five similar hospitals associated with the same health care authority made more progress with implementing a complex inpatient discharge innovation whereas the other three experienced more difficulties in doing so. Methodology: We conducted a qualitative comparative case study of the implementation process at five comparable urban hospitals adopting the same inpatient discharge innovation mandated by their health care authority. We analyzed documents and conducted 39 interviews of the health care authority and hospital executives and frontline managers across the five sites over a 1-year period while the implementation was ongoing. Findings: In two and a half years, two of the participating hospitals had made significant progress with implementing the innovation and had begun to realize benefits; they exemplified an integrated implementation mode. Three sites had made minimal progress, following a fragmented implementation mode. In the former mode, a semiautonomous health care organization developed a clear overall purpose and chose one umbrella initiative to implement it. The integrative initiative subsumed the rest and guided resource allocation and the practices of hospital executives, frontline managers, and staff who had bought into it. In contrast, in the fragmented implementation mode, the health care authority had several overlapping, competing innovations that overwhelmed the sites and impeded their implementation. Practice Implications: Implementing a complex innovation across hospital sites required (a) early prioritization of one initiative as integrative, (b) the commitment of additional (traded off or new) human resources, (c) deliberate upfront planning and continual support for and evaluation of implementation, and (d) allowance for local customization within the general principles of standardization. PMID:26469705

A Technology Enhanced Learning Model for Quality Education

NASA Astrophysics Data System (ADS)

Sherly, Elizabeth; Uddin, Md. Meraj

Technology Enhanced Learning and Teaching (TELT) Model provides learning through collaborations and interactions with a framework for content development and collaborative knowledge sharing system as a supplementary for learning to improve the quality of education system. TELT deals with a unique pedagogy model for Technology Enhanced Learning System which includes course management system, digital library, multimedia enriched contents and video lectures, open content management system and collaboration and knowledge sharing systems. Open sources like Moodle and Wiki for content development, video on demand solution with a low cost mid range system, an exhaustive digital library are provided in a portal system. The paper depicts a case study of e-learning initiatives with TELT model at IIITM-K and how effectively implemented.

The integrated model for solving the single-period deterministic inventory routing problem

NASA Astrophysics Data System (ADS)

Rahim, Mohd Kamarul Irwan Abdul; Abidin, Rahimi; Iteng, Rosman; Lamsali, Hendrik

2016-08-01

This paper discusses the problem of efficiently managing inventory and routing problems in a two-level supply chain system. Vendor Managed Inventory (VMI) policy is an integrating decisions between a supplier and his customers. We assumed that the demand at each customer is stationary and the warehouse is implementing a VMI. The objective of this paper is to minimize the inventory and the transportation costs of the customers for a two-level supply chain. The problem is to determine the delivery quantities, delivery times and routes to the customers for the single-period deterministic inventory routing problem (SP-DIRP) system. As a result, a linear mixed-integer program is developed for the solutions of the SP-DIRP problem.

The need to disentangle key concepts from ecosystem-approach jargon.

PubMed

Waylen, K A; Hastings, E J; Banks, E A; Holstead, K L; Irvine, R J; Blackstock, K L

2014-10-01

The ecosystem approach--as endorsed by the Convention on Biological Diversity (CDB) in 2000-is a strategy for holistic, sustainable, and equitable natural resource management, to be implemented via the 12 Malawi Principles. These principles describe the need to manage nature in terms of dynamic ecosystems, while fully engaging with local peoples. It is an ambitious concept. Today, the term is common throughout the research and policy literature on environmental management. However, multiple meanings have been attached to the term, resulting in confusion. We reviewed references to the ecosystem approach from 1957 to 2012 and identified 3 primary uses: as an alternative to ecosystem management or ecosystem-based management; in reference to an integrated and equitable approach to resource management as per the CBD; and as a term signifying a focus on understanding and valuing ecosystem services. Although uses of this term and its variants may overlap in meaning, typically, they do not entirely reflect the ethos of the ecosystem approach as defined by the CBD. For example, there is presently an increasing emphasis on ecosystem services, but focusing on these alone does not promote decentralization of management or use of all forms of knowledge, both of which are integral to the CBD's concept. We highlight that the Malawi Principles are at risk of being forgotten. To better understand these principles, more effort to implement them is required. Such efforts should be evaluated, ideally with comparative approaches, before allowing the CBD's concept of holistic and socially engaged management to be abandoned or superseded. It is possible that attempts to implement all 12 principles together will face many challenges, but they may also offer a unique way to promote holistic and equitable governance of natural resources. Therefore, we believe that the CBD's concept of the ecosystem approach demands more attention. © 2014 Society for Conservation Biology.

Bottleneck analysis and strategic planning using Tanahashi model for childhood diarrhea management in Gujarat, Western India.

PubMed

Rupani, Mihir Prafulbhai; Gaonkar, Narayan T; Bhatt, Gneyaa S

2016-10-01

In spite of continued efforts, India is still lagging behind in achieving its MDG goals. The objectives of this study were to identify stake-holders who have a role to play in childhood diarrhea management, to identify gaps in childhood diarrhea management and to propose strategic options for relieving these gaps. Bottleneck analysis exercise was carried out based on the Tanahashi model in six High Priority Districts (HPDs) of Gujarat in period between July-November 2013. The major bottlenecks identified for Childhood Diarrhea management were poor demand generation, unsafe drinking water, poor access to improved sanitation facility and lack of equitable distribution and replenishment mechanisms for Oral Rehydration Solution (ORS) packets and Zinc tablets till the front-line worker level. The main strategic options that were suggested for relieving these bottlenecks were Zinc-ORS roll out in scale-up districts, develop Information Education Communication/Behaviour Change Communication (IEC/BCC) plan for childhood diarrhea management at state/district level, use of Drug Logistics Information Management System (DLIMS) software for supply chain management of Zinc-ORS, strengthening of chlorination activity at household level, monitoring implementation of Nirmal Bharat Abhiyaan (NBA) for constructing improved sanitation facilities at household level and to develop an IEC/BCC plan for hygiene promotion and usage of sanitary latrines. Use of Zinc tablets need to be intensified through an effective scale-up. Adequate demand generation activity is needed. There is need to address safe drinking water and improved sanitation measures at household levels. Multi-sectoral engagements and ownership of Zinc-ORS program is the need of the hour. Copyright © 2016 Elsevier Ltd. All rights reserved.

Distributed control system for demand response by servers

NASA Astrophysics Data System (ADS)

Hall, Joseph Edward

Within the broad topical designation of smart grid, research in demand response, or demand-side management, focuses on investigating possibilities for electrically powered devices to adapt their power consumption patterns to better match generation and more efficiently integrate intermittent renewable energy sources, especially wind. Devices such as battery chargers, heating and cooling systems, and computers can be controlled to change the time, duration, and magnitude of their power consumption while still meeting workload constraints such as deadlines and rate of throughput. This thesis presents a system by which a computer server, or multiple servers in a data center, can estimate the power imbalance on the electrical grid and use that information to dynamically change the power consumption as a service to the grid. Implementation on a testbed demonstrates the system with a hypothetical but realistic usage case scenario of an online video streaming service in which there are workloads with deadlines (high-priority) and workloads without deadlines (low-priority). The testbed is implemented with real servers, estimates the power imbalance from the grid frequency with real-time measurements of the live outlet, and uses a distributed, real-time algorithm to dynamically adjust the power consumption of the servers based on the frequency estimate and the throughput of video transcoder workloads. Analysis of the system explains and justifies multiple design choices, compares the significance of the system in relation to similar publications in the literature, and explores the potential impact of the system.

Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

PubMed

Kakyo, Tracy Alexis; Xiao, Lily Dongxia

2017-06-01

Ensuring safe and quality care for patients in hospitals is an important part of a nurse manager's role. Continuous quality improvement has been identified as one approach that leads to the delivery of quality care services to patients and is widely used by nurse managers to improve patient care. Nurse managers' experiences in initiating continuous quality improvement activities in resource-poor healthcare settings remain largely unknown. Research evidence is highly demanded in these settings to address disease burden and evidence-based practice. This interpretive qualitative study was conducted to gain an understanding of nurse managers' Continuous Quality Improvement experiences in rural hospitals in Uganda. Nurse managers in rural healthcare settings used their role to prioritize quality improvement activities, monitor the Continuous Quality Improvement process, and utilize in-service education to support continuous quality improvement. The nurse managers in our sample encountered a number of barriers during the implementation of Continuous Quality Improvement, including: limited patient participation, lack of materials, and limited human resources. Efforts to address the challenges faced through good governance and leadership development require more attention. © 2017 John Wiley & Sons Australia, Ltd.

Family Health Services project: the way forward.

PubMed

Dabiri, O M

1993-01-01

Nigerians did not readily accept family planning when Family Health Services (FHS) began in 1988. FHS has made much headway in training, IEC (information, education, and communication), and constituency building and advocacy. Its staff have identified obstacles to implementation, especially program sustainability and management structure. Key limits to sustainability of IEC efforts were inadequately trained personnel and inability of trained personnel to apply what they learned at work stations. The Federal Ministry and Social Services' role in the FHS project was not clearly defined. Some private sector factors contributing to a confused management structure were inadequate method mix, high contraceptive cost, poor monitoring of quality of care, and no coordination of family planning training with the public factor. FHS has since decided to focus its efforts on increasing the demand for and availability of modern contraceptives and improving the quality of family planning services of both the public and private sectors. FHS hopes that accomplishing these activities will reduce fertility, morbidity, and mortality. Strategic plans include a regional focus, quality of care, a variety of methods offered, intensification, hospital and clinics, a management information system, contraceptive logistics, distribution regulations, and addressing social, cultural, and behavioral factors. To effectively implement the strategy, USAID and the Federal Ministry held a workshop in 1993 to effect full integration of Nigerian experience in the 2nd phase of the project (FHS II). Participants reviewed the strengths and weaknesses of the first phase and agreed on implementation. For example, nongovernmental organizations should implement FHS II. FHS II includes training, IEC, and commodities/logistics.

Bacillus Calmette-Guérin (BCG) vaccine: A global assessment of demand and supply balance.

PubMed

Cernuschi, Tania; Malvolti, Stefano; Nickels, Emily; Friede, Martin

2018-01-25

Over the past decade, several countries across all regions, income groups and procurement methods have been unable to secure sufficient BCG vaccine supply. While the frequency of stock-outs has remained rather stable, duration increased in 2014-2015 due to manufacturing issues and attracted the attention of national, regional and global immunization stakeholders. This prompted an in-depth analysis of supply and demand dynamics aiming to characterize supply risks. This analysis is unique as it provides a global picture, where previous analyses have focused on a portion of the market procuring through UN entities. Through literature review, supplier interviews, appraisal of shortages, stock-outs and historical procurement data, and through demand forecasting, this analysis shows an important increase in global capacity in 2017: supply is sufficient to meet forecasted BCG vaccine demand and possibly buffer market shocks. Nevertheless, risks remain mainly due to supply concentration and limited investment in production process improvements, as well as inflexibility in demand. Identification of these market risks will allow implementation of risk-mitigating interventions in three areas: (1) enhancing information sharing between major global health actors, countries and suppliers, (2) identifying interests and incentives to expand product registration and investment in the BCG manufacturing process, and (3) working with countries for tighter vaccine management. Copyright © 2017. Published by Elsevier Ltd.

Refrigerated Warehouse Demand Response Strategy Guide

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

Scott, Doug; Castillo, Rafael; Larson, Kyle

This guide summarizes demand response measures that can be implemented in refrigerated warehouses. In an appendix, it also addresses related energy efficiency opportunities. Reducing overall grid demand during peak periods and energy consumption has benefits for facility operators, grid operators, utility companies, and society. State wide demand response potential for the refrigerated warehouse sector in California is estimated to be over 22.1 Megawatts. Two categories of demand response strategies are described in this guide: load shifting and load shedding. Load shifting can be accomplished via pre-cooling, capacity limiting, and battery charger load management. Load shedding can be achieved by lightingmore » reduction, demand defrost and defrost termination, infiltration reduction, and shutting down miscellaneous equipment. Estimation of the costs and benefits of demand response participation yields simple payback periods of 2-4 years. To improve demand response performance, it’s suggested to install air curtains and another form of infiltration barrier, such as a rollup door, for the passageways. Further modifications to increase efficiency of the refrigeration unit are also analyzed. A larger condenser can maintain the minimum saturated condensing temperature (SCT) for more hours of the day. Lowering the SCT reduces the compressor lift, which results in an overall increase in refrigeration system capacity and energy efficiency. Another way of saving energy in refrigerated warehouses is eliminating the use of under-floor resistance heaters. A more energy efficient alternative to resistance heaters is to utilize the heat that is being rejected from the condenser through a heat exchanger. These energy efficiency measures improve efficiency either by reducing the required electric energy input for the refrigeration system, by helping to curtail the refrigeration load on the system, or by reducing both the load and required energy input.« less

Daily Use of Energy Management Strategies and Occupational Well-being: The Moderating Role of Job Demands.

PubMed

Parker, Stacey L; Zacher, Hannes; de Bloom, Jessica; Verton, Thomas M; Lentink, Corine R

2017-01-01

We examine the relationships among employees' use of energy management strategies and two occupational well-being outcomes: job satisfaction and emotional exhaustion. Based on conservation of resources theory, it was hypothesized that employees with high job demands would benefit more from using energy management strategies (i.e., including prosocial, organizing, and meaning-related strategies), compared to employees with low job demands. We tested this proposition using a quantitative diary study. Fifty-four employees provided data twice daily across one work week (on average, 7 daily entries). Supporting the hypotheses, prosocial energy management was positively related to job satisfaction. Moreover, employees with high job demands were less emotionally exhausted when using prosocial strategies. Contrary to predictions, when using organizing strategies, employees with low job demands had higher job satisfaction and lower emotional exhaustion. Under high job demands, greater use of organizing strategies was associated with lower job satisfaction and higher emotional exhaustion. Finally, use of meaning-related strategies was associated with higher emotional exhaustion when job demands were low. With this research, we position energy management as part of a resource investment process aimed at maintaining and improving occupational well-being. Our findings show that this resource investment will be more or less effective depending on the type of strategy used and the existing drain on resources (i.e., job demands). This is the first study to examine momentary effects of distinct types of work-related energy management strategies on occupational well-being.

Daily Use of Energy Management Strategies and Occupational Well-being: The Moderating Role of Job Demands

PubMed Central

Parker, Stacey L.; Zacher, Hannes; de Bloom, Jessica; Verton, Thomas M.; Lentink, Corine R.

2017-01-01

We examine the relationships among employees’ use of energy management strategies and two occupational well-being outcomes: job satisfaction and emotional exhaustion. Based on conservation of resources theory, it was hypothesized that employees with high job demands would benefit more from using energy management strategies (i.e., including prosocial, organizing, and meaning-related strategies), compared to employees with low job demands. We tested this proposition using a quantitative diary study. Fifty-four employees provided data twice daily across one work week (on average, 7 daily entries). Supporting the hypotheses, prosocial energy management was positively related to job satisfaction. Moreover, employees with high job demands were less emotionally exhausted when using prosocial strategies. Contrary to predictions, when using organizing strategies, employees with low job demands had higher job satisfaction and lower emotional exhaustion. Under high job demands, greater use of organizing strategies was associated with lower job satisfaction and higher emotional exhaustion. Finally, use of meaning-related strategies was associated with higher emotional exhaustion when job demands were low. With this research, we position energy management as part of a resource investment process aimed at maintaining and improving occupational well-being. Our findings show that this resource investment will be more or less effective depending on the type of strategy used and the existing drain on resources (i.e., job demands). This is the first study to examine momentary effects of distinct types of work-related energy management strategies on occupational well-being. PMID:28912741

Land use and water use in the Antelope Valley, California

USGS Publications Warehouse

Templin, William E.; Phillips, Steven P.; Cherry, Daniel E.; DeBortoli, Myrna L.; Haltom, T.C.; McPherson, Kelly R.; Mrozek, C.A.

1995-01-01

Urban land use and water use in the Antelope Valley, California, have increased significantly since development of the valley began in the late 1800's.. Ground water has been a major source of water in this area because of limited local surface-water resources. Ground-water pumpage is reported to have increased from about 29,000 acre-feet in 1919 to about 400,000 acre-feet in the 1950's. Completion of the California Aqueduct to this area in the early 1970's conveyed water from the Sacramento-San Joaquin Delta, about 400 miles to the north. Declines in groundwater levels and increased costs of electrical power in the 1970's resulted in a reduction in the quantity of ground water that was pumped annually for irrigation uses. Total annual reported ground-water pumpage decreased to a low of about 53,200 acre-feet in 1983 and increased to about 91,700 acre-feet in 1991 as a result of rapid urban development and the 1987-92 drought. This increased urban development, in combination with several years of drought, renewed concern about a possible return to extensive depletion of ground-water storage and increased land subsidence.Increased water demands are expected to continue as a result of increased urban development. Water-demand forecasts in 1980 for the Antelope Valley indicated that total annual water demand by 2020 was expected to be about 250,000 acre-feet, with agricultural demand being about 65 percent of this total. In 1990, total water demand was projected to be about 175,000 acre-feet by 2010; however, agricultural water demand was expected to account for only 37 percent of the total demand. New and existing land- and water-use data were collected and compiled during 1992-93 to identify present and historical land and water uses. In 1993, preliminary forecasts for total water demand by 2010 ranged from about 127,500 to 329,000 acre-feet. These wide-ranging estimates indicate that forecasts can change with time as factors that affect water demand change and different forecasting methods are used. The forecasts using the MWD_MAIN (Metropolitan Water District of Southern California Municipal and Industrial Needs) water-demand forecasting system yielded the largest estimates of water demand. These forecasts were based on projections of population growth and other socioeconomic variables. Initial forecasts using the MWD_MAIN forecasting system commonly are considered "interim" or preliminary. Available historical and future socioeconomic data required for the forecasting system are limited for this area. Decisions on local water-resources demand management may be made by members of the Antelope Valley Water Group and other interested parties based on this report, other studies, their best judgement, and cumulative knowledge of local conditions. Potential water-resource management actions in the Antelope Valley include (1) increasing artificial ground-water recharge when excess local runoff (or imported water supplies) are available; (2) implementing water-conservation best-management practices; and (3) optimizing ground-water pumpage throughout the basin.

Improving medical stores management through automation and effective communication.

PubMed

Kumar, Ashok; Cariappa, M P; Marwaha, Vishal; Sharma, Mukti; Arora, Manu

2016-01-01

Medical stores management in hospitals is a tedious and time consuming chore with limited resources tasked for the purpose and poor penetration of Information Technology. The process of automation is slow paced due to various inherent factors and is being challenged by the increasing inventory loads and escalating budgets for procurement of drugs. We carried out an indepth case study at the Medical Stores of a tertiary care health care facility. An iterative six step Quality Improvement (QI) process was implemented based on the Plan-Do-Study-Act (PDSA) cycle. The QI process was modified as per requirement to fit the medical stores management model. The results were evaluated after six months. After the implementation of QI process, 55 drugs of the medical store inventory which had expired since 2009 onwards were replaced with fresh stock by the suppliers as a result of effective communication through upgraded database management. Various pending audit objections were dropped due to the streamlined documentation and processes. Inventory management improved drastically due to automation, with disposal orders being initiated four months prior to the expiry of drugs and correct demands being generated two months prior to depletion of stocks. The monthly expense summary of drugs was now being done within ten days of the closing month. Improving communication systems within the hospital with vendor database management and reaching out to clinicians is important. Automation of inventory management requires to be simple and user-friendly, utilizing existing hardware. Physical stores monitoring is indispensable, especially due to the scattered nature of stores. Staff training and standardized documentation protocols are the other keystones for optimal medical store management.

Agile parallel bioinformatics workflow management using Pwrake.

PubMed

Mishima, Hiroyuki; Sasaki, Kensaku; Tanaka, Masahiro; Tatebe, Osamu; Yoshiura, Koh-Ichiro

2011-09-08

In bioinformatics projects, scientific workflow systems are widely used to manage computational procedures. Full-featured workflow systems have been proposed to fulfil the demand for workflow management. However, such systems tend to be over-weighted for actual bioinformatics practices. We realize that quick deployment of cutting-edge software implementing advanced algorithms and data formats, and continuous adaptation to changes in computational resources and the environment are often prioritized in scientific workflow management. These features have a greater affinity with the agile software development method through iterative development phases after trial and error.Here, we show the application of a scientific workflow system Pwrake to bioinformatics workflows. Pwrake is a parallel workflow extension of Ruby's standard build tool Rake, the flexibility of which has been demonstrated in the astronomy domain. Therefore, we hypothesize that Pwrake also has advantages in actual bioinformatics workflows. We implemented the Pwrake workflows to process next generation sequencing data using the Genomic Analysis Toolkit (GATK) and Dindel. GATK and Dindel workflows are typical examples of sequential and parallel workflows, respectively. We found that in practice, actual scientific workflow development iterates over two phases, the workflow definition phase and the parameter adjustment phase. We introduced separate workflow definitions to help focus on each of the two developmental phases, as well as helper methods to simplify the descriptions. This approach increased iterative development efficiency. Moreover, we implemented combined workflows to demonstrate modularity of the GATK and Dindel workflows. Pwrake enables agile management of scientific workflows in the bioinformatics domain. The internal domain specific language design built on Ruby gives the flexibility of rakefiles for writing scientific workflows. Furthermore, readability and maintainability of rakefiles may facilitate sharing workflows among the scientific community. Workflows for GATK and Dindel are available at http://github.com/misshie/Workflows.

Agile parallel bioinformatics workflow management using Pwrake

PubMed Central

2011-01-01

Background In bioinformatics projects, scientific workflow systems are widely used to manage computational procedures. Full-featured workflow systems have been proposed to fulfil the demand for workflow management. However, such systems tend to be over-weighted for actual bioinformatics practices. We realize that quick deployment of cutting-edge software implementing advanced algorithms and data formats, and continuous adaptation to changes in computational resources and the environment are often prioritized in scientific workflow management. These features have a greater affinity with the agile software development method through iterative development phases after trial and error. Here, we show the application of a scientific workflow system Pwrake to bioinformatics workflows. Pwrake is a parallel workflow extension of Ruby's standard build tool Rake, the flexibility of which has been demonstrated in the astronomy domain. Therefore, we hypothesize that Pwrake also has advantages in actual bioinformatics workflows. Findings We implemented the Pwrake workflows to process next generation sequencing data using the Genomic Analysis Toolkit (GATK) and Dindel. GATK and Dindel workflows are typical examples of sequential and parallel workflows, respectively. We found that in practice, actual scientific workflow development iterates over two phases, the workflow definition phase and the parameter adjustment phase. We introduced separate workflow definitions to help focus on each of the two developmental phases, as well as helper methods to simplify the descriptions. This approach increased iterative development efficiency. Moreover, we implemented combined workflows to demonstrate modularity of the GATK and Dindel workflows. Conclusions Pwrake enables agile management of scientific workflows in the bioinformatics domain. The internal domain specific language design built on Ruby gives the flexibility of rakefiles for writing scientific workflows. Furthermore, readability and maintainability of rakefiles may facilitate sharing workflows among the scientific community. Workflows for GATK and Dindel are available at http://github.com/misshie/Workflows. PMID:21899774

Production practices affecting worker task demands in concrete operations: A case study.

PubMed

Memarian, Babak; Mitropoulos, Panagiotis

2015-01-01

Construction work involves significant physical, mental, and temporal task demands. Excessive task demands can have negative consequences for safety, errors and production. This exploratory study investigates the magnitude and sources of task demands on a concrete operation, and examines the effect of the production practices on the workers' task demands. The NASA Task Load Index was used to measure the perceived task demands of two work crews. The operation involved the construction of a cast-in-place concrete building under high schedule pressures. Interviews with each crew member were used to identify the main sources of the perceived demands. Extensive field observations and interviews with the supervisors and crews identified the production practices. The workers perceived different level of task demands depending on their role. The production practices influenced the task demands in two ways: (1) practices related to work organization, task design, resource management, and crew management mitigated the task demands; and (2) other practices related to work planning and crew management increased the crew's ability to cope with and adapt to high task demands. The findings identify production practices that regulate the workers' task demands. The effect of task demands on performance is mitigated by the ability to cope with high demands.

A review of BIM (Building Information Modeling) implementation in Indonesia construction industry

NASA Astrophysics Data System (ADS)

Suryadinata Telaga, Abdi

2018-05-01

Construction projects in Indonesia have been growing rapidly in the last three years. Therefore, construction management is very important to ensure completion of construction projects are within schedule and budget. Utilization of building information modeling (BIM) can increase the efficiency of a construction project. However, the implementation of BIM in Indonesia is still not known. This paper is intended to review the implementation of BIM in Indonesia through literature analysis. To find BIM articles in Indonesia, Firstly, searching was limited to English articles published in reputed journals or conferences. However the results were limited, then the search was expanded to the article using Indonesian languages that published in journal and conference. Based on the number of articles, the results showed that BIM research in Indonesia is still in a dearth. Furthermore, BIM study cases were conducted in a limited location and within a small population. Nevertheless, the literature shared the conclusion that BIM can increase project efficiency, but the implementation was hindered by high initial investment cost, inadequate human resources, small demand, and technology resistant. The research contributes to providing a current reported level of BIM implementation in Indonesia. In the future research to study of BIM implementation comprehensively in Indonesia is eminent.

Confronting water in an Israeli-Palestinian peace agreement

NASA Astrophysics Data System (ADS)

Brooks, David; Trottier, Julie

2010-03-01

SummaryTrans-boundary water agreements are usually conceived as allocation agreements. In other words, water is treated as if it were a pie to be divided among the riparian states. The treatment of water as if it were as immobile as land may be useful in the short term, but it is fundamentally flawed as a means to avoid conflict as well as to ensure efficient, equitable, and sustainable management of water over the long term. This article proposes to avoid quantitative allocations within international water agreements, whether they be presented as percentage or fixed allocations or whether or not accompanied by a periodic revision clause. It proposes instead an ongoing joint management structure that allows for continuous conflict resolution concerning water demands and uses in a manner that effectively de-nationalises water uses. As well, it builds on existing, functioning institutions that are already active over a variety of scalar levels. It disaggregates what is usually perceived as a national water demand into its component institutions and re-aggregates them within an international institutional context. Though this approach for building trans-boundary water agreements can prove useful in any geographical situation, this article uses the Israeli-Palestinian conflict as a model. It proposes to respect the existing differences in the institutional management of water between the two entities and to reach four general objectives: economic efficiency, social and political equity, ecological sustainability, and the ability to implement the agreement in practice. The institutional design and proposed mechanisms follow five key principles for shared management: water allocations that are not fixed but variable over time; equality in rights and responsibilities; priority for demand management over supply management; continuous monitoring of water quality and quantity; and mediation among competing uses of fresh water. This institutional structure balances water quantity and water quality issues and economic and environmental goals in a de-securitised fashion. Though specifically applied to water shared by Israelis and Palestinians, the objectives, principles and institutional structure are relevant to any place in the world where trans-boundary water divides rather than unites two or more peoples.

EPA'S PHOTOVOLTAIC DEMAND-SIDE MANAGEMENT COST-SHARED DEMONSTRATIONS

EPA Science Inventory

The paper discusses an investigation of how photovoltaics (PV) may be used as both a pollution-mitigating energy replacement for fossil fuels and a demand-side management (DSM) option to reduce peak electrical demands of commercial and residential buildings. leven electric utilit...

U.S. EPA'S PHOTOVOLTAIC DEMAND-SIDE MANAGEMENT PROJECT

EPA Science Inventory

The paper discusses an investigation of how photovoltaic (PV) may be used as both a pollution-mitigating energy replacement for fossil fuels and a demand-side management (DSM) option to reduce peak electrical demands of commercial and residential buildings. leven electric utiliti...

New York State energy-analytic information system: first-stage implementation

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

Allentuck, J.; Carroll, O.; Fiore, L.

1979-09-01

So that energy policy by state government may be formulated within the constraints imposed by policy determined at the national level - yet reflect the diverse interests of its citizens - large quantities of data and sophisticated analytic capabilities are required. This report presents the design of an energy-information/analytic system for New York State, the data for a base year, 1976, and projections of these data. At the county level, 1976 energy-supply demand data and electric generating plant data are provided as well. Data-base management is based on System 2000. Three computerized models provide the system's basic analytic capacity. Themore » Brookhaven Energy System Network Simulator provides an integrating framework while a price-response model and a weather sensitive energy demand model furnished a short-term energy response estimation capability. The operation of these computerized models is described. 62 references, 25 figures, 39 tables.« less

Towards a Functionally-Formed Air Traffic System-of-Systems

NASA Technical Reports Server (NTRS)

Conway, Sheila R.; Consiglio, Maria C.

2005-01-01

Incremental improvements to the national aviation infrastructure have not resulted in sufficient increases in capacity and flexibility to meet emerging demand. Unfortunately, revolutionary changes capable of substantial and rapid increases in capacity have proven elusive. Moreover, significant changes have been difficult to implement, and the operational consequences of such change, difficult to predict due to the system s complexity. Some research suggests redistributing air traffic control functions through the system, but this work has largely been dismissed out of hand, accused of being impractical. However, the case for functionally-based reorganization of form can be made from a theoretical, systems perspective. This paper investigates Air Traffic Management functions and their intrinsic biases towards centralized/distributed operations, grounded in systems engineering and information technology theories. Application of these concepts to a small airport operations design is discussed. From this groundwork, a robust, scalable system transformation plan may be made in light of uncertain demand.

Smart Building: Decision Making Architecture for Thermal Energy Management.

PubMed

Uribe, Oscar Hernández; Martin, Juan Pablo San; Garcia-Alegre, María C; Santos, Matilde; Guinea, Domingo

2015-10-30

Smart applications of the Internet of Things are improving the performance of buildings, reducing energy demand. Local and smart networks, soft computing methodologies, machine intelligence algorithms and pervasive sensors are some of the basics of energy optimization strategies developed for the benefit of environmental sustainability and user comfort. This work presents a distributed sensor-processor-communication decision-making architecture to improve the acquisition, storage and transfer of thermal energy in buildings. The developed system is implemented in a near Zero-Energy Building (nZEB) prototype equipped with a built-in thermal solar collector, where optical properties are analysed; a low enthalpy geothermal accumulation system, segmented in different temperature zones; and an envelope that includes a dynamic thermal barrier. An intelligent control of this dynamic thermal barrier is applied to reduce the thermal energy demand (heating and cooling) caused by daily and seasonal weather variations. Simulations and experimental results are presented to highlight the nZEB thermal energy reduction.

Plant protection and growth stimulation by microorganisms: biotechnological applications of Bacilli in agriculture.

PubMed

Pérez-García, Alejandro; Romero, Diego; de Vicente, Antonio

2011-04-01

The increasing demand for a steady, healthy food supply requires an efficient control of the major pests and plant diseases. Current management practices are based largely on the application of synthetic pesticides. The excessive use of agrochemicals has caused serious environmental and health problems. Therefore, there is a growing demand for new and safer methods to replace or at least supplement the existing control strategies. Biological control, that is, the use of natural antagonists to combat pests or plant diseases has emerged as a promising alternative to chemical pesticides. The Bacilli offer a number of advantages for their application in agricultural biotechnology. Several Bacillus-based products have been marketed as microbial pesticides, fungicides or fertilisers. Bacillus-based biopesticides are widely used in conventional agriculture, by contrast, implementation of Bacillus-based biofungicides and biofertilizers is still a pending issue. Copyright © 2010 Elsevier Ltd. All rights reserved.

Maintaining professional resilience through group restorative supervision.

PubMed

Wallbank, Sonya

2013-08-01

Restorative clinical supervision has been delivered to over 2,500 professionals and has shown to be highly effective in reducing burnout, stress and increasing compassion satisfaction. Demand for the programme has shown that a sustainable model of implementation is needed for organisations who may not be able to invest in continued individual sessions. Following the initial six sessions, group restorative supervision has been developed and this paper reports on the programme's success in maintaining and continuing to improve compassion satisfaction, stress and burnout through the process of restorative group supervision. This means that organisations can continue to maintain the programme once the initial training has been completed and have confidence within the restorative group supervision to support professionals in managing the emotional demands of their role. The restorative groups have also had inadvertent positive benefits in workplace functioning. The paper outlines how professionals have been able to use this learning to support them in being more effective.

The Employer Perspective on Sustainable Employability in the Construction Industry.

PubMed

Tonnon, Susanne C; van der Veen, Rozan; Westerman, Marjan J; Robroek, Suzan J W; van der Ploeg, Hidde P; van der Beek, Allard J; Proper, Karin I

2017-01-01

To determine the measures employers in the construction industry take to promote sustainable employability, the barriers and facilitators that influence implementation and employer needs. Questionnaire among 499 employers and interviews with 17 employers. Employers expressed a need for alternative jobs for workers who can no longer perform physically demanding tasks, as well as means to stimulate proactive employee behavior. Measures frequently targeted the work environment (95%) and employee health (79%), less frequently personal development (63%) and organization (65%). Implementation was influenced by economic factors, rules and regulations, client demands, employee demands, company vision, company culture, and time/manpower/expertise. Implementation of measures aimed at reducing physical load and the promotion of personal development are needed.

The relevance of public health research for practice: A 30-year perspective.

PubMed

Diderichsen, Finn

2018-06-01

The Nordic context where public health responsibility is strongly devolved to municipalities raises specific demands on public health research. The demands for causal inference of disease aetiology and intervention efficacy is not different, but in addition there is a need for population health science that describes local prevalence, distribution and clustering of determinants. Knowledge of what interventions and policies work, for whom and under what conditions is essential, but instead of assuming context independence and demanding high external validity it is important to understand how contextual factors linked to groups and places modify both effects and implementation. More implementation studies are needed, but the infrastructure for that research in terms of theories and instruments for monitoring implementation is needed. Much of this was true also 30 years ago, but with increasing spending on both public health research and practice, the demands are increasing that major improvement of population health and health equity are actually achieved.

New solutions for personalised health management: citizens' needs, healthcare changes, and market perspectives round table debate.

PubMed

Olsson, Silas; Hofmann, Isa; Brambilla, Piero Maria; Jacobsson, Ulf; Kennedy, Paul; Roca, Josep; Schmitt, Karl-Jürgen; Wyke, Alexandra

2004-01-01

The aim with the round table was to give additional inputs and views to the specific technology oriented presentations focusing on issues dealing with the need, patients' view, the use and the business opportunities relating to wearable eHealth systems for personalised health management. Wearable eHealth systems for personalised health management are targeting citizens, patients at health risks and patients enrolled in open care or home care for monitoring, treatment or follow up. The developments so far show promises for these group categories, and in addition, could support developments in health care organisations and systems. However, the ethical issues and data privacy nature have to be seriously taken into account. The market is not yet developed, and this is the situation both in Europe and in the US. To be able to give the customers solid product information a standardised test bed for new equipment and services might speed up the market development. In the round table discussion it was highlighted that one has to differ between needs and demands. Needs are related to the prevalence of the diseases, the health risks, etc. Demands are more related to market developments and customers' willingness to pay for the new products and services. Further, technical interoperability was seen as a fundamental prerequisite for market acceptance. As wearable eHealth systems for personalised health management differ completely from traditional way of deliver healthcare, new reimbursement systems have to be developed and implemented.

Benefits of economic criteria for water scarcity management under global changes: insights from a large-scale hydroeconomic framework

NASA Astrophysics Data System (ADS)

Neverre, Noémie; Dumas, Patrice; Nassopoulos, Hypatia

2016-04-01

Global changes are expected to exacerbate water scarcity issues in the Mediterranean region in the next decades. In this work, we investigate the impacts of reservoirs operation rules based on an economic criterion. We examine whether can they help reduce the costs of water scarcity, and whether they become more relevant under future climatic and socioeconomic conditions. We develop an original hydroeconomic model able to compare future water supply and demand on a large scale, while representing river basin heterogeneity. On the demand side, we focus on the two main sectors of water use: the irrigation and domestic sectors. Demands are projected in terms of both quantity and economic value. Irrigation requirements are computed for 12 types of crops, at the 0.5° spatial resolution, under future climatic conditions (A1B scenario). The computation of the economic benefits of irrigation water is based on a yield comparison approach between rainfed and irrigated crops. For the domestic sector, we project the combined effects of demographic growth, economic development and water cost evolution on future demands. The economic value of domestic water is defined as the economic surplus. On the supply side, we evaluate the impacts of climate change on water inflows to the reservoirs. Operating rules of the reservoirs are set up using a parameterisation-simulation-optimisation approach. The objective is to maximise water benefits. We introduce prudential parametric rules in order to take into account spatial and temporal trade-offs. The methodology is applied to Algeria at the 2050 horizon. Overall, our results show that the supply-demand imbalance and its costs will increase in most basins under future climatic and socioeconomic conditions. Our results suggest that the benefits of operating rules based on economic criteria are not unequivocally increased with global changes: in some basins the positive impact of economic prioritisation is higher under future conditions, but in other basins it is higher under historical conditions. Global changes may be an incentive to use valuation in operating rules in some basins. In other basins, the benefits of reservoirs management based on economic criteria are less pronounced; in this case, trade-offs could arise between implementing economic based operation policies or not. Given its generic nature and low data requirements, the framework developed could be implemented in other regions concerned with water scarcity and its cost, or extended to a global coverage. Water policies at the country or regional level could be assessed.

The physician as a manager.

PubMed

McDonagh, T J

1982-02-01

The practice of occupational medicine has undergone considerable change over the last decade. Increased awareness of potential health hazards associated with the workplace and its products and wastes, the interest of society and workers in these subjects, and related governmental regulation have resulted in expanded occupational health programs within industry. The occupational physician has become a key company resource in the optimal management of the business impacts of health-related issues. Health-related matters often have noteworthy business implications, and the occupational physician needs to spend considerable time as a manager in the planning, resourcing, implementation, evaluation, and stewardship of programs. Thus he is experiencing greater demands and often is inadequately prepared for this nonclinical, nonscientific role. Therefore, the preparation of occupational physicians to assume such managerial responsibilities needs to receive high priority. The physician must be willing to accept this challenge both to ensure the program's success and to retain a leadership position in occupational health programs.

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.

Development of the competitive business in the context of environmental legislation in Croatia.

PubMed

Matesić, Mirjana; Kalambura, Sanja; Bacun, Dubravka

2014-03-01

Environmental protection has a key role in the context of crisis management. It is not just about development of the industry of environmental protection and implementation of new ways of management in innovative solutions in solving problems. Important area of improvement is also revision of environmental legislation aiming at simplification and reduction of costs of procedures for the business. This paper discusses problems of business sector in Croatia related to transposition of demanding environmental EU regulation, it suggests improvements such as simplification of special waste management systems, of environmental impact assessments processes, environmental permitting etc. The paper considers revision of environmental protection not by lowering environmental standards, but by introducing transparent and compromising models between business and environmental protection, based on sustainable development, with control mechanisms which don't impact functioning of business sector (and its competitiveness), therefore allowing successful protection of environment and its renewable and non-renewable resources.

Implementing change in health professions education: stakeholder analysis and coalition building.

PubMed

Baum, Karyn D; Resnik, Cheryl D; Wu, Jennifer J; Roey, Steven C

2007-01-01

The challenges facing the health sciences education fields are more evident than ever. Professional health sciences educators have more demands on their time, more knowledge to manage, and ever-dwindling sources of financial support. Change is often necessary to either keep programs viable or meet the changing needs of health education. This article outlines a simple but powerful three-step tool to help educators become successful agents of change. Through the application of principles well known and widely used in business management, readers will understand the concepts behind stakeholder analysis and coalition building. These concepts are part of a powerful tool kit that educators need in order to become effective agents of change in the health sciences environment. Using the example of curriculum change at a school of veterinary medicine, we will outline the three steps involved, from stakeholder identification and analysis to building and managing coalitions for change.

A Uniform Framework of Global Nuclear Materials Management

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

Dupree, S.A.; Mangan, D.L.; Sanders, T.L

1999-04-20

Global Nuclear Materials Management (GNMM) anticipates and supports a growing international recognition of the importance of uniform, effective management of civilian, excess defense, and nuclear weapons materials. We expect thereto be a continuing increase in both the number of international agreements and conventions on safety, security, and transparency of nuclear materials, and the number of U.S.-Russian agreements for the safety, protection, and transparency of weapons and excess defense materials. This inventory of agreements and conventions may soon expand into broad, mandatory, international programs that will include provisions for inspection, verification, and transparency, To meet such demand the community must buildmore » on the resources we have, including State agencies, the IAEA and regional organizations. By these measures we will meet the future expectations for monitoring and inspection of materials, maintenance of safety and security, and implementation of transparency measures.« less

Knowledge structure representation and automated updates in intelligent information management systems

NASA Technical Reports Server (NTRS)

Corey, Stephen; Carnahan, Richard S., Jr.

1990-01-01

A continuing effort to apply rapid prototyping and Artificial Intelligence techniques to problems associated with projected Space Station-era information management systems is examined. In particular, timely updating of the various databases and knowledge structures within the proposed intelligent information management system (IIMS) is critical to support decision making processes. Because of the significantly large amounts of data entering the IIMS on a daily basis, information updates will need to be automatically performed with some systems requiring that data be incorporated and made available to users within a few hours. Meeting these demands depends first, on the design and implementation of information structures that are easily modified and expanded, and second, on the incorporation of intelligent automated update techniques that will allow meaningful information relationships to be established. Potential techniques are studied for developing such an automated update capability and IIMS update requirements are examined in light of results obtained from the IIMS prototyping effort.

The Students in Front of Us: Reform for the Current Generation of Urban High School Students

ERIC Educational Resources Information Center

Burks, Joe; Hochbein, Craig

2015-01-01

The implementation of education policies requiring the turnaround of persistently low-achieving schools has demanded reforms that will not only improve achievement, but also deliver results in a short period of time. To meet such demands, Jefferson County Public Schools educators implemented Project Proficiency (PP). Results from…

An Integrated Hydrologic-Economic Modeling Tool for Evaluating Water Management Responses to Climate Change in the Boise River Basin

NASA Astrophysics Data System (ADS)

Schmidt, R. D.; Taylor, R. G.; Stodick, L. D.; Contor, B. A.

2009-12-01

A recent federal interagency report on climate change and water management (Brekke et. al., 2009) describes several possible management responses to the impacts of climate change on water supply and demand. Management alternatives include changes to water supply infrastructure, reservoir system operations, and water demand policies. Water users in the Bureau of Reclamation’s Boise Project (located in the Lower Boise River basin in southwestern Idaho) would be among those impacted both hydrologically and economically by climate change. Climate change and management responses to climate change are expected to cause shifts in water supply and demand. Supply shifts would result from changes in basin precipitation patterns, and demand shifts would result from higher evapotranspiration rates and a longer growing season. The impacts would also extend to non-Project water users in the basin, since most non-Project groundwater pumpers and drain water diverters rely on hydrologic externalities created by seepage losses from Boise Project water deliveries. An integrated hydrologic-economic model was developed for the Boise basin to aid Reclamation in evaluating the hydrologic and economic impacts of various management responses to climate change. A spatial, partial-equilibrium, economic optimization model calculates spatially-distinct equilibrium water prices and quantities, and maximizes a social welfare function (the sum of consumer and producers surpluses) for all agricultural and municipal water suppliers and demanders (both Project and non-Project) in the basin. Supply-price functions and demand-price functions are exogenous inputs to the economic optimization model. On the supply side, groundwater and river/reservoir models are used to generate hydrologic responses to various management alternatives. The response data is then used to develop water supply-price functions for Project and non-Project water users. On the demand side, crop production functions incorporating crop distribution, evapotranspiration rates, irrigation efficiencies, and crop prices are used to develop water demand-price functions for agricultural water users. Demand functions for municipal and industrial water users are also developed. Recent applications of the integrated model have focused on the hydrologic and economic impacts of demand management alternatives, including large-scale canal lining conservation measures, and market-based water trading between canal diverters and groundwater pumpers. A supply management alternative being investigated involves revising reservoir rule curves to compensate for climate change impacts on timing of reservoir filling.

Probabilistic Predictions of Traffic Demand for En Route Sectors Based on Individual Flight Data

DOT National Transportation Integrated Search

2010-01-01

The Traffic Flow Management System (TFMS) predicts the demand for each sector, and traffic managers use these predictions to spot possible congestion and to take measures to prevent it. These predictions of sector demand, however, are currently made ...

Interactions between lean management and the psychosocial work environment in a hospital setting - a multi-method study.

PubMed

Ulhassan, Waqar; von Thiele Schwarz, Ulrica; Thor, Johan; Westerlund, Hugo

2014-10-22

As health care struggles to meet increasing demands with limited resources, Lean has become a popular management approach. It has mainly been studied in relation to health care performance. The empirical evidence as to how Lean affects the psychosocial work environment has been contradictory. This study aims to study the interaction between Lean and the psychosocial work environment using a comprehensive model that takes Lean implementation information, as well as Lean theory and the particular context into consideration. The psychosocial work environment was measured twice with the Copenhagen Psychosocial Questionnaire (COPSOQ) employee survey during Lean implementations on May-June 2010 (T1) (n = 129) and November-December 2011 (T2) (n = 131) at three units (an Emergency Department (ED), Ward-I and Ward-II). Information based on qualitative data analysis of the Lean implementations and context from a previous paper was used to predict expected change patterns in the psychosocial work environment from T1 to T2 and subsequently compared with COPSOQ-data through linear regression analysis. Between T1 and T2, qualitative information showed a well-organized and steady Lean implementation on Ward-I with active employee participation, a partial Lean implementation on Ward-II with employees not seeing a clear need for such an intervention, and deterioration in already implemented Lean activities at ED, due to the declining interest of top management. Quantitative data analysis showed a significant relation between the expected and actual results regarding changes in the psychosocial work environment. Ward-I showed major improvements especially related to job control and social support, ED showed a major decline with some exceptions while Ward-II also showed improvements similar to Ward-I. The results suggest that Lean may have a positive impact on the psychosocial work environment given that it is properly implemented. Also, the psychosocial work environment may even deteriorate if Lean work deteriorates after implementation. Employee managers and researchers should note the importance of employee involvement in the change process. Employee involvement may minimize the intervention's harmful effects on psychosocial work factors. We also found that a multi-method may be suitable for investigating relations between Lean and the psychosocial work environment.

Implementing nurse-initiated and managed antiretroviral treatment (NIMART) in South Africa: a qualitative process evaluation of the STRETCH trial

PubMed Central

2012-01-01

Background Task-shifting is promoted widely as a mechanism for expanding antiretroviral treatment (ART) access. However, the evidence for nurse-initiated and managed ART (NIMART) in Africa is limited, and little is known about the key barriers and enablers to implementing NIMART programmes on a large scale. The STRETCH (Streamlining Tasks and Roles to Expand Treatment and Care for HIV) programme was a complex educational and organisational intervention implemented in the Free State Province of South Africa to enable nurses providing primary HIV/AIDS care to expand their roles and include aspects of care and treatment usually provided by physicians. STRETCH used a phased implementation approach and ART treatment guidelines tailored specifically to nurses. The effects of STRETCH on pre-ART mortality, ART provision, and the quality of HIV/ART care were evaluated through a randomised controlled trial. This study was conducted alongside the trial to develop a contextualised understanding of factors affecting the implementation of the programme. Methods This study was a qualitative process evaluation using in-depth interviews and focus group discussions with patients, health workers, health managers, and other key informants as well as observation in clinics. Research questions focused on perceptions of STRETCH, changes in health provider roles, attitudes and patient relationships, and impact of the implementation context on trial outcomes. Data were analysed collaboratively by the research team using thematic analysis. Results NIMART appears to be highly acceptable among nurses, patients, and physicians. Managers and nurses expressed confidence in their ability to deliver ART successfully. This confidence developed slowly and unevenly, through a phased and well-supported approach that guided nurses through training, re-prescription, and initiation. The research also shows that NIMART changes the working and referral relationships between health staff, demands significant training and support, and faces workload and capacity constraints, and logistical and infrastructural challenges. Conclusions Large-scale NIMART appears to be feasible and acceptable in the primary level public sector health services in South Africa. Successful implementation requires a comprehensive approach with: an incremental and well supported approach to implementation; clinical guidelines tailored to nurses; and significant health services reorganisation to accommodate the knock-on effects of shifts in practice. Trial registration ISRCTN46836853 PMID:22800379

Supervisors in ergonomic change of meat cutting work.

PubMed

Vogel, K

2012-01-01

Being a supervisor is an important and lonely occupation. The aim of this study was to identify barriers and opportunities in working conditions for supervisors, being facilitators and implementers of change for meat cutters. Nine supervisors of meat cutters in one large company were interviewed. The semi-structured interviews covered their roles as supervisors, performance of the change process and their own working conditions. Notes were taken and structured in themes. Similarities, differences, plus and minus were identified. There was a nuanced view on the change processes and their effects. The change processes and the decisions were anchored in a democratic process with groups of employees and the union. All were clear on what demands the company had on them. They were secure in a functioning network of peers and their immediate superior. On their own education, most were as a whole satisfied, but in need of more training and talked of lifelong learning. They considered their work demanding and lonely, with a need both to be manager and leader. A shared leadership could mean doing a better job. There is a need for education and training as a manager and leader as well as the opportunity to discuss with peers.

Demand generation and social mobilisation for integrated community case management (iCCM) and child health: Lessons learned from successful programmes in Niger and Mozambique

PubMed Central

Sharkey, Alyssa B; Martin, Sandrine; Cerveau, Teresa; Wetzler, Erica; Berzal, Rocio

2014-01-01

Aim We present the approaches used in and outcomes resulting from integrated community case management (iCCM) programmes in Niger and Mozambique with a strong focus on demand generation and social mobilisation. Methods We use a case study approach to describe the programme and contextual elements of the Niger and Mozambique programmes. Results Awareness and utilisation of iCCM services and key family practices increased following the implementation of the Niger and Mozambique iCCM and child survival programmes, as did care–seeking within 24 hours and care–seeking from appropriate, trained providers in Mozambique. These approaches incorporated interpersonal communication activities and community empowerment/participation for collective change, partnerships and networks among key stakeholder groups within communities, media campaigns and advocacy efforts with local and national leaders. Conclusions iCCM programmes that train and equip community health workers and successfully engage and empower community members to adopt new behaviours, have appropriate expectations and to trust community health workers’ ability to assess and treat illnesses can lead to improved care–seeking and utilisation, and community ownership for iCCM. PMID:25520800

Animal Health and Welfare Issues Facing Organic Production Systems

PubMed Central

Sutherland, Mhairi A.; Webster, Jim; Sutherland, Ian

2013-01-01

Simple Summary The demand for organically grown, animal derived produce is increasing due to a growing desire for consumer products that have minimal chemical inputs and high animal welfare standards. Evaluation of the scientific literature suggests that a major challenge facing organic animal production systems is the management and treatment of health-related issues. However, implementation of effective management practices can help organic animal producers achieve and maintain high standards of health and welfare, which is necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. Abstract The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. PMID:26479750

Collaborative Learning Environments for Management Education.

ERIC Educational Resources Information Center

Seufert, Sabine; Seufert, Andreas

Confronted with the pressure of a rapidly changing environment, organizations demand new skills and capabilities of future managers. These demands and the findings of learning theory necessitate a corresponding change in education of tomorrow's managers. Future management education requires a balance between the imparting of knowledge to the…

The different modes of hydro-economic analysis (Invited)

NASA Astrophysics Data System (ADS)

Harou, J. J.; Binions, O.; Erfani, T.

2013-12-01

In the face of growing water demands, climate change and spatial and temporal water access variability, accurately assessing the economic impacts of proposed water resource management changes is useful. The objective of this project funded by UK Water Industry Research was to present and demonstrate a framework for identifying and using the ';value of water' to enable water utilities and their regulators to make better decisions. A hydro-economic model can help evaluate water management options in terms of their hydrological and economic impact at different locations throughout a catchment over time. In this talk we discuss three modes in which hydro-economic models can be implemented: evaluative, behavioral and prescriptive. In evaluation mode economic water demand and benefit functions are used to post-process water resource management model results to assess the economic impacts (over space and time) of a policy under consideration. In behavioral hydro-economic models users are represented as agents and the economics is used to help predict their actions. In prescriptive mode optimization is used to find the most economically efficient management actions such as allocation patterns or source selection. These three types of hydro-economic analysis are demonstrated on a UK watershed (Great River Ouse) that includes 97 different water abstractors from amongst the public water supply, agriculture, industry and energy plant cooling sectors. The following issues under dry and normal historical conditions were investigated: Supply/demand investment planning, societal cost of environmental flows, water market prices, and scarcity-sensitive charges for water rights. The talk discusses which hydro-economic modeling mode is used to study each of these issues and why; example results are shown and discussed. The topic of how hydro-economic models can be built and deployed effectively is covered along with how existing water utility operational and planning tools can be converted into hydro-economic models.

Informing Adaptation Decisions: What Do We Need to Know and What Do We Need to Do?

NASA Astrophysics Data System (ADS)

Pulwarty, R. S.; Webb, R. S.

2014-12-01

The demand for improved climate knowledge and information is well documented. As noted in the IPCC Reports (SREX, AR5) and other assessments, this demand has increased pressure for better information to support planning under changing rates of extremes event occurrence. This demand has focused on mechanisms used to respond to past variability and change, including, integrated resource management (watersheds, coasts), infrastructure design, information systems, technological optimization, financial risk management, and behavioral and institutional change. Climate inputs range from static site design statistics (return periods) to dynamic, emergent thresholds and transitions preceded by steep response curves and punctuated equilibria. Tradeoffs are evident in the use of risk-based anticipatory strategies vs. resilience measures. In such settings, annual decision calendars for operational requirements can confound adaptation expectations. Key knowledge assessment questions include: (1) How predictable are potential impacts of events in the context of other stressors, (2) how is action to anticipate such impacts informed, and (3) How often should criteria for "robustness" be reconsidered? To illustrate, we will discuss the climate information needs and uses for two areas of concern for both short and long-term risks (i) climate and disaster risk financing, and (ii) watershed management. The presentation will focus on the climate information needed for (1) improved monitoring, modeling and methods for understanding and analyzing exposure risks, (2) generating risk profiles, (3) developing information systems and scenarios for critical thresholds across climate time and space scales, (4) embedding annual decision calendars in the context of longer-term risk management, (5) gaming experiments to show the net benefits of new information. We will conclude with a discussion of the essential climate variables needed to implement services-delivery and development efforts such as the Global Framework for Climate Services and the Pilot Program on Climate Resilience.

Ridesharing: Transportation demand management

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

Valdez, R.; Wang, J.; Flynn, C.P.

1989-01-01

The 13 papers in the report deal with the following areas: Comparison of transportation demand management market research study results and transportation management association development in three suburban activity centers; Ten cities' strategies for transportation demand management; Key considerations for developing local government transportation system management programs; First Hill Action Plan: A unique public/private approach to transportation demand management; Comparison of travel behavior before and after the opening of HOV lanes in a suburban travel corridor; Evaluation of Springfield instant carpooling; George Washington Bridge bus-carpool lane: 1-Year Operational Report; Guaranteed Ride Home: An insurance program for HOV users; Evaluation ofmore » Ridefinders and Central Richmond Association's transportation and parking information service; Vanpools: Pricing and market penetration; Cost-effectiveness of private employer ridesharing programs: An employer's assessment; Temporal analysis of handicapped ridership in specialized transportation service: Lexington/Fayette County experience; Characterization of the 'publico' system of Puerto Rico.« less

The role of integrated scientific approach facing the changing ocean policy. The case of the Mediterranean

NASA Astrophysics Data System (ADS)

Vallega, Adalberto

1999-08-01

In the mid-1980s the debate about the role of oceanography vis-à-vis the evolving demand for ocean research was initiated in the framework of the Intergovernmental Oceanographic Commission (IOC) of UNESCO. That discussion was basically triggered by the need to meet the demand for research generated by the United Nations Conference on the Human Environment (1972). More recently, also as a consequence of the inputs from the United Nations Conference on Environment and Development (UNCED, 1992), the discussion of the role of oceanography in the framework of the co-operation between physical and social disciplines was initiated focusing on the prospect of building up the ocean science. The prospect of the ocean science as designed by IOC (1984) was finalised only to integrate the branches of oceanography. To discuss how that design could be implemented on the basis of progress in epistemology and ocean policy, the subject is focused on considering three levels: i) the epistemological level, where the option between positivism- and constructivism- based epistemologies has arisen; ii) the logical level, where the option is concerned with disjunctive and conjunctive logic; and iii) the methodological level, where the option regards the analytical-deductive and the inductive-axiomatic methods. The thesis is sustained that, to meet the demand for management-oriented research, the pathway including constructivist epistemology, conjunctive logic and inductive-axiomatic methods could be usefully adopted as the cement of inter-disciplinarity. The second part of the paper is concerned with the Mediterranean, and how holism-referred and management-aimed investigations might be conducted by applying the above conceptual approach is considered: i) presenting the individual emerging subject areas on which the demand for management patterns is expected to focus in the mid- and long-run; ii) illustrating the major aspects of the individual subject areas to be investigated; iii) deducing what leading role might be assigned to oceanography in building up inter-disciplinary approaches; iv) which disciplines might be stimulated to co-operate. The subject areas considered with reference to the Mediterranean include: i) integrated coastal management; ii) the deep-ocean coastal uses with special consideration of living resources management; iii) the protection of biodiversity. Ocean Geographical Information Systems (OGIS), data management, and education and training are presented as intersecting research areas calling for inter-disciplinary approaches. As a conclusion, a breakdown of questions on which discussion might be concentrated is considered.

Strengthening district health service management and delivery through internal contracting: lessons from pilot projects in Cambodia.

PubMed

Khim, Keovathanak; Annear, Peter Leslie

2013-11-01

Following a decade of piloting different models of contracting, in mid-2009 the Cambodian Ministry of Health began to test a form of 'internal contracting' for health care delivery in selected health districts (including hospitals and health centers) contracted by the provincial health department as Special Operating Agencies (SOAs) and provided with greater management autonomy. This study assesses the internal contracting approach as a means for improving the management of district health services and strengthening service delivery. While the study may contribute to the emerging field now known as performance-based financing, the lessons deal more broadly with the impact of management reform and increased autonomy in contrast to traditional public sector line-management and budgeting. Carried out during 2011, the study was based on: (i) a review of the literature and of operational documents; (ii) primary data from semi-structured key informant interviews with 20 health officials in two provinces involved in four SOA pilot districts; and (iii) routine data from the 2011 SOA performance monitoring report. Five prerequisites were identified for effective contract management and improved service delivery: a clear understanding of roles and responsibilities by the contracting parties; implementation of clear rules and procedures; effective management of performance; effective monitoring of the contract; and adequate and timely provision of resources. Both the level and allocation of incentives and management bottlenecks at various levels continue to impede implementation. We conclude that, in contracted arrangements like these, the clear separation of contracting functions (purchasing, commissioning, monitoring and regulating), management autonomy where responsibilities are genuinely devolved and accepted, and the provision of resources adequate to meet contract demands are necessary conditions for success. Copyright © 2013 Elsevier Ltd. All rights reserved.

From dictatorship to a reluctant democracy: stroke therapists talking about self-management

PubMed Central

Kilbride, Cherry

2014-01-01

Purpose Self-management is being increasingly promoted within chronic conditions including stroke. Concerns have been raised regarding professional ownership of some programmes, yet little is known of the professional’s experience. This paper aims to present the views of trained therapists about the utility of a specific self-management approach in stroke rehabilitation. Method Eleven stroke therapists trained in the self-management approach participated in semi-structured interviews. These were audio recorded, transcribed verbatim and analysed thematically. Results Two overriding themes emerged. The first was the sense that in normal practice therapists act as “benign dictators”, committed to help their patients, but most comfortable when they, the professional, are in control. Following the adoption of the self-management approach therapists challenged themselves to empower stroke survivors to take control of their own recovery. However, therapists had to confront many internal and external challenges in this transition of power resulting in the promotion of a somewhat “reluctant democracy”. Conclusions This study illustrates that stroke therapists desire a more participatory approach to rehabilitation. However, obstacles challenged the successful delivery of this goal. If self-management is an appropriate model to develop in post stroke pathways, then serious consideration must be given to how and if these obstacles can be overcome. Implications for Rehabilitation Stroke therapists perceive that self-management is appropriate for encouraging ownership of rehabilitation post stroke. Numerous obstacles were identified as challenging the implementation of self-management post stroke. These included: professional models, practices and expectations; institutional demands and perceived wishes of stroke survivors. For self-management to be effectively implemented by stroke therapists, these obstacles must be considered and overcome. This should be as part of an integrated therapy service, rather than as an add-on. PMID:23594054

From dictatorship to a reluctant democracy: stroke therapists talking about self-management.

PubMed

Norris, Meriel; Kilbride, Cherry

2014-01-01

Self-management is being increasingly promoted within chronic conditions including stroke. Concerns have been raised regarding professional ownership of some programmes, yet little is known of the professional's experience. This paper aims to present the views of trained therapists about the utility of a specific self-management approach in stroke rehabilitation. Eleven stroke therapists trained in the self-management approach participated in semi-structured interviews. These were audio recorded, transcribed verbatim and analysed thematically. Two overriding themes emerged. The first was the sense that in normal practice therapists act as "benign dictators", committed to help their patients, but most comfortable when they, the professional, are in control. Following the adoption of the self-management approach therapists challenged themselves to empower stroke survivors to take control of their own recovery. However, therapists had to confront many internal and external challenges in this transition of power resulting in the promotion of a somewhat "reluctant democracy". This study illustrates that stroke therapists desire a more participatory approach to rehabilitation. However, obstacles challenged the successful delivery of this goal. If self-management is an appropriate model to develop in post stroke pathways, then serious consideration must be given to how and if these obstacles can be overcome. Stroke therapists perceive that self-management is appropriate for encouraging ownership of rehabilitation post stroke. Numerous obstacles were identified as challenging the implementation of self-management post stroke. These included: professional models, practices and expectations; institutional demands and perceived wishes of stroke survivors. For self-management to be effectively implemented by stroke therapists, these obstacles must be considered and overcome. This should be as part of an integrated therapy service, rather than as an add-on.

Autonomous smart sensor network for full-scale structural health monitoring

NASA Astrophysics Data System (ADS)

Rice, Jennifer A.; Mechitov, Kirill A.; Spencer, B. F., Jr.; Agha, Gul A.

2010-04-01

The demands of aging infrastructure require effective methods for structural monitoring and maintenance. Wireless smart sensor networks offer the ability to enhance structural health monitoring (SHM) practices through the utilization of onboard computation to achieve distributed data management. Such an approach is scalable to the large number of sensor nodes required for high-fidelity modal analysis and damage detection. While smart sensor technology is not new, the number of full-scale SHM applications has been limited. This slow progress is due, in part, to the complex network management issues that arise when moving from a laboratory setting to a full-scale monitoring implementation. This paper presents flexible network management software that enables continuous and autonomous operation of wireless smart sensor networks for full-scale SHM applications. The software components combine sleep/wake cycling for enhanced power management with threshold detection for triggering network wide tasks, such as synchronized sensing or decentralized modal analysis, during periods of critical structural response.

[Management accounting in hospital setting].

PubMed

Brzović, Z; Richter, D; Simunić, S; Bozić, R; Hadjina, N; Piacun, D; Harcet, B

1998-12-01

The periodic income and expenditure accounts produced at the hospital and departmental level enable successful short term management, but, in the long run do not help remove tensions between health care demand and limited resources, nor do they enable optimal medical planning within the limited financial resources. We are trying to estabilish disease category costs based on case mixing according to diagnostic categories (diagnosis related groups, DRG, or health care resource groups, HRG) and calculation of hospital standard product costs, e.g., radiology cost, preoperative nursing cost etc. The average DRG cost is composed of standard product costs plus any costs specific to a diagnostic category. As an example, current costing procedure for hip artheroplasty in the University Hospital Center Zagreb is compared to the management accounting approach based on British Health Care Resource experience. The knowledge of disease category costs based on management accounting requirements facilitates the implementation of medical programs within the given financial resources and devolves managerial responsibility closer to the clinical level where medical decisions take place.

Evaluating Outdoor Water Use Demand under Changing Climatic and Demographic Conditions: An Agent-based Modeling Approach

NASA Astrophysics Data System (ADS)

Kanta, L.

2016-12-01

Outdoor water use for landscape and irrigation constitutes a significant end use in residential water demand. In periods of water shortages, utilities may reduce garden demands by implementing irrigation system audits, rebate programs, local ordinances, and voluntary or mandatory water use restrictions. Because utilities do not typically record outdoor and indoor water uses separately, the effects of policies for reducing garden demands cannot be readily calculated. The volume of water required to meet garden demands depends on the housing density or lawn size, type of vegetation, climatic conditions, efficiency of garden irrigation systems, and consumer water-use behaviors. Many existing outdoor demand estimation methods are deterministic and do not include consumer responses to conservation campaigns. In addition, mandatory restrictions may have a substantial impact on reducing outdoor demands, but the effectiveness of mandatory restrictions depends on the timing and the frequency of restrictions, in addition to the distribution of housing density and consumer types within a community. This research investigates a garden end-use model by coupling an agent-based modeling approach and a mechanistic-stochastic water demand model to create a methodology for estimating garden demand and evaluating demand reduction policies. The garden demand model is developed for two water utilities, using a diverse data sets, including residential customer billing records, records of outdoor conservation programs, frequency and type of mandatory water use restrictions, lot size distribution, population growth, and climatic data. A set of garden irrigation parameter values, which are based on the efficiency of irrigation systems and irrigation habits of consumers, are determined for a set of conservation ordinances and restrictions. The model parameters are then validated using customer water usage data from the participating water utilities. A sensitivity analysis is conducted for garden irrigation parameters to determine the most significant factors that should be considered by water utilities to reduce outdoor demand. Data from multiple sources and the agent-based modeling methodology are integrated using a holistic approach to assist utilities in efficiently and sustainably managing outdoor demand.

Evaluating Outdoor Water Use Demand under Changing Climatic and Demographic Conditions: An Agent-based Modeling Approach

NASA Astrophysics Data System (ADS)

Kanta, L.; Berglund, E. Z.; Soh, M. H.

2017-12-01

Outdoor water-use for landscape and irrigation constitutes a significant end-use in total residential water demand. In periods of water shortages, utilities may reduce garden demands by implementing irrigation system audits, rebate programs, local ordinances, and voluntary or mandatory water-use restrictions. Because utilities do not typically record outdoor and indoor water-uses separately, the effects of policies for reducing garden demands cannot be readily calculated. The volume of water required to meet garden demands depends on the housing density, lawn size, type of vegetation, climatic conditions, efficiency of garden irrigation systems, and consumer water-use behaviors. Many existing outdoor demand estimation methods are deterministic and do not include consumer responses to conservation campaigns. In addition, mandatory restrictions may have a substantial impact on reducing outdoor demands, but the effectiveness of mandatory restrictions depends on the timing and the frequency of restrictions, in addition to the distribution of housing density and consumer types within a community. This research investigates a garden end-use model by coupling an agent-based modeling approach and a mechanistic-stochastic water demand model to create a methodology for estimating garden demand and evaluating demand reduction policies. The garden demand model is developed for two water utilities, using a diverse data sets, including residential customer billing records, outdoor conservation programs, frequency and type of mandatory water-use restrictions, lot size distribution, population growth, and climatic data. A set of garden irrigation parameter values, which are based on the efficiency of irrigation systems and irrigation habits of consumers, are determined for a set of conservation ordinances and restrictions. The model parameters are then validated using customer water usage data from the participating water utilities. A sensitivity analysis is conducted for garden irrigation parameters to determine the most significant factors that should be considered by water utilities to reduce outdoor demand. Data from multiple sources and the agent-based modeling methodology are integrated using a holistic approach to assist utilities in efficiently and sustainably managing outdoor demand.

Identifying water price and population criteria for meeting future urban water demand targets

NASA Astrophysics Data System (ADS)

Ashoori, Negin; Dzombak, David A.; Small, Mitchell J.

2017-12-01

Predictive models for urban water demand can help identify the set of factors that must be satisfied in order to meet future targets for water demand. Some of the explanatory variables used in such models, such as service area population and changing temperature and rainfall rates, are outside the immediate control of water planners and managers. Others, such as water pricing and the intensity of voluntary water conservation efforts, are subject to decisions and programs implemented by the water utility. In order to understand this relationship, a multiple regression model fit to 44 years of monthly demand data (1970-2014) for Los Angeles, California was applied to predict possible future demand through 2050 under alternative scenarios for the explanatory variables: population, price, voluntary conservation efforts, and temperature and precipitation outcomes predicted by four global climate models with two CO2 emission scenarios. Future residential water demand in Los Angeles is projected to be largely driven by price and population rather than climate change and conservation. A median projection for the year 2050 indicates that residential water demand in Los Angeles will increase by approximately 36 percent, to a level of 620 million m3 per year. The Monte Carlo simulations of the fitted model for water demand were then used to find the set of conditions in the future for which water demand is predicted to be above or below the Los Angeles Department of Water and Power 2035 goal to reduce residential water demand by 25%. Results indicate that increases in price can not ensure that the 2035 water demand target can be met when population increases. Los Angeles must rely on furthering their conservation initiatives and increasing their use of stormwater capture, recycled water, and expanding their groundwater storage. The forecasting approach developed in this study can be utilized by other cities to understand the future of water demand in water-stressed areas. Improving water demand forecasts will help planners understand and optimize future investments in water supply infrastructure and related programs.

Engineering management consideration for an integrated aeronautical mobile satellite service

NASA Astrophysics Data System (ADS)

Belcher, John M.

In order to meet local air traffic control terminal requirements as well as national and transborder requirements, countries have developed communications, navigation, and surveillance (CNS) systems having little systems integration and a solely ground-based solution to air traffic control problems. It is believed that the application of satellite technology is the only currently viable solution that will enable international civil aviation to overcome the shortcomings of the presently available CNS systems. If properly implemented, available satellite system technology integrated with avionics and ground based capabilities, can be used to meet new global aviation demands. A clear transition plan has to be implemented so as to ensure continuity of service, recognize user-borne costs, and satisfy institutional and national objectives in the progress toward a universal air traffic management (ATM) system. ATM systems design should rely on a modular approach for flexibility and upgrading. An aeronautical mobile satellite service is intended to provide a worldwide satellite data link and direct air/ground voice communication. Institutional and financial roadblocks for implemetation of a global based approach will likely be far greater than technical constraints.

Disease management programs: barriers and benefits.

PubMed

Magnezi, Racheli; Kaufman, Galit; Ziv, Arnona; Kalter-Leibovici, Ofra; Reuveni, Haim

2013-04-01

The healthcare system in Israel faces difficulties similar to those of most industrialized countries, including limited resources, a growing chronically ill population, and demand for high quality care. Disease management programs (DMPs) for patients with a chronic illness aim to alleviate some of these problems, primarily by improving patient self-management skills and quality of care. This study surveyed the opinions of senior healthcare administrators regarding barriers, benefits, and support for implementing DMPs. Cross-sectional survey. A 21-item questionnaire was self-completed by 87 of 105 (83%) healthcare administrators included in the study. Participants were 65.5% male and 47% physicians, 25.3% nurses, 17.3% administrators, and 10.3% other healthcare professionals. The main perceived benefit of DMPs among all respondents was improving quality of care. Other benefits noted were better contact with patients (81.6%) and better compliance with treatment (75.9%). Efficient long-term utilization of system resources was perceived as a benefit by only 58.6%. The main perceived barriers to implementing DMPs were lack of budgetary resources (69%) and increased time required versus financial compensation received (63.2%). The benefits of DMPs were patient oriented; barriers were perceived as financial and limiting professional autonomy. Information regarding long-term benefits (better patient outcomes) that ultimately provide better value for the system versus short-term barriers (increased costs and expenditures of time without compensation) might encourage the implementation of DMPs in countries faced with a growing population of patients with at least 1 chronic illness.

Analysis and Simulation of Traffic Control for Resource Management in DVB-Based Broadband Satellite Access Networks

NASA Astrophysics Data System (ADS)

Impemba, Ernesto; Inzerilli, Tiziano

2003-07-01

Integration of satellite access networks with the Internet is seen as a strategic goal to achieve in order to provide ubiquitous broadband access to Internet services in Next Generation Networks (NGNs). One of the main interworking aspects which has been most studied is an efficient management of satellite resources, i.e. bandwidth and buffer space, in order to satisfy most demanding application requirements as to delay control and bandwidth assurance. In this context, resource management in DVB-S/DVB-RCS satellite technologies, emerging technologies for broadband satellite access and transport of IP applications, is a research issue largely investigated as a means to provide efficient bi-directional communications across satellites. This is in particular one of the principal goals of the SATIP6 project, sponsored within the 5th EU Research Programme Framework, i.e. IST. In this paper we present a possible approach to efficiently exploit bandwidth, the most critical resource in a broadband satellite access network, while pursuing satisfaction of delay and bandwidth requirements for applications with guaranteed QoS through a traffic control architecture to be implemented in ground terminals. Performance of this approach is assessed in terms of efficient exploitation of the uplink bandwidth and differentiation and minimization of queuing delays for most demanding applications over a time-varying capacity. Opnet simulations is used as analysis tool.

Leadership characteristics and business management in modern academic surgery.

PubMed

Büchler, Peter; Martin, David; Knaebel, Hanns-Peter; Büchler, Markus W

2006-04-01

Management skills are necessary to successfully lead a surgical department in future. This article focuses on practical aspects of surgical management, leadership and training. It demonstrates how the implementation of business management concepts changes workflow management and surgical training. A systematic Medline search was performed and business management publications were analysed. Neither management nor leadership skills are inborn but acquired. Management is about planning, controlling and putting appropriate structures in place. Leadership is anticipating and coping with change and people, and adopting a visionary stance. More change requires more leadership. Changes in surgery occur with unprecedented speed because of a growing demand for surgical procedures with limited financial resources. Modern leadership and management theories have to be tailored to surgery. It is clear that not all of them are applicable but some of them are essential for surgeons. In business management, common traits of successful leaders include team orientation and communication skills. As the most important character, however, appears to be the emotional intelligence. Novel training concepts for surgeons include on-the-job training and introduction of improved workflow management systems, e.g. the central case management. The need for surgeons with advanced skills in business, finance and organisational management is evident and will require systematic and tailored training.

The economics, financing and implementation of HIV treatment as prevention: what will it take to get there?

PubMed

Wilson, David; Taaffe, Jessica; Fraser-Hurt, Nicole; Gorgens, Marelize

2014-01-01

The 2013 Lancet Commission Report, Global Health 2035, rightly pointed out that we are at a unique place in history where a "grand convergence" of health initiatives to reduce both infectious diseases, and child and maternal mortality--diseases that still plague low income countries--would yield good returns in terms of development and health outcomes. This would also be a good economic investment. Such investments would support achieving health goals of reducing under-five (U5) mortality to 16 per 1000 live births, reducing deaths due to HIV/AIDS to 8 per 100,000 population, and reducing annual TB deaths to 4 per 100,000 population. Treatment as prevention (TasP) holds enormous potential in reducing HIV transmission, and morbidity and mortality associated with HIV/AIDS--and therefore contributing to Global Health 2035 goals. However, TasP requires large financial investments and poses significant implementation challenges. In this review, we discuss the potential effectiveness, financing and implementation of TasP. Overall, we conclude that TasP shows great promise as a cost-effective intervention to address the dual aims of reducing new HIV infections and reducing the global burden of HIV-related disease. Successful implementation will be no easy feat, though. The dramatic increases in the numbers of persons who need antiretroviral therapy (ART) under a TasP approach will pose enormous challenges at all stages of the HIV treatment cascade: HIV diagnosis, antiretroviral (ARV) initiation, ARV adherence and retention, and increased drug resistance with long-term enrolment on ART. Overcoming these implementation challenges will require targeted implementation, not focusing exclusively on TasP, most-at-risk population (MARP)-friendly services for key populations, integrating services, task shifting, more efficient programme management, balancing supply and demand, integration into universal health coverage efforts, demand creation, improved ART retention and adherence strategies, the use of incentives to improve HIV treatment outcomes and reduce unit costs, continued operational research and tapping into technological innovations.

Modeling Water Utility Investments and Improving Regulatory Policies using Economic Optimisation in England and Wales

NASA Astrophysics Data System (ADS)

Padula, S.; Harou, J. J.

2012-12-01

Water utilities in England and Wales are regulated natural monopolies called 'water companies'. Water companies must obtain periodic regulatory approval for all investments (new supply infrastructure or demand management measures). Both water companies and their regulators use results from least economic cost capacity expansion optimisation models to develop or assess water supply investment plans. This presentation first describes the formulation of a flexible supply-demand planning capacity expansion model for water system planning. The model uses a mixed integer linear programming (MILP) formulation to choose the least-cost schedule of future supply schemes (reservoirs, desalination plants, etc.) and demand management (DM) measures (leakage reduction, water efficiency and metering options) and bulk transfers. Decisions include what schemes to implement, when to do so, how to size schemes and how much to use each scheme during each year of an n-year long planning horizon (typically 30 years). In addition to capital and operating (fixed and variable) costs, the estimated social and environmental costs of schemes are considered. Each proposed scheme is costed discretely at one or more capacities following regulatory guidelines. The model uses a node-link network structure: water demand nodes are connected to supply and demand management (DM) options (represented as nodes) or to other demand nodes (transfers). Yields from existing and proposed are estimated separately using detailed water resource system simulation models evaluated over the historical period. The model simultaneously considers multiple demand scenarios to ensure demands are met at required reliability levels; use levels of each scheme are evaluated for each demand scenario and weighted by scenario likelihood so that operating costs are accurately evaluated. Multiple interdependency relationships between schemes (pre-requisites, mutual exclusivity, start dates, etc.) can be accounted for by additional constraints. User-defined annual water saving profiles are used for DM schemes so that water conservation 'yields' can follow observed patterns. A two-stage optimization procedure is applied to deal with network infeasibilities which appear in large applications. We apply the model to a regional system of seven water companies in the South East of England, the driest part of the UK with its largest and fastest growing population. The model's spatial units are water supply zones, i.e. interconnected zones of equal supply reliability; each company contains between 3 and 8 of these. Economic benefits of greater sharing of resources among water companies (regional water transfers) are evaluated by considering bi-directional interconnections between all neighboring supply zones. Next we describe an extension of the model to investigate how current regulations incentivize companies to invest in an attempt to understand how better regulations can incentivize more water transfers. Finally, an attempt is made to change from the current model assumption of perfect cooperation between companies to one that represents the fact that each company is a private company seeking to maximize its own benefits. Limitations and advantages of the formulations are discussed and recommendations for capacity expansion modeling are made.

Integrated water resources management of the Ichkeul basin taking into account the durability of its wetland ecosystem using WEAP model

NASA Astrophysics Data System (ADS)

Shabou, M.; Lili-Chabaane, Z.; Gastli, W.; Chakroun, H.; Ben Abdallah, S.; Oueslati, I.; Lasram, F.; Laajimi, R.; Shaiek, M.; Romdhane, M. S.; Mnajja, A.

2012-04-01

The Conservation of coastal wetlands in the Mediterranean area is generally faced with development issues. It is the case of Tunisia where the precipitation is irregular in time and space. For the equity of water use (drinking, irrigation), there is a planning at the national level allowing the possibility of water transfer from regions rich in water resources to poor ones. This plan was initially done in Tunisia without taking into account the wetlands ecosystems and their specificities. The main purpose of this study is to find a model able to integrate simultaneously available resources and various water demands within a watershed by taking into account the durability of related wetland ecosystems. It is the case of the Ichkeul basin. This later is situated in northern of Tunisia, having an area of 2080 km2 and rainfall of about 600 mm/year. Downstream this basin, the Ichkeul Lake is characterized by a double alternation of seasonal high water and low salinity in winter and spring and low water levels and high salinity in summer and autumn that makes the Ichkeul an exceptional ecosystem. The originality of this hydrological system of Lake-marsh conditions is related to the presence of aquatic vegetation in the lake and special rich and varied hygrophilic in the marshes that constitutes the main source of food for large migrating water birds. After the construction of three dams on the principle rivers that are feeding the Ichkeul Lake, aiming particularly to supply the local irrigation and the drinking water demand of cities in the north and the east of Tunisia, freshwater inflow to the lake is greatly reduced causing a hydrological disequilibrium that influences the ecological conditions of the different species. Therefore, to ensure the sustainability of the water resources management, it's important to find a trade off between the existing hydrological and ecological systems taking into account water demands of various users (drinking, irrigation fishing, and ecosystem sustainability). All these particularities of the Ichkeul watershed are modeled through the use of WEAP model (Water Evaluation and planning system). This model aims to incorporate supply, demand, water quality and ecological considerations into a practical yet robust tool for integrated water resources planning. For surface water supply, WEAP requires among other data head flow, and evaporation rate for every reach. For quantifying demands, a GIS water resources and uses was implemented on the watershed. Many studies were done to prepare the input data. WEAP results show that the pressure on Ichkeul water resources is increasing leading to greater problems of unsatisfied demand. Different solutions were tested and evaluated. This study illustrates that WEAP offers the possibility to compare several scenarios of water management concerning dams, aquifers and demands. Therefore it could be used to negotiate and discuss water sharing between all stakeholders to improve integrated water resources management.

ICAT: Integrating data infrastructure for facilities based science

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

Flannery, Damian; Matthews, Brian; Griffin, Tom

2009-12-21

ICAT: Integrating data infrastructure for facilities based science Damian Flannery, Brian Matthews, Tom Griffin, Juan Bicarregui, Michael Gleaves, Laurent Lerusse, Roger Downing, Alun Ashton, Shoaib Sufi, Glen Drinkwater, Kerstin Kleese Abstract— Scientific facilities, in particular large-scale photon and neutron sources, have demanding requirements to manage the increasing quantities of experimental data they generate in a systematic and secure way. In this paper, we describe the ICAT infrastructure for cataloguing facility generated experimental data which has been in development within STFC and DLS for several years. We consider the factors which have influenced its design and describe its architecture and metadatamore » model, a key tool in the management of data. We go on to give an outline of its current implementation and use, with plans for its future development.« less

Spatially explicit data: stewardship and ethical challenges in science.

PubMed

Hartter, Joel; Ryan, Sadie J; Mackenzie, Catrina A; Parker, John N; Strasser, Carly A

2013-09-01

Scholarly communication is at an unprecedented turning point created in part by the increasing saliency of data stewardship and data sharing. Formal data management plans represent a new emphasis in research, enabling access to data at higher volumes and more quickly, and the potential for replication and augmentation of existing research. Data sharing has recently transformed the practice, scope, content, and applicability of research in several disciplines, in particular in relation to spatially specific data. This lends exciting potentiality, but the most effective ways in which to implement such changes, particularly for disciplines involving human subjects and other sensitive information, demand consideration. Data management plans, stewardship, and sharing, impart distinctive technical, sociological, and ethical challenges that remain to be adequately identified and remedied. Here, we consider these and propose potential solutions for their amelioration.

Stock management in hospital pharmacy using chance-constrained model predictive control.

PubMed

Jurado, I; Maestre, J M; Velarde, P; Ocampo-Martinez, C; Fernández, I; Tejera, B Isla; Prado, J R Del

2016-05-01

One of the most important problems in the pharmacy department of a hospital is stock management. The clinical need for drugs must be satisfied with limited work labor while minimizing the use of economic resources. The complexity of the problem resides in the random nature of the drug demand and the multiple constraints that must be taken into account in every decision. In this article, chance-constrained model predictive control is proposed to deal with this problem. The flexibility of model predictive control allows taking into account explicitly the different objectives and constraints involved in the problem while the use of chance constraints provides a trade-off between conservativeness and efficiency. The solution proposed is assessed to study its implementation in two Spanish hospitals. Copyright © 2015 Elsevier Ltd. All rights reserved.

The effect of perceived person-job fit on employee attitudes toward change in trauma centers.

PubMed

Zatzick, Christopher D; Zatzick, Douglas F

2013-01-01

Employee attitudes toward change are critical for health care organizations implementing new procedures and practices. When employees are more positive about the change, they are likely to behave in ways that support the change, whereas when employees are negative about the change, they will resist the changes. This study examined how perceived person-job (demands-abilities) fit influences attitudes toward change after an externally mandated change. Specifically, we propose that perceived person-job fit moderates the negative relationship between individual job impact and attitudes toward change. We examined this issue in a sample of Level 1 trauma centers facing a regulatory mandate to develop an alcohol screening and brief intervention program. A survey of 200 providers within 20 trauma centers assessed perceived person-job fit, individual job impact, and attitudes toward change approximately 1 year after the mandate was enacted. Providers who perceived a better fit between their abilities and the new job demands were more positive about the change. Further, the impact of the alcohol screening and brief intervention program on attitudes toward change was mitigated by perceived fit, where the relationship between job impact and change attitudes was more negative for providers who perceived a worse fit as compared with those who perceived a better fit. Successful implementation of changes to work processes and procedures requires provider support of the change. Management can enhance this support by improving perceived person-job fit through ongoing training sessions that enhance providers' abilities to implement the new procedures.

Data Model Management for Space Information Systems

NASA Technical Reports Server (NTRS)

Hughes, J. Steven; Crichton, Daniel J.; Ramirez, Paul; Mattmann, chris

2006-01-01

The Reference Architecture for Space Information Management (RASIM) suggests the separation of the data model from software components to promote the development of flexible information management systems. RASIM allows the data model to evolve independently from the software components and results in a robust implementation that remains viable as the domain changes. However, the development and management of data models within RASIM are difficult and time consuming tasks involving the choice of a notation, the capture of the model, its validation for consistency, and the export of the model for implementation. Current limitations to this approach include the lack of ability to capture comprehensive domain knowledge, the loss of significant modeling information during implementation, the lack of model visualization and documentation capabilities, and exports being limited to one or two schema types. The advent of the Semantic Web and its demand for sophisticated data models has addressed this situation by providing a new level of data model management in the form of ontology tools. In this paper we describe the use of a representative ontology tool to capture and manage a data model for a space information system. The resulting ontology is implementation independent. Novel on-line visualization and documentation capabilities are available automatically, and the ability to export to various schemas can be added through tool plug-ins. In addition, the ingestion of data instances into the ontology allows validation of the ontology and results in a domain knowledge base. Semantic browsers are easily configured for the knowledge base. For example the export of the knowledge base to RDF/XML and RDFS/XML and the use of open source metadata browsers provide ready-made user interfaces that support both text- and facet-based search. This paper will present the Planetary Data System (PDS) data model as a use case and describe the import of the data model into an ontology tool. We will also describe the current effort to provide interoperability with the European Space Agency (ESA)/Planetary Science Archive (PSA) which is critically dependent on a common data model.

Making Sense While Steering through the Fog: Principals' Metaphors within a National Reform Implementation

ERIC Educational Resources Information Center

Ganon-Shilon, Sherry; Schechter, Chen

2017-01-01

Principals' implementation of national reforms in the educational arena resembles a wild ride on a roller coaster as they face with contradicting demands, ongoing confusion and ambiguity. As critical change agents, principals interpret and translate reform demands into local practices through a process of sense-making. This current qualitative…

A State of the Art Review on the Impact of Technology on Skill Demand in OECD Countries.

ERIC Educational Resources Information Center

Kim, Young-Hwa

2002-01-01

Review of research since the 1980s shows a consistent trend toward higher skill demands in Organisation for Economic Cooperation and Development countries. There is evidence both that higher skills are needed to implement technology and that implementing technology raises skill requirements. Automation is displacing low-skilled jobs and creating…

Selecting quantitative water management measures at the river basin scale in a global change context

NASA Astrophysics Data System (ADS)

Girard, Corentin; Rinaudo, Jean-Daniel; Caballero, Yvan; Pulido-Velazquez, Manuel

2013-04-01

One of the main challenges in the implementation of the Water Framework Directive (WFD) in the European Union is the definition of programme of measures to reach the good status of the European water bodies. In areas where water scarcity is an issue, one of these challenges is the selection of water conservation and capacity expansion measures to ensure minimum environmental in-stream flow requirements. At the same time, the WFD calls for the use of economic analysis to identify the most cost-effective combination of measures at the river basin scale to achieve its objective. With this respect, hydro-economic river basin models, by integrating economics, environmental and hydrological aspects at the river basin scale in a consistent framework, represent a promising approach. This article presents a least-cost river basin optimization model (LCRBOM) that selects the combination of quantitative water management measures to meet environmental flows for future scenarios of agricultural and urban demand taken into account the impact of the climate change. The model has been implemented in a case study on a Mediterranean basin in the south of France, the Orb River basin. The water basin has been identified as in need for quantitative water management measures in order to reach the good status of its water bodies. The LCRBOM has been developed using GAMS, applying Mixed Integer Linear Programming. It is run to select the set of measures that minimizes the total annualized cost of the applied measures, while meeting the demands and minimum in-stream flow constraints. For the economic analysis, the programme of measures is composed of water conservation measures on agricultural and urban water demands. It compares them with measures mobilizing new water resources coming from groundwater, inter-basin transfers and improvement in reservoir operating rules. The total annual cost of each measure is calculated for each demand unit considering operation, maintenance and investment costs. The results show that by combining quantitative water management measures, the flow regime can be improved to better mimic the natural flow regime. However, the acceptability of the higher cost of the program of measures is not yet assessed. Other stages such as stakeholder participation and negotiation processes are as well required to design an acceptable programme of measures. For this purpose, this type of model opens the path to investigate the problems of equity issues, and measures and costs allocation among the stakeholders of the basin. Acknowledgments: The study has been partially supported by the Hérault General Council, the Languedoc-Rousillon Regional Council, the Rhône Mediterranean Corsica Water Agency and the BRGM, as well as the European Community 7th Framework Project GENESIS (n. 226536) on groundwater systems, and the Plan Nacional I+D+I 2008-2011 of the Spanish Ministry of Science and Innovation (subprojects CGL2009-13238-C02-01 and CGL2009-13238-C02-02).

Expert knowledge elicitation using computer simulation: the organization of frail elderly case management as an illustration.

PubMed

Chiêm, Jean-Christophe; Van Durme, Thérèse; Vandendorpe, Florence; Schmitz, Olivier; Speybroeck, Niko; Cès, Sophie; Macq, Jean

2014-08-01

Various elderly case management projects have been implemented in Belgium. This type of long-term health care intervention involves contextual factors and human interactions. These underlying complex mechanisms can be usefully informed with field experts' knowledge, which are hard to make explicit. However, computer simulation has been suggested as one possible method of overcoming the difficulty of articulating such elicited qualitative views. A simulation model of case management was designed using an agent-based methodology, based on the initial qualitative research material. Variables and rules of interaction were formulated into a simple conceptual framework. This model has been implemented and was used as a support for a structured discussion with experts in case management. The rigorous formulation provided by the agent-based methodology clarified the descriptions of the interventions and the problems encountered regarding: the diverse network topologies of health care actors in the project; the adaptation time required by the intervention; the communication between the health care actors; the institutional context; the organization of the care; and the role of the case manager and his or hers personal ability to interpret the informal demands of the frail older person. The simulation model should be seen primarily as a tool for thinking and learning. A number of insights were gained as part of a valuable cognitive process. Computer simulation supporting field experts' elicitation can lead to better-informed decisions in the organization of complex health care interventions. © 2013 John Wiley & Sons, Ltd.

China's Classification-Based Forest Management: Procedures, Problems, and Prospects

NASA Astrophysics Data System (ADS)

Dai, Limin; Zhao, Fuqiang; Shao, Guofan; Zhou, Li; Tang, Lina

2009-06-01

China’s new Classification-Based Forest Management (CFM) is a two-class system, including Commodity Forest (CoF) and Ecological Welfare Forest (EWF) lands, so named according to differences in their distinct functions and services. The purposes of CFM are to improve forestry economic systems, strengthen resource management in a market economy, ease the conflicts between wood demands and public welfare, and meet the diversified needs for forest services in China. The formative process of China’s CFM has involved a series of trials and revisions. China’s central government accelerated the reform of CFM in the year 2000 and completed the final version in 2003. CFM was implemented at the provincial level with the aid of subsidies from the central government. About a quarter of the forestland in China was approved as National EWF lands by the State Forestry Administration in 2006 and 2007. Logging is prohibited on National EWF lands, and their landowners or managers receive subsidies of about 70 RMB (US10) per hectare from the central government. CFM represents a new forestry strategy in China and its implementation inevitably faces challenges in promoting the understanding of forest ecological services, generalizing nationwide criteria for identifying EWF and CoF lands, setting up forest-specific compensation mechanisms for ecological benefits, enhancing the knowledge of administrators and the general public about CFM, and sustaining EWF lands under China’s current forestland tenure system. CFM does, however, offer a viable pathway toward sustainable forest management in China.

Foundations of the participatory approach in the Mekong River basin management.

PubMed

Budryte, Paulina; Heldt, Sonja; Denecke, Martin

2018-05-01

Integrated Water Resource Management (IWRM) was acknowledged as a leading concept in the water management for the last two decades by academia, political decision-makers and experts. It strongly promotes holistic management and participatory approaches. The flexibility and adaptability of IWRM concept are especially important for large, transboundary river basins - e.g. the Mekong river basin - where natural processes and hazards, as well as, human-made "disasters" are demanding for a comprehensive approach. In the Mekong river basin, the development and especially the enforcement of one common strategy has always been a struggle. The past holds some unsuccessful experiences. In 2016 Mekong River Commission published IWRM-based Basin Development Strategy 2016-2020 and The Mekong River Commission Strategic Plan 2016-2020. They should be the main guiding document for the Mekong river development in the near future. This study analyzes how the concept of public participation resembles the original IWRM participatory approach in these documents. Therefore, IWRM criteria for public participation in international literature and official documents from the Mekong river basin are compared. As there is often a difference between "de jure" and "de facto" implementation of public participation in management concepts, the perception of local stakeholders was assessed in addition. The results of social survey give an insight if local people are aware of Mekong river basin development and present their dominant attitudes about the issue. The findings enable recommendations how to mitigate obstacles in the implementation of common development strategy. Copyright © 2017 Elsevier B.V. All rights reserved.

Compassion Fatigue, Burnout, and Neonatal Abstinence Syndrome.

PubMed

Sweigart, Erin

2017-01-01

NICU nurses have seen a dramatic increase in cases of neonatal abstinence syndrome (NAS). The care needs of infants with NAS are highly demanding and can lead to feelings of frustration and emotional exhaustion among NICU nurses. Although studies have examined the experiences of nurses caring for NAS patients, none have specifically addressed the risk for compassion fatigue and burnout. Nurses need practical strategies to reduce their risk for compassion fatigue and burnout when caring for these patients. Improved education and implementation of self-care measures can help nurses more effectively manage stress and positively impact care of these infants and their families.

Accounting for water management issues within hydrological simulation: Alternative modelling options and a network optimization approach

NASA Astrophysics Data System (ADS)

Efstratiadis, Andreas; Nalbantis, Ioannis; Rozos, Evangelos; Koutsoyiannis, Demetris

2010-05-01

In mixed natural and artificialized river basins, many complexities arise due to anthropogenic interventions in the hydrological cycle, including abstractions from surface water bodies, groundwater pumping or recharge and water returns through drainage systems. Typical engineering approaches adopt a multi-stage modelling procedure, with the aim to handle the complexity of process interactions and the lack of measured abstractions. In such context, the entire hydrosystem is separated into natural and artificial sub-systems or components; the natural ones are modelled individually, and their predictions (i.e. hydrological fluxes) are transferred to the artificial components as inputs to a water management scheme. To account for the interactions between the various components, an iterative procedure is essential, whereby the outputs of the artificial sub-systems (i.e. abstractions) become inputs to the natural ones. However, this strategy suffers from multiple shortcomings, since it presupposes that pure natural sub-systems can be located and that sufficient information is available for each sub-system modelled, including suitable, i.e. "unmodified", data for calibrating the hydrological component. In addition, implementing such strategy is ineffective when the entire scheme runs in stochastic simulation mode. To cope with the above drawbacks, we developed a generalized modelling framework, following a network optimization approach. This originates from the graph theory, which has been successfully implemented within some advanced computer packages for water resource systems analysis. The user formulates a unified system which is comprised of the hydrographical network and the typical components of a water management network (aqueducts, pumps, junctions, demand nodes etc.). Input data for the later include hydraulic properties, constraints, targets, priorities and operation costs. The real-world system is described through a conceptual graph, whose dummy properties are the conveyance capacity and the unit cost of each link. Unit costs are either real or artificial, and positive or negative. Positive costs are set to prohibit undesirable fluxes and negative ones to force fulfilling water demands for various uses. The assignment of costs is based on a recursive algorithm that implements the physical constraints and the user-specified hierarchy for the water uses. Referring to the desired management policy, an optimal allocation is achieved regarding the unknown fluxes within the hydrosystem (flows, abstractions, water losses) by minimizing the total transportation cost through the graph. The mathematical structure of the problem enables use of accurate and exceptionally fast solvers. The proposed methodology is effective, efficient and easy to implement, in order to link on-line multiple modelling components, thus ensuring a comprehensive overview of the process interactions in complex and heavily modified hydrosystems. It is applicable to hydrological simulators of the semi-distributed type, in which it allows integrating groundwater models and flood routing schemes within decision support modules. The methodology is implemented within the HYGROGEIOS computer package, which is illustrated by example applications in modified river basins in Greece.

The economic and environmental consequences of implementing nitrogen-efficient technologies and management practices in agriculture.

PubMed

Zhang, Xin; Mauzerall, Denise L; Davidson, Eric A; Kanter, David R; Cai, Ruohong

2015-03-01

Technologies and management practices (TMPs) that reduce the application of nitrogen (N) fertilizer while maintaining crop yields can improve N use efficiency (NUE) and are important tools for meeting the dual challenges of increasing food production and reducing N pollution. However, because farmers operate to maximize their profits, incentives to implement TMPs are limited, and TMP implementation will not always reduce N pollution. Therefore, we have developed the NUE Economic and Environmental impact analytical framework (NUE) to examine the economic and environmental consequences of implementing TMPs in agriculture, with a specific focus on farmer profits, N fertilizer consumption, N losses, and cropland demand. Our analytical analyses show that impact of TMPs on farmers' economic decision-making and the environment is affected by how TMPs change the yield ceiling and the N fertilization rate at the ceiling and by how the prices of TMPs, fertilizer, and crops vary. Technologies and management practices that increase the yield ceiling appear to create a greater economic incentive for farmers than TMPs that do not but may result in higher N application rates and excess N losses. Nevertheless, the negative environmental impacts of certain TMPs could be avoided if their price stays within a range determined by TMP yield response, fertilizer price, and crop price. We use a case study on corn production in the midwestern United States to demonstrate how NUE can be applied to farmers' economic decision-making and policy analysis. Our NUE framework provides an important tool for policymakers to understand how combinations of fertilizer, crop, and TMP prices affect the possibility of achieving win-win outcomes for farmers and the environment. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

A future Demand Side Management (DSM) opportunity for utility as variable renewable penetrate scale up using agriculture.

NASA Astrophysics Data System (ADS)

Ines, A.; Bhattacharjee, A.; Modi, V.; Robertson, A. W.; Lall, U.; Kocaman Ayse, S.; Chaudhary, S.; Kumar, A.; Ganapathy, A.; Kumar, A.; Mishra, V.

2015-12-01

Energy demand management, also known as demand side management (DSM), is the modification of consumer demand for energy through various methods such as smart metering, incentive based schemes, payments for turning off loads or rescheduling loads. Usually, the goal of demand side management is to encourage the consumer to use less power during periods of peak demand, or to move the time of energy use to off-peak times. Peak demand management does not necessarily decrease total energy consumption, but could be expected to reduce the need for investments in networks and/or power plants for meeting peak demands. Electricity use can vary dramatically on short and medium time frames, and the pricing system may not reflect the instantaneous cost as additional higher-cost that are brought on-line. In addition, the capacity or willingness of electricity consumers to adjust to prices by altering elasticity of demand may be low, particularly over short time frames. In the scenario of Indian grid setup, the retail customers do not follow real-time pricing and it is difficult to incentivize the utility companies for continuing the peak demand supply. A question for the future is how deeper penetration of renewable will be handled? This is a challenging problem since one has to deal with high variability, while managing loss of load probabilities. In the case of managing the peak demand using agriculture, in the future as smart metering matures with automatic turn on/off for a pump, it will become possible to provide an ensured amount of water or energy to the farmer while keeping the grid energized for 24 hours. Supply scenarios will include the possibility of much larger penetration of solar and wind into the grid. While, in absolute terms these sources are small contributors, their role will inevitably grow but DSM using agriculture could help reduce the capital cost. The other option is of advancing or delaying pump operating cycle even by several hours, will still ensure soil moisture requirements met while, balancing the overall system load with generation, reducing critical power mismatches. Through this presentation the author will describe different techniques and results from field experiments in India.

Early nurse attrition in New Zealand and associated policy implications.

PubMed

Walker, L; Clendon, J

2018-03-01

To examine the factors contributing to nurses choosing to exit the nursing profession before retirement age. Population growth, ageing and growing demand for health services mean increased demand for nurses. Better retention could help meet this demand, yet little work has been done in New Zealand to understand early attrition. An online survey of registered and enrolled nurses and nurse practitioners who had left nursing was used. This study reports analysis of responses from 285 ex-nurses aged under 55. The primary reasons nurses left the profession were as follows: workplace concerns; personal challenges; career factors; family reasons; lack of confidence; leaving for overseas; unwillingness to complete educational requirements; poor work-life balance; and inability to find suitable nursing work. Most nurses discussed their intentions to leave with a family member or manager and most reported gaining transferrable skills through nursing. Nurses leave for many reasons. Implementing positive practice environments and individualized approaches to retaining staff may help reduce this attrition. Generational changes in the nature of work and careers mean that nurses may continue to leave the profession sooner than anticipated by policymakers. If the nursing workforce is to be able to meet projected need, education, recruitment and retention policies must urgently address issues leading to early attrition. In particular, policies improving the wider environmental context of nursing practice and ensuring that working environments are safe and nurses are well supported must be developed and implemented. Equally, national nursing workforce planning must take into account that nursing is no longer viewed as a career for life. © 2017 International Council of Nurses.

Developing a nurse-led clinic using transformational leadership.

PubMed

Gousy, Mamood; Green, Kim

2015-03-25

Nurses are at the forefront of implementing and managing change, given constantly changing healthcare services and the increase in demand for health care. Therefore, it is important to identify the best style of leadership to engage nurses in implementing service-led improvements. This article explores the effects of transformational leadership in bringing about service-led improvements in health care, using the example of setting up a nurse-led acupuncture clinic to optimise the care of patients with chronic pain. Transformational leadership was used throughout the project - from the initial local planning, training and development, through to liaising with the appropriate staff and deciding on an evaluation strategy. Transformational leadership proved to be an effective way to engage and empower nurses and other members of the chronic pain team to enable them to achieve the project aims.

Pediatric Headache Clinic Model: Implementation of Integrative Therapies in Practice.

PubMed

Esparham, Anna; Herbert, Anne; Pierzchalski, Emily; Tran, Catherine; Dilts, Jennifer; Boorigie, Madeline; Wingert, Tammie; Connelly, Mark; Bickel, Jennifer

2018-06-12

The demand for integrative medicine has risen in recent years as research has demonstrated the efficacy of such treatments. The public has also become more conscientious of the potential limitations of conventional treatment alone. Because primary headache syndromes are often the culmination of genetics, lifestyle, stress, trauma, and environmental factors, they are best treated with therapies that are equally multifaceted. The Children’s Mercy Hospital, Kansas City, Missouri Headache Clinic has successfully incorporated integrative therapies including nutraceuticals, acupuncture, aromatherapy, biofeedback, relaxation training, hypnosis, psychology services, and lifestyle recommendations for headache management. This paper provides a detailed review of the implementation of integrative therapies for headache treatment and discusses examples through case studies. It can serve as a model for other specialty settings intending to incorporate all evidenced-based practices, whether complementary or conventional.

Improving medical stores management through automation and effective communication

PubMed Central

Kumar, Ashok; Cariappa, M.P.; Marwaha, Vishal; Sharma, Mukti; Arora, Manu

2016-01-01

Background Medical stores management in hospitals is a tedious and time consuming chore with limited resources tasked for the purpose and poor penetration of Information Technology. The process of automation is slow paced due to various inherent factors and is being challenged by the increasing inventory loads and escalating budgets for procurement of drugs. Methods We carried out an indepth case study at the Medical Stores of a tertiary care health care facility. An iterative six step Quality Improvement (QI) process was implemented based on the Plan–Do–Study–Act (PDSA) cycle. The QI process was modified as per requirement to fit the medical stores management model. The results were evaluated after six months. Results After the implementation of QI process, 55 drugs of the medical store inventory which had expired since 2009 onwards were replaced with fresh stock by the suppliers as a result of effective communication through upgraded database management. Various pending audit objections were dropped due to the streamlined documentation and processes. Inventory management improved drastically due to automation, with disposal orders being initiated four months prior to the expiry of drugs and correct demands being generated two months prior to depletion of stocks. The monthly expense summary of drugs was now being done within ten days of the closing month. Conclusion Improving communication systems within the hospital with vendor database management and reaching out to clinicians is important. Automation of inventory management requires to be simple and user-friendly, utilizing existing hardware. Physical stores monitoring is indispensable, especially due to the scattered nature of stores. Staff training and standardized documentation protocols are the other keystones for optimal medical store management. PMID:26900225

Optimization of pressure gauge locations for water distribution systems using entropy theory.

PubMed

Yoo, Do Guen; Chang, Dong Eil; Jun, Hwandon; Kim, Joong Hoon

2012-12-01

It is essential to select the optimal pressure gauge location for effective management and maintenance of water distribution systems. This study proposes an objective and quantified standard for selecting the optimal pressure gauge location by defining the pressure change at other nodes as a result of demand change at a specific node using entropy theory. Two cases are considered in terms of demand change: that in which demand at all nodes shows peak load by using a peak factor and that comprising the demand change of the normal distribution whose average is the base demand. The actual pressure change pattern is determined by using the emitter function of EPANET to reflect the pressure that changes practically at each node. The optimal pressure gauge location is determined by prioritizing the node that processes the largest amount of information it gives to (giving entropy) and receives from (receiving entropy) the whole system according to the entropy standard. The suggested model is applied to one virtual and one real pipe network, and the optimal pressure gauge location combination is calculated by implementing the sensitivity analysis based on the study results. These analysis results support the following two conclusions. Firstly, the installation priority of the pressure gauge in water distribution networks can be determined with a more objective standard through the entropy theory. Secondly, the model can be used as an efficient decision-making guide for gauge installation in water distribution systems.

Telerehabilitation booster sessions and remote patient monitoring in the management of chronic low back pain: A case series.

PubMed

Peterson, Seth

2018-05-01

Improvements in chronic low back pain (CLBP) seen in physical therapy do not appear to be retained over the long term. Booster sessions have been proposed, but barriers exist to their implementation. Telerehabilitation (TR) and remote patient monitoring (RPM) may be ways to circumvent these barriers. The purpose of this case series was to describe the implementation of TR booster sessions and RPM in three patients with CLBP. Three females with CLBP tracked their daily pain level and home exercise program adherence using a mobile phone application for 12 months following discharge from traditional face-to-face physical therapy. Synchronous audio and video TR booster sessions were conducted at months 1, 3, 6, and 12. All patients met their individual goals. They demonstrated excellent home exercise program adherence and self-efficacy. A temporary increase in pain was seen in all patients, but they managed solely with the TR booster sessions and without other healthcare resources. Satisfaction with the program was very high. This case series describes the use of TR booster sessions and RPM in three patients with CLBP. The positive results suggest this approach may be helpful in improving long-term management of patients with CLBP but demand further investigation.

A Masters Programme in Telecommunications Management--Demand-Based Curriculum Design

ERIC Educational Resources Information Center

Gharaibeh, Khaled M.; Kaylani, Hazem; Murphy, Noel; Brennan, Conor; Itradat, Awni; Al-Bataineh, Mohammed; Aloqlah, Mohammed; Salhieh, Loay; Altarazi, Safwan; Rawashdeh, Nathir; del Carmen Bas Cerdá, María; Conchado Peiró, Andrea; Al-Zoubi, Asem; Harb, Bassam; Bany Salameh, Haythem

2015-01-01

This paper presents a curriculum design approach for a Masters Programme in Telecommunications Management based on demand data obtained from surveying the needs of potential students of the proposed programme. Through online surveys disseminated at telecom companies in Jordan, it was possible to measure the demand for such a programme and to…

Impact of transportation demand management (TDM) elements on managed lanes toll prices.

DOT National Transportation Integrated Search

2015-03-01

This research involved a simulation comparing three days of actual traffic data for the I-95 Express : Lanes and General Purpose Lanes in Miami, Florida to a hypothetical scenario where all transportation : demand management (TDM) activities and toll...

Project UCARE : Uniform Commuter Assistance Reporting and Evaluation for transportation demand management programs.

DOT National Transportation Integrated Search

2013-09-01

Moving Ahead for Progress in the 21st Century Act (MAP-21) places emphasis upon results and better management of programs for effective and efficient service delivery. With an increased focus on measuring performance, the transportation demand manage...

A hybrid inventory management system respondingto regular demand and surge demand

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

Mohammad S. Roni; Mingzhou Jin; Sandra D. Eksioglu

2014-06-01

This paper proposes a hybrid policy for a stochastic inventory system facing regular demand and surge demand. The combination of two different demand patterns can be observed in many areas, such as healthcare inventory and humanitarian supply chain management. The surge demand has a lower arrival rate but higher demand volume per arrival. The solution approach proposed in this paper incorporates the level crossing method and mixed integer programming technique to optimize the hybrid inventory policy with both regular orders and emergency orders. The level crossing method is applied to obtain the equilibrium distributions of inventory levels under a givenmore » policy. The model is further transformed into a mixed integer program to identify an optimal hybrid policy. A sensitivity analysis is conducted to investigate the impact of parameters on the optimal inventory policy and minimum cost. Numerical results clearly show the benefit of using the proposed hybrid inventory model. The model and solution approach could help healthcare providers or humanitarian logistics providers in managing their emergency supplies in responding to surge demands.« less

The process and challenges of obtaining and sustaining clinical placements for nursing and allied health students.

PubMed

Taylor, Christine; Angel, Liz; Nyanga, Lucy; Dickson, Cathy

2017-10-01

To describe the process and challenges from a project that aimed to develop processes, source new placements and place students primarily in the discipline of nursing, but also occupational therapy, physiotherapy, podiatry, social work, and speech therapy. Clinical experience in health facilities is an essential element of health professional education, yet globally, there is a lack of clinical placements to meet demands. Educational providers are seeking placements in nontraditional facilities, yet little has been reported on the challenges in the process of procuring clinical placements. The project used a descriptive approach within a quality implementation framework. The project was guided by the quality implementation framework that included four critical steps: considerations of the host setting, structuring the implementation, supporting the implementation and improving future applications. A total of 115 new student placements were finalised across six health disciplines, including elderly care, nongovernment organisations and general practice. Sixty-two nursing students were placed in the new placements during the project. Challenges included communication, the time-consuming nature of the process and 'gatekeeping' blocks to obtaining placements. Recommendations included the importance of personal interaction in developing and maintaining relationships, and the need for clear communication processes and documentation. Potential areas for research are also given. There is great potential for growth in establishing new placements outside the traditional placement facilities for nursing and allied health and for expanding already existing nonhospital placements. Clinical professional experiences are essential to any nursing or allied health programme. There is an increasing demand for, and global lack of, clinical placements for nursing and allied health students. The results provide nursing and allied health educators and managers a framework for planning clinical placement procurement, and assisting in decision-making and developing strategies and processes for practice. © 2016 John Wiley & Sons Ltd.

Risk-trading in flood management: An economic model.

PubMed

Chang, Chiung Ting

2017-09-15

Although flood management is no longer exclusively a topic of engineering, flood mitigation continues to be associated with hard engineering options. Flood adaptation or the capacity to adapt to flood risk, as well as a demand for internalizing externalities caused by flood risk between regions, complicate flood management activities. Even though integrated river basin management has long been recommended to resolve the above issues, it has proven difficult to apply widely, and sometimes even to bring into existence. This article explores how internalization of externalities as well as the realization of integrated river basin management can be encouraged via the use of a market-based approach, namely a flood risk trading program. In addition to maintaining efficiency of optimal resource allocation, a flood risk trading program may also provide a more equitable distribution of benefits by facilitating decentralization. This article employs a graphical analysis to show how flood risk trading can be implemented to encourage mitigation measures that increase infiltration and storage capacity. A theoretical model is presented to demonstrate the economic conditions necessary for flood risk trading. Copyright © 2017 Elsevier Ltd. All rights reserved.

Coupling Agent-Based and Groundwater Modeling to Explore Demand Management Strategies for Shared Resources

NASA Astrophysics Data System (ADS)

Al-Amin, S.

2015-12-01

Municipal water demands in growing population centers in the arid southwest US are typically met through increased groundwater withdrawals. Hydro-climatic uncertainties attributed to climate change and land use conversions may also alter demands and impact the replenishment of groundwater supply. Groundwater aquifers are not necessarily confined within municipal and management boundaries, and multiple diverse agencies may manage a shared resource in a decentralized approach, based on individual concerns and resources. The interactions among water managers, consumers, and the environment influence the performance of local management strategies and regional groundwater resources. This research couples an agent-based modeling (ABM) framework and a groundwater model to analyze the effects of different management approaches on shared groundwater resources. The ABM captures the dynamic interactions between household-level consumers and policy makers to simulate water demands under climate change and population growth uncertainties. The groundwater model is used to analyze the relative effects of management approaches on reducing demands and replenishing groundwater resources. The framework is applied for municipalities located in the Verde River Basin, Arizona that withdraw groundwater from the Verde Formation-Basin Fill-Carbonate aquifer system. Insights gained through this simulation study can be used to guide groundwater policy-making under changing hydro-climatic scenarios for a long-term planning horizon.

Lessons Learned from Implementing E-Learning for the Education of Health Professionals in Resource-Constrained Countries

ERIC Educational Resources Information Center

Gupta, Manu; Marsden, Sophie; Oluka, Tony; Sharma, Reetu; Lucas, Henry

2017-01-01

The growing global demand for tertiary education has led to the increased use of e-learning approaches around the world. Demand has increased most rapidly in low and middle income countries (LMICs), which account for half of the students currently enrolled in higher educational institutions (HEIs). But the implementation of e-learning programmes…

Information flow in the DAMA project beyond database managers: information flow managers

NASA Astrophysics Data System (ADS)

Russell, Lucian; Wolfson, Ouri; Yu, Clement

1996-12-01

To meet the demands of commercial data traffic on the information highway, a new look at managing data is necessary. One projected activity, sharing of point of sale information, is being considered in the Demand Activated Manufacturing Project (DAMA) of the American Textile Partnership (AMTEX) project. A scenario is examined in which 100 000 retail outlets communicate over a period of days. They provide the latest estimate of demand for sewn products across a chain of 26 000 suppliers through the use of bill of materials explosions at four levels of detail. Enabling this communication requires an approach that shares common features with both workflows and database management. A new paradigm, the information flow manager, is developed to handle this situation, including the case where members of the supply chain fail to communicate and go out of business. Techniques for approximation are introduced so as to keep estimates of demand as current as possible.

Comprehensive primary health care under neo-liberalism in Australia.

PubMed

Baum, Fran; Freeman, Toby; Sanders, David; Labonté, Ronald; Lawless, Angela; Javanparast, Sara

2016-11-01

This paper applies a critical analysis of the impact of neo-liberal driven management reform to examine changes in Australian primary health care (PHC) services over five years. The implementation of comprehensive approaches to primary health care (PHC) in seven services: five state-managed and two non-government organisations (NGOs) was tracked from 2009 to 2014. Two questions are addressed: 1) How did the ability of Australian PHC services to implement comprehensive PHC change over the period 2009-2014? 2) To what extent is the ability of the PHC services to implement comprehensive PHC shaped by neo-liberal health sector reform processes? The study reports on detailed tracking and observations of the changes and in-depth interviews with 63 health service managers and practitioners, and regional and central health executives. The documented changes were: in the state-managed services (although not the NGOs) less comprehensive service coverage and more focus on clinical services and integration with hospitals and much less development activity including community development, advocacy, intersectoral collaboration and attention to the social determinants. These changes were found to be associated with practices typical of neo-liberal health sector reform: considerable uncertainty, more directive managerial control, budget reductions and competitive tendering and an emphasis on outputs rather than health outcomes. We conclude that a focus on clinical service provision, while highly compatible with neo-liberal reforms, will not on its own produce the shifts in population disease patterns that would be required to reduce demand for health services and promote health. Comprehensive PHC is much better suited to that task. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Management practices associated with pain in cattle on western Canadian cow-calf operations: A mixed methods study.

PubMed

Moggy, M A; Pajor, E A; Thurston, W E; Parker, S; Greter, A M; Schwartzkopf-Genswein, K S; Campbell, J R; Windeyer, M C

2017-02-01

The implementation of on-farm pain mitigation strategies is dependent on feasibility and importance to producers. Currently, there is a lack of information regarding adoption of management practices associated with pain in cattle within the Canadian beef industry. The objective of this mixed methods study was to describe pain-associated practices implemented on farm and producer perceptions toward pain mitigation strategies. A questionnaire about calving management and calf processing was delivered to 109 cow-calf producers in western Canada. In addition, 15 respondents were purposively selected based on questionnaire responses to participate in individual semistructured, on-farm interviews. The prevalence of pain mitigation strategies used for dystocia and cesarean section by respondents were 46 and 100%, respectively. The majority of operations reported castrating and dehorning calves before 3 mo of age (95 and 89%, respectively). The majority of operations did not use pain mitigation strategies for castration and dehorning (90 and 85%, respectively). Branding was practiced by 57% of respondents, 4% of which used pain mitigation. Thematic content analysis revealed that producers' perception of pain were influenced by what they referred to as "common sense," relatability to cattle, visual evidence of pain, and age of the animal. Factors that influenced participant rationale for the implementation of pain mitigation practices included access to information and resources, age of the animal, benefit to the operation, cost and logistics, market demands, and personal conscience. Overall, management practices were generally in compliance with published Canadian guidelines. Results of this study may provide direction for future policy making, research, and extension efforts to encourage the adoption of pain mitigation strategies.

Implementation of an opioid detoxification management pathway reduces emergency department length of stay.

PubMed

Bellew, Shawna D; Collins, Sean P; Barrett, Tyler W; Russ, Stephan E; Jones, Ian D; Slovis, Corey M; Self, Wesley H

2018-05-25

With the rise of opioid use in the United States, the increasing demand for treatment for opioid use disorders presents both a challenge and an opportunity to develop new care pathways for ED patients seeking opioid detoxification. We set out to improve the care of patients presenting to our ED seeking opioid detoxification by implementing a standardized management pathway and to measure the effects of this intervention. We conducted a before-after study of the effects of an opioid detoxification management pathway on ED length of stay, use of resources (social worker consultation, laboratory tests obtained), and return visits to the same ED within 30 days of discharge. All data were collected retrospectively by review of the electronic health record. Ultimately, 107 patients presented to the ED that met criteria, 52 in the intervention period and 55 in the pre-intervention period. Median ED length of stay in the intervention period was 152 (IQR 93-237) minutes compared to 312 (IQR 187-468) minutes in the pre-intervention period (p<0.001). Patients in the intervention period less frequently had a social work consultation (32.7% vs. 83.6%, p<0.001) or had laboratory tests obtained (32.7% vs 74.5%, p<0.001) and more frequently were prescribed a medication for withdrawal symptoms (57.7% vs. 29.1%, p=0.003). Implementation of an opioid detoxification management pathway reduced ED length of stay, reduced utilization of resources, and increased the proportion of patients prescribed medications for symptom relief. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Fatigue Risk Management: A Maritime Framework

PubMed Central

Grech, Michelle Rita

2016-01-01

It is evident that despite efforts directed at mitigating the risk of fatigue through the adoption of hours of work and rest regulations and development of codes and guidelines, fatigue still remains a concern in shipping. Lack of fatigue management has been identified as a contributory factor in a number of recent accidents. This is further substantiated through research reports with shortfalls highlighted in current fatigue management approaches. These approaches mainly focus on prescriptive hours of work and rest and include an individualistic approach to managing fatigue. The expectation is that seafarers are responsible to manage and tolerate fatigue as part of their working life at sea. This attitude is an accepted part of a seafarer’s role. Poor compliance is one manifest of this problem with shipboard demands making it hard for seafarers to follow hours of work and rest regulations, forcing them into this “poor compliance” trap. This makes current fatigue management approaches ineffective. This paper proposes a risk based approach and way forward for the implementation of a fatigue risk management framework for shipping, aiming to support the hours of work and rest requirements. This forms part of the work currently underway to review and update the International Maritime Organization, Guidelines on Fatigue. PMID:26840326

Fatigue Risk Management: A Maritime Framework.

PubMed

Grech, Michelle Rita

2016-01-29

It is evident that despite efforts directed at mitigating the risk of fatigue through the adoption of hours of work and rest regulations and development of codes and guidelines, fatigue still remains a concern in shipping. Lack of fatigue management has been identified as a contributory factor in a number of recent accidents. This is further substantiated through research reports with shortfalls highlighted in current fatigue management approaches. These approaches mainly focus on prescriptive hours of work and rest and include an individualistic approach to managing fatigue. The expectation is that seafarers are responsible to manage and tolerate fatigue as part of their working life at sea. This attitude is an accepted part of a seafarer's role. Poor compliance is one manifest of this problem with shipboard demands making it hard for seafarers to follow hours of work and rest regulations, forcing them into this "poor compliance" trap. This makes current fatigue management approaches ineffective. This paper proposes a risk based approach and way forward for the implementation of a fatigue risk management framework for shipping, aiming to support the hours of work and rest requirements. This forms part of the work currently underway to review and update the International Maritime Organization, Guidelines on Fatigue.

Workaholism and mental health problems among municipal middle managers in Norway.

PubMed

Midje, Hilde H; Nafstad, Ingunn T; Syse, Jonn; Torp, Steffen

2014-10-01

To provide empirical knowledge about the antecedents and outcomes of workaholism among municipal middle managers within the framework of the job demands-resources model. We used a self-administered questionnaire to collect cross-sectional data (n = 118) on job demands, job resources, work engagement, workaholism, and mental health problems. Workaholism correlated positively with both work engagement and mental health problems. Job demands affected workaholism and mental health problems more strongly than did job resources. The results indicate that workaholism does not mediate the effects of certain work characteristics on mental health problems, but rather that workaholics create excessive job demands that harm their health. Preventing workaholism should be a central concern of municipal stakeholders because workaholic behavior among middle managers may harm organizational performance and employee health and middle managers' own health.

Mass casualty events: blood transfusion emergency preparedness across the continuum of care.

PubMed

Doughty, Heidi; Glasgow, Simon; Kristoffersen, Einar

2016-04-01

Transfusion support is a key enabler to the response to mass casualty events (MCEs). Transfusion demand and capability planning should be an integrated part of the medical planning process for emergency system preparedness. Historical reviews have recently supported demand planning for MCEs and mass gatherings; however, computer modeling offers greater insights for resource management. The challenge remains balancing demand and supply especially the demand for universal components such as group O red blood cells. The current prehospital and hospital capability has benefited from investment in the management of massive hemorrhage. The management of massive hemorrhage should address both hemorrhage control and hemostatic support. Labile blood components cannot be stockpiled and a large surge in demand is a challenge for transfusion providers. The use of blood components may need to be triaged and demand managed. Two contrasting models of transfusion planning for MCEs are described. Both illustrate an integrated approach to preparedness where blood transfusion services work closely with health care providers and the donor community. Preparedness includes appropriate stock management and resupply from other centers. However, the introduction of alternative transfusion products, transfusion triage, and the greater use of an emergency donor panel to provide whole blood may permit greater resilience. © 2016 AABB.

A multi-period distribution network design model under demand uncertainty

NASA Astrophysics Data System (ADS)

Tabrizi, Babak H.; Razmi, Jafar

2013-05-01

Supply chain management is taken into account as an inseparable component in satisfying customers' requirements. This paper deals with the distribution network design (DND) problem which is a critical issue in achieving supply chain accomplishments. A capable DND can guarantee the success of the entire network performance. However, there are many factors that can cause fluctuations in input data determining market treatment, with respect to short-term planning, on the one hand. On the other hand, network performance may be threatened by the changes that take place within practicing periods, with respect to long-term planning. Thus, in order to bring both kinds of changes under control, we considered a new multi-period, multi-commodity, multi-source DND problem in circumstances where the network encounters uncertain demands. The fuzzy logic is applied here as an efficient tool for controlling the potential customers' demand risk. The defuzzifying framework leads the practitioners and decision-makers to interact with the solution procedure continuously. The fuzzy model is then validated by a sensitivity analysis test, and a typical problem is solved in order to illustrate the implementation steps. Finally, the formulation is tested by some different-sized problems to show its total performance.

Strategies for Improved Hospital Response to Mass Casualty Incidents.

PubMed

TariVerdi, Mersedeh; Miller-Hooks, Elise; Kirsch, Thomas

2018-03-19

Mass casualty incidents are a concern in many urban areas. A community's ability to cope with such events depends on the capacities and capabilities of its hospitals for handling a sudden surge in demand of patients with resource-intensive and specialized medical needs. This paper uses a whole-hospital simulation model to replicate medical staff, resources, and space for the purpose of investigating hospital responsiveness to mass casualty incidents. It provides details of probable demand patterns of different mass casualty incident types in terms of patient categories and arrival patterns, and accounts for related transient system behavior over the response period. Using the layout of a typical urban hospital, it investigates a hospital's capacity and capability to handle mass casualty incidents of various sizes with various characteristics, and assesses the effectiveness of designed demand management and capacity-expansion strategies. Average performance improvements gained through capacity-expansion strategies are quantified and best response actions are identified. Capacity-expansion strategies were found to have superadditive benefits when combined. In fact, an acceptable service level could be achieved by implementing only 2 to 3 of the 9 studied enhancement strategies. (Disaster Med Public Health Preparedness. 2018;page 1 of 13).

Ergonomic intervention for employed persons with rheumatic conditions.

PubMed

Allaire, Saralynn J; Backman, Catherine L; Alheresh, Rawan; Baker, Nancy A

2013-01-01

Prior articles in this series on employment and arthritis have documented the major impact arthritis and other rheumatic conditions have on employment. As expected, physically demanding job tasks, including hand use, are substantial risk factors for work limitation. Computer use has been increasing. People with arthritis may choose occupations involving extensive computer use to avoid occupations with other physical demands. But studies show many people with arthritis conditions have difficulty using computers.Ergonomic assessment and implementation helps relieve the physical and other demands of jobs. The Ergonomic Assessment Tool for Arthritis (EATA) is specifically for people with arthritis conditions. Since the EATA can be conducted off worksite, it is feasible to use with workers not wishing to disclose their condition to their employer. Available research supports the effectiveness of ergonomic intervention as a viable method to reduce work limitation for persons with arthritis. Some workers will need additional vocational intervention to remain employed long term. However, ergonomic intervention is a useful first step, as it promotes awareness of arthritis effects on work activities. Assisting workers with arthritis or other rheumatic conditions to use ergonomics to enhance their ability to work well should be an important aspect of managing these conditions.

Handling Uncertain Gross Margin and Water Demand in Agricultural Water Resources Management using Robust Optimization

NASA Astrophysics Data System (ADS)

Chaerani, D.; Lesmana, E.; Tressiana, N.

2018-03-01

In this paper, an application of Robust Optimization in agricultural water resource management problem under gross margin and water demand uncertainty is presented. Water resource management is a series of activities that includes planning, developing, distributing and managing the use of water resource optimally. Water resource management for agriculture can be one of the efforts to optimize the benefits of agricultural output. The objective function of agricultural water resource management problem is to maximizing total benefits by water allocation to agricultural areas covered by the irrigation network in planning horizon. Due to gross margin and water demand uncertainty, we assume that the uncertain data lies within ellipsoidal uncertainty set. We employ robust counterpart methodology to get the robust optimal solution.

Solar + Storage Synergies for Managing Commercial-Customer Demand Charges

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

Gagnon, Pieter J.; Govindarajan, Anand; Bird, Lori A.

We study the synergies between behind-the-meter solar and storage in reducing commercial-customer demand charges. This follows two previous studies that examined demand charge savings for stand-alone solar in both the residential and commercial sectors. In this study we show that solar and storage show consistent synergies for demand charge management, that the magnitude of reductions are highly customer-specific, and that the magnitude of savings is influenced by the design of the electricity tariff.

Demand forecast model based on CRM

NASA Astrophysics Data System (ADS)

Cai, Yuancui; Chen, Lichao

2006-11-01

With interiorizing day by day management thought that regarding customer as the centre, forecasting customer demand becomes more and more important. In the demand forecast of customer relationship management, the traditional forecast methods have very great limitation because much uncertainty of the demand, these all require new modeling to meet the demands of development. In this paper, the notion is that forecasting the demand according to characteristics of the potential customer, then modeling by it. The model first depicts customer adopting uniform multiple indexes. Secondly, the model acquires characteristic customers on the basis of data warehouse and the technology of data mining. The last, there get the most similar characteristic customer by their comparing and forecast the demands of new customer by the most similar characteristic customer.

An insula-frontostriatal network mediates flexible cognitive control by adaptively predicting changing control demands

PubMed Central

Jiang, Jiefeng; Beck, Jeffrey; Heller, Katherine; Egner, Tobias

2015-01-01

The anterior cingulate and lateral prefrontal cortices have been implicated in implementing context-appropriate attentional control, but the learning mechanisms underlying our ability to flexibly adapt the control settings to changing environments remain poorly understood. Here we show that human adjustments to varying control demands are captured by a reinforcement learner with a flexible, volatility-driven learning rate. Using model-based functional magnetic resonance imaging, we demonstrate that volatility of control demand is estimated by the anterior insula, which in turn optimizes the prediction of forthcoming demand in the caudate nucleus. The caudate's prediction of control demand subsequently guides the implementation of proactive and reactive attentional control in dorsal anterior cingulate and dorsolateral prefrontal cortices. These data enhance our understanding of the neuro-computational mechanisms of adaptive behaviour by connecting the classic cingulate-prefrontal cognitive control network to a subcortical control-learning mechanism that infers future demands by flexibly integrating remote and recent past experiences. PMID:26391305

Effective Management of High-Use/High-Demand Space Using Restaurant-Style Pagers

ERIC Educational Resources Information Center

Gonzalez, Adriana

2012-01-01

The library landscape is changing at a fast pace, with an increase in the demand for study space including quiet, individualized study space; open group study space; and as enclosed group study space. In large academic libraries, managing limited high-demand resources is crucial and is partially being driven by the greater emphasis on group…