Operational performance management of priced facilities

DOT National Transportation Integrated Search

2011-03-01

The Texas Department of Transportation and its agency partners have implemented various forms of lane management and pricing over the past three decades, including HOV lanes, managed lanes, and toll roads. As more of these complex transportation faci...

Clotrimazole-cyclodextrin based approach for the management and treatment of Candidiasis - A formulation and chemistry-based evaluation.

PubMed

Mohammed, Noorullah Naqvi; Pandey, Pankaj; Khan, Nayaab S; Elokely, Khaled M; Liu, Haining; Doerksen, Robert J; Repka, Michael A

2016-08-01

Clotrimazole (CT) is a poorly soluble antifungal drug that is most commonly employed as a topical treatment in the management of vaginal candidiasis. The present work focuses on a formulation approach to enhance the solubility of CT using cyclodextrin (CD) complexation. A CT-CD complex was prepared by a co-precipitation method. Various characterization techniques such as differential scanning calorimetry, infrared (IR) and X-ray spectroscopy, scanning electron microscopy and nuclear magnetic resonance (NMR) spectroscopy were performed to evaluate the complex formation and to understand the interactions between CT and CD. Computational molecular modeling was performed using the Schrödinger suite and Gaussian 09 program to understand structural conformations of the complex. The phase solubility curve followed an AL-type curve, indicating formation of a 1:1 complex. Molecular docking studies supported the data obtained through NMR and IR studies. Enthalpy changes confirmed that complexation was an exothermic and enthalpically favorable phenomenon. The CT-CD complexes were formulated in a gel and evaluated for release and antifungal activity. The in vitro release studies performed using gels demonstrated a sustained release of CT from the CT-CD complex with the complex exhibiting improved release relative to the un-complexed CT. Complexed CT-CD exhibited better fungistatic activity toward different Candida species than un-complexed CT.

Visualizing land-use and management complexity within biogeochemical cycles of an agricultural landscape

Treesearch

Kai Nils Nitzsche; Gernot Verch; Katrin Premke; Arthur Gessler; Zachary Kayler

2016-01-01

Crop fields are cultivated across continuities of soil, topography, and local climate that drive biological processes and nutrient cycling at the landscape scale; yet land management and agricultural research are often performed at the field scale, potentially neglecting the context of the surrounding landscape. Adding to this complexity is the overlap of ecosystems...

Management Strategies for Complex Adaptive Systems: Sensemaking, Learning, and Improvisation

ERIC Educational Resources Information Center

McDaniel, Reuben R., Jr.

2007-01-01

Misspecification of the nature of organizations may be a major reason for difficulty in achieving performance improvement. Organizations are often viewed as machine-like, but complexity science suggests that organizations should be viewed as complex adaptive systems. I identify the characteristics of complex adaptive systems and give examples of…

Systems approach provides management control of complex programs

NASA Technical Reports Server (NTRS)

Dudek, E. F., Jr.; Mc Carthy, J. F., Jr.

1970-01-01

Integrated program management process provides management visual assistance through three interrelated charts - system model that identifies each function to be performed, matrix that identifies personnel responsibilities for these functions, process chart that breaks down the functions into discrete tasks.

Aspects of transport system management within mining complex using information and telecommunication systems

NASA Astrophysics Data System (ADS)

Semykina, A. S.; Zagorodniy, N. A.; Konev, A. A.; Duganova, E. V.

2018-05-01

The paper considers aspects of transport system management within the mining complex. It indicates information and telecommunication systems that are used to increase transportation efficiency. It also describes key advantages and disadvantages. It is found that software products of the Modular Company used in pits allow increasing transport performance, minimizing losses and ensuring efficient transportation of minerals.

Sustainability, Complexity and Learning: Insights from Complex Systems Approaches

ERIC Educational Resources Information Center

Espinosa, A.; Porter, T.

2011-01-01

Purpose: The purpose of this research is to explore core contributions from two different approaches to complexity management in organisations aiming to improve their sustainability,: the Viable Systems Model (VSM), and the Complex Adaptive Systems (CAS). It is proposed to perform this by summarising the main insights each approach offers to…

Why are You Late?: Investigating the Role of Time Management in Time-Based Prospective Memory

PubMed Central

Waldum, Emily R; McDaniel, Mark A.

2016-01-01

Time-based prospective memory tasks (TBPM) are those that are to be performed at a specific future time. Contrary to typical laboratory TBPM tasks (e.g., “hit the “z” key every 5 minutes”), many real-world TBPM tasks require more complex time-management processes. For instance to attend an appointment on time, one must estimate the duration of the drive to the appointment and then utilize this estimate to create and execute a secondary TBPM intention (e.g., “I need to start driving by 1:30 to make my 2:00 appointment on time”). Future under- and overestimates of drive time can lead to inefficient TBPM performance with the former lending to missed appointments and the latter to long stints in the waiting room. Despite the common occurrence of complex TBPM tasks in everyday life, to date, no studies have investigated how components of time management, including time estimation, affect behavior in such complex TBPM tasks. Therefore, the current study aimed to investigate timing biases in both older and younger adults and further to determine how such biases along with additional time management components including planning and plan fidelity influence complex TBPM performance. Results suggest for the first time that younger and older adults do not always utilize similar timing strategies, and as a result, can produce differential timing biases under the exact same environmental conditions. These timing biases, in turn, play a vital role in how efficiently both younger and older adults perform a later TBPM task that requires them to utilize their earlier time estimate. PMID:27336325

Beyond the short term : transportation asset management for long-term sustainability, accountability and performance

DOT National Transportation Integrated Search

2010-01-01

Transportation Asset Management (TAM) has long been recognized as a sound, long-term approach to managing infrastructure. It provides decision makers with a rational, long-term systematic process for making difficult and complex decisions about how t...

25 CFR 1200.16 - What criteria will be used in evaluating the management plan?

Code of Federal Regulations, 2010 CFR

2010-04-01

... performance record for funds management, and the ability to compensate the tribe if the entity is found liable for failing to comply with the tribe's management plan (i.e., its assets, bonding, and insurance). (b... complexity of the proposed management plan to determine whether the tribe has the experience to manage its...

25 CFR 1200.16 - What criteria will be used in evaluating the management plan?

Code of Federal Regulations, 2011 CFR

2011-04-01

... performance record for funds management, and the ability to compensate the tribe if the entity is found liable for failing to comply with the tribe's management plan (i.e., its assets, bonding, and insurance). (b... complexity of the proposed management plan to determine whether the tribe has the experience to manage its...

Civilian Workforce 2020: Strategies for Modernizing Human Resources Management in the Department of the Navy

DTIC Science & Technology

2000-08-18

heavy reliance on contractors to perform much of the work performed by civilian employees . While this trend is expected to continue, a critical mass...manage, and, if necessary, terminate non- performing employees . Accountability measures should be clear and have consequences. ◆ Investments in human...complexity of work increas- es and the performance of industrial-type functions is shifted to contractors. The impact of this shift on the occupational

JMS: An Open Source Workflow Management System and Web-Based Cluster Front-End for High Performance Computing.

PubMed

Brown, David K; Penkler, David L; Musyoka, Thommas M; Bishop, Özlem Tastan

2015-01-01

Complex computational pipelines are becoming a staple of modern scientific research. Often these pipelines are resource intensive and require days of computing time. In such cases, it makes sense to run them over high performance computing (HPC) clusters where they can take advantage of the aggregated resources of many powerful computers. In addition to this, researchers often want to integrate their workflows into their own web servers. In these cases, software is needed to manage the submission of jobs from the web interface to the cluster and then return the results once the job has finished executing. We have developed the Job Management System (JMS), a workflow management system and web interface for high performance computing (HPC). JMS provides users with a user-friendly web interface for creating complex workflows with multiple stages. It integrates this workflow functionality with the resource manager, a tool that is used to control and manage batch jobs on HPC clusters. As such, JMS combines workflow management functionality with cluster administration functionality. In addition, JMS provides developer tools including a code editor and the ability to version tools and scripts. JMS can be used by researchers from any field to build and run complex computational pipelines and provides functionality to include these pipelines in external interfaces. JMS is currently being used to house a number of bioinformatics pipelines at the Research Unit in Bioinformatics (RUBi) at Rhodes University. JMS is an open-source project and is freely available at https://github.com/RUBi-ZA/JMS.

JMS: An Open Source Workflow Management System and Web-Based Cluster Front-End for High Performance Computing

PubMed Central

Brown, David K.; Penkler, David L.; Musyoka, Thommas M.; Bishop, Özlem Tastan

2015-01-01

Complex computational pipelines are becoming a staple of modern scientific research. Often these pipelines are resource intensive and require days of computing time. In such cases, it makes sense to run them over high performance computing (HPC) clusters where they can take advantage of the aggregated resources of many powerful computers. In addition to this, researchers often want to integrate their workflows into their own web servers. In these cases, software is needed to manage the submission of jobs from the web interface to the cluster and then return the results once the job has finished executing. We have developed the Job Management System (JMS), a workflow management system and web interface for high performance computing (HPC). JMS provides users with a user-friendly web interface for creating complex workflows with multiple stages. It integrates this workflow functionality with the resource manager, a tool that is used to control and manage batch jobs on HPC clusters. As such, JMS combines workflow management functionality with cluster administration functionality. In addition, JMS provides developer tools including a code editor and the ability to version tools and scripts. JMS can be used by researchers from any field to build and run complex computational pipelines and provides functionality to include these pipelines in external interfaces. JMS is currently being used to house a number of bioinformatics pipelines at the Research Unit in Bioinformatics (RUBi) at Rhodes University. JMS is an open-source project and is freely available at https://github.com/RUBi-ZA/JMS. PMID:26280450

The Influence of Cultural Factors on Trust in Automation

ERIC Educational Resources Information Center

Chien, Shih-Yi James

2016-01-01

Human interaction with automation is a complex process that requires both skilled operators and complex system designs to effectively enhance overall performance. Although automation has successfully managed complex systems throughout the world for over half a century, inappropriate reliance on automation can still occur, such as the recent…

Training Manager Competencies: The Standards. Third Edition.

ERIC Educational Resources Information Center

Foxon, Marguerite; Richey, Rita C.; Roberts, Robert C.; Spannaus, Timothy W.

In this third edition of "Training Manager Competencies: The Standards," the International Board of Standards for Training, Performance and Instruction (IBSTPI) presents an updated definition and discussion of the competencies of training managers. It is an expanded view that reflects the complexities and pressures of current practice…

Crew workload-management strategies - A critical factor in system performance

NASA Technical Reports Server (NTRS)

Hart, Sandra G.

1989-01-01

This paper reviews the philosophy and goals of the NASA/USAF Strategic Behavior/Workload Management Program. The philosophical foundation of the program is based on the assumption that an improved understanding of pilot strategies will clarify the complex and inconsistent relationships observed among objective task demands and measures of system performance and pilot workload. The goals are to: (1) develop operationally relevant figures of merit for performance, (2) quantify the effects of strategic behaviors on system performance and pilot workload, (3) identify evaluation criteria for workload measures, and (4) develop methods of improving pilots' abilities to manage workload extremes.

Data driven performance measures for effective management of complex transportation networks.

DOT National Transportation Integrated Search

2014-02-01

This research aims to explore performance measures quantified based on different transportation data sources. It examined the major : performance measures that can help describe both traffic operations and safety conditions. The available data source...

Planning and task management in Parkinson's disease: differential emphasis in dual-task performance.

PubMed

Bialystok, Ellen; Craik, Fergus I M; Stefurak, Taresa

2008-03-01

Seventeen patients diagnosed with Parkinson's disease completed a complex computer-based task that involved planning and management while also performing an attention-demanding secondary task. The tasks were performed concurrently, but it was necessary to switch from one to the other. Performance was compared to a group of healthy age-matched control participants and a group of young participants. Parkinson's patients performed better than the age-matched controls on almost all measures and as well as the young controls in many cases. However, the Parkinson's patients achieved this by paying relatively less attention to the secondary task and focusing attention more on the primary task. Thus, Parkinson's patients can apparently improve their performance on some aspects of a multidimensional task by simplifying task demands. This benefit may occur as a consequence of their inflexible exaggerated attention to some aspects of a complex task to the relative neglect of other aspects.

Stage call: Cardiovascular reactivity to audition stress in musicians

PubMed Central

Chanwimalueang, Theerasak; Aufegger, Lisa; Adjei, Tricia; Wasley, David; Cruder, Cinzia; Mandic, Danilo P.

2017-01-01

Auditioning is at the very center of educational and professional life in music and is associated with significant psychophysical demands. Knowledge of how these demands affect cardiovascular responses to psychosocial pressure is essential for developing strategies to both manage stress and understand optimal performance states. To this end, we recorded the electrocardiograms (ECGs) of 16 musicians (11 violinists and 5 flutists) before and during performances in both low- and high-stress conditions: with no audience and in front of an audition panel, respectively. The analysis consisted of the detection of R-peaks in the ECGs to extract heart rate variability (HRV) from the notoriously noisy real-world ECGs. Our data analysis approach spanned both standard (temporal and spectral) and advanced (structural complexity) techniques. The complexity science approaches—namely, multiscale sample entropy and multiscale fuzzy entropy—indicated a statistically significant decrease in structural complexity in HRV from the low- to the high-stress condition and an increase in structural complexity from the pre-performance to performance period, thus confirming the complexity loss theory and a loss in degrees of freedom due to stress. Results from the spectral analyses also suggest that the stress responses in the female participants were more parasympathetically driven than those of the male participants. In conclusion, our findings suggest that interventions to manage stress are best targeted at the sensitive pre-performance period, before an audition begins. PMID:28437466

Managing and Querying Image Annotation and Markup in XML.

PubMed

Wang, Fusheng; Pan, Tony; Sharma, Ashish; Saltz, Joel

2010-01-01

Proprietary approaches for representing annotations and image markup are serious barriers for researchers to share image data and knowledge. The Annotation and Image Markup (AIM) project is developing a standard based information model for image annotation and markup in health care and clinical trial environments. The complex hierarchical structures of AIM data model pose new challenges for managing such data in terms of performance and support of complex queries. In this paper, we present our work on managing AIM data through a native XML approach, and supporting complex image and annotation queries through native extension of XQuery language. Through integration with xService, AIM databases can now be conveniently shared through caGrid.

Managing and Querying Image Annotation and Markup in XML

PubMed Central

Wang, Fusheng; Pan, Tony; Sharma, Ashish; Saltz, Joel

2010-01-01

Proprietary approaches for representing annotations and image markup are serious barriers for researchers to share image data and knowledge. The Annotation and Image Markup (AIM) project is developing a standard based information model for image annotation and markup in health care and clinical trial environments. The complex hierarchical structures of AIM data model pose new challenges for managing such data in terms of performance and support of complex queries. In this paper, we present our work on managing AIM data through a native XML approach, and supporting complex image and annotation queries through native extension of XQuery language. Through integration with xService, AIM databases can now be conveniently shared through caGrid. PMID:21218167

Why are you late? Investigating the role of time management in time-based prospective memory.

PubMed

Waldum, Emily R; McDaniel, Mark A

2016-08-01

Time-based prospective memory tasks (TBPM) are those that are to be performed at a specific future time. Contrary to typical laboratory TBPM tasks (e.g., hit the Z key every 5 min), many real-world TBPM tasks require more complex time-management processes. For instance, to attend an appointment on time, one must estimate the duration of the drive to the appointment and then use this estimate to create and execute a secondary TBPM intention (e.g., "I need to start driving by 1:30 to make my 2:00 appointment on time"). Future under- and overestimates of drive time can lead to inefficient TBPM performance with the former lending to missed appointments and the latter to long stints in the waiting room. Despite the common occurrence of complex TBPM tasks in everyday life, to date, no studies have investigated how components of time management, including time estimation, affect behavior in such complex TBPM tasks. Therefore, the current study aimed to investigate timing biases in both older and younger adults and, further, to determine how such biases along with additional time management components including planning and plan fidelity influence complex TBPM performance. Results suggest for the first time that younger and older adults do not always utilize similar timing strategies, and as a result, can produce differential timing biases under the exact same environmental conditions. These timing biases, in turn, play a vital role in how efficiently both younger and older adults perform a later TBPM task that requires them to utilize their earlier time estimate. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Empowerment and performance of managers and subordinates in elderly care: A longitudinal and multilevel study.

PubMed

Hagerman, Heidi; Högberg, Hans; Skytt, Bernice; Wadensten, Barbro; Engström, Maria

2017-11-01

To investigate relationships between first-line managers' ratings of structural and psychological empowerment, and the subordinates' ratings of structural empowerment, as well as their ratings of the managers' leadership-management performance. Work situations in elderly care are complex. To date, few studies have used a longitudinal, correlational and multilevel design to study the working life of subordinates and managers. In five Swedish municipalities, questionnaires were answered twice during 2010-12 by 56 first-line managers and 769 subordinates working in nursing homes or home-help services. First-line managers' empowerment at Time 1 partially predicted subordinate's structural empowerment and ratings of their managers' leadership-management performance at Time 2. Changes over time partially revealed that the more access managers had to structural empowerment, i.e. increase over time, the higher the ratings were for structural empowerment and managerial leadership-management performance among subordinates. Findings strengthen research and theoretical suggestions linking first-line managers' structural empowerment to their subordinates' structural empowerment and ratings of their manager's leadership-management performance. Managers with high access to structural empowerment are more likely to provide subordinates access to structural empowerment. © 2017 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

Case Management for Patients with Complex Multimorbidity: Development and Validation of a Coordinated Intervention between Primary and Hospital Care

PubMed Central

Giménez-Campos, María Soledad; Villar-López, Julia; Faubel-Cava, Raquel; Donat-Castelló, Lucas; Valdivieso-Martínez, Bernardo; Soriano-Melchor, Elisa; Bahamontes-Mulió, Amparo; García-Gómez, Juan M.

2017-01-01

In the past few years, healthcare systems have been facing a growing demand related to the high prevalence of chronic diseases. Case management programs have emerged as an integrated care approach for the management of chronic disease. Nevertheless, there is little scientific evidence on the impact of using a case management program for patients with complex multimorbidity regarding hospital resource utilisation. We evaluated an integrated case management intervention set up by community-based care at outpatient clinics with nurse case managers from a telemedicine unit. The hypothesis to be tested was whether improved continuity of care resulting from the integration of community-based and hospital services reduced the use of hospital resources amongst patients with complex multimorbidity. A retrospective cohort study was performed using a sample of 714 adult patients admitted to the program between January 2012 and January 2015. We found a significant decrease in the number of emergency room visits, unplanned hospitalizations, and length of stay, and an expected increase in the home care hospital-based episodes. These results support the hypothesis that case management interventions can reduce the use of unplanned hospital admissions when applied to patients with complex multimorbidity. PMID:28970745

Scientific Programming Using Java: A Remote Sensing Example

NASA Technical Reports Server (NTRS)

Prados, Don; Mohamed, Mohamed A.; Johnson, Michael; Cao, Changyong; Gasser, Jerry

1999-01-01

This paper presents results of a project to port remote sensing code from the C programming language to Java. The advantages and disadvantages of using Java versus C as a scientific programming language in remote sensing applications are discussed. Remote sensing applications deal with voluminous data that require effective memory management, such as buffering operations, when processed. Some of these applications also implement complex computational algorithms, such as Fast Fourier Transformation analysis, that are very performance intensive. Factors considered include performance, precision, complexity, rapidity of development, ease of code reuse, ease of maintenance, memory management, and platform independence. Performance of radiometric calibration code written in Java for the graphical user interface and of using C for the domain model are also presented.

AANA Journal course: update for nurse anesthetists--ERR WATCH: anesthesia crisis resource management from the nurse anesthetist's perspective.

PubMed

Fletcher, J L

1998-12-01

Anesthesia crisis resource management (ACRM) was developed by David Gaba, MD, and colleagues at Stanford University in the early 1990s. Derived from cockpit resource management of the aviation industry, ACRM addresses the issues of human performance and patient safety in anesthesia. Due to the inherent complexity of our dynamic work environment, we are frequently faced with situations that could escalate into critical incidents. ACRM explains the role of personal and environmental factors that can contribute to the evolution of critical incidents and provides the practitioner with some behavioral and intellectual guidelines to manage the risks more effectively. ERR WATCH is an acronym I developed to interpret the principles of ACRM from the nurse anesthetist's perspective. It provides a quick review of the major principles of ACRM, which are Environment, Resources, Reevaluation, Workload, Attention, Teamwork, Communication, and Help. Used together with good clinical management, these principles may provide an edge in solving complex problems and improving performance.

Managerial leadership assessment - Personality correlates of and sex differences in ratings by leaders, peers, and followers

NASA Technical Reports Server (NTRS)

Gibson, Robert H.; Wilhelm, John

1989-01-01

A performance appraisal was conducted at a Fortune 500 airline. Evaluations of each manager were taken from his or her management, peers and subordinates. These ratings were related to personality clusters revealing patterns for males similar to those found between personality and performance in pilot populations. A case is made that piloting aircraft requires similar skills to managing other complex enterprises and that similar profiles predict success in each.

A novel scene management technology for complex virtual battlefield environment

NASA Astrophysics Data System (ADS)

Sheng, Changchong; Jiang, Libing; Tang, Bo; Tang, Xiaoan

2018-04-01

The efficient scene management of virtual environment is an important research content of computer real-time visualization, which has a decisive influence on the efficiency of drawing. However, Traditional scene management methods do not suitable for complex virtual battlefield environments, this paper combines the advantages of traditional scene graph technology and spatial data structure method, using the idea of management and rendering separation, a loose object-oriented scene graph structure is established to manage the entity model data in the scene, and the performance-based quad-tree structure is created for traversing and rendering. In addition, the collaborative update relationship between the above two structural trees is designed to achieve efficient scene management. Compared with the previous scene management method, this method is more efficient and meets the needs of real-time visualization.

Radioactive Waste Management Complex performance assessment: Draft

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

Case, M.J.; Maheras, S.J.; McKenzie-Carter, M.A.

1990-06-01

A radiological performance assessment of the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory was conducted to demonstrate compliance with appropriate radiological criteria of the US Department of Energy and the US Environmental Protection Agency for protection of the general public. The calculations involved modeling the transport of radionuclides from buried waste, to surface soil and subsurface media, and eventually to members of the general public via air, ground water, and food chain pathways. Projections of doses were made for both offsite receptors and individuals intruding onto the site after closure. In addition, uncertainty analyses were performed. Resultsmore » of calculations made using nominal data indicate that the radiological doses will be below appropriate radiological criteria throughout operations and after closure of the facility. Recommendations were made for future performance assessment calculations.« less

Implementing complex innovations: factors influencing middle manager support.

PubMed

Chuang, Emmeline; Jason, Kendra; Morgan, Jennifer Craft

2011-01-01

Middle manager resistance is often described as a major challenge for upper-level administrators seeking to implement complex innovations such as evidence-based protocols or new skills training. However, factors influencing middle manager support for innovation implementation are currently understudied in the U.S. health care literature. This article examined the factors that influence middle managers' support for and participation in the implementation of work-based learning, a complex innovation adopted by health care organizations to improve the jobs, educational pathways, skills, and/or credentials of their frontline workers. We conducted semistructured interviews and focus groups with 92 middle managers in 17 health care organizations. Questions focused on understanding middle managers' support for work-based learning as a complex innovation, facilitators and barriers to the implementation process, and the systems changes needed to support the implementation of this innovation. Factors that emerged as influential to middle manager support were similar to those found in broader models of innovation implementation within the health care literature. However, our findings extend previous research by developing an understanding about how middle managers perceived these constructs and by identifying specific strategies for how to influence middle manager support for the innovation implementation process. These findings were generally consistent across different types of health care organizations. Study findings suggest that middle manager support was highest when managers felt the innovation fit their workplace needs and priorities and when they had more discretion and control over how it was implemented. Leaders seeking to implement innovations should consider the interplay between middle managers' control and discretion, their narrow focus on the performance of their own departments or units, and the dedication of staff and other resources for empowering their managers to implement these complex innovations.

Managing interoperability and complexity in health systems.

PubMed

Bouamrane, M-M; Tao, C; Sarkar, I N

2015-01-01

In recent years, we have witnessed substantial progress in the use of clinical informatics systems to support clinicians during episodes of care, manage specialised domain knowledge, perform complex clinical data analysis and improve the management of health organisations' resources. However, the vision of fully integrated health information eco-systems, which provide relevant information and useful knowledge at the point-of-care, remains elusive. This journal Focus Theme reviews some of the enduring challenges of interoperability and complexity in clinical informatics systems. Furthermore, a range of approaches are proposed in order to address, harness and resolve some of the many remaining issues towards a greater integration of health information systems and extraction of useful or new knowledge from heterogeneous electronic data repositories.

Managing Complexity: Impact of Organization and Processing Style on Nonverbal Memory in Autism Spectrum Disorders

ERIC Educational Resources Information Center

Tsatsanis, Katherine D.; Noens, Ilse L. J.; Illmann, Cornelia L.; Pauls, David L.; Volkmar, Fred R.; Schultz, Robert T.; Klin, Ami

2011-01-01

The contributions of cognitive style and organization to processing and recalling a complex novel stimulus were examined by comparing the Rey Osterrieth Complex Figure (ROCF) test performance of children, adolescents, and adults with ASD to clinical controls (CC) and non-impaired controls (NC) using the "Developmental Scoring System."…

Putting it altogether: improving performance in heart failure outcomes, part 2.

PubMed

Clancy, Thomas R

2009-09-01

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 10th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. As follow-up to the case study in this column's June 2009 article, this article highlights the interventions and outcomes of the study.

Analysis of Factors Influencing Building Refurbishment Project Performance

NASA Astrophysics Data System (ADS)

Ishak, Nurfadzillah; Aswad Ibrahim, Fazdliel; Azizi Azizan, Muhammad

2018-03-01

Presently, the refurbishment approach becomes favourable as it creates opportunities to incorporate sustainable value with other building improvement. In this regard, this approach needs to be implemented due to the issues on overwhelming ratio of existing building to new construction, which also can contribute to the environmental problem. Refurbishment principles imply to minimize the environmental impact and upgrading the performance of an existing building to meet new requirements. In theoretically, building project's performance has a direct bearing on related to its potential for project success. However, in refurbishment building projects, the criteria for measure are become wider because the projects are a complex and multi-dimensional which encompassing many factors which reflect to the nature of works. Therefore, this impetus could be achieve by examine the direct empirical relationship between critical success factors (CSFs) and complexity factors (CFs) during managing the project in relation to delivering success on project performance. The research findings will be expected as the basis of future research in establish appropriate framework that provides information on managing refurbishment building projects and enhancing the project management competency for a better-built environment.

Rust and Thinning Management Effect on Cup Quality and Plant Performance for Two Cultivars of Coffea arabica L.

PubMed

Echeverria-Beirute, Fabian; Murray, Seth C; Klein, Patricia; Kerth, Chris; Miller, Rhonda; Bertrand, Benoit

2018-05-30

Beverage quality is a complex attribute of coffee ( Coffea arabica L.). Genotype (G), environment (E), management (M), postharvest processing, and roasting are all involved. However, little is known about how G × M interactions influence beverage quality. We investigated how yield and coffee leaf rust (CLR) disease (caused by Hemileia vastatrix Berk. et Br.) management affect cup quality and plant performance, in two coffee cultivars. Sensory and chemical analyses revealed that 10 of 70 attributes and 18 of 154 chemical volatile compounds were significantly affected by G and M. Remarkably, acetaminophen was found for the first time in roasted coffee and in higher concentrations under more stressful conditions. A principal component analysis described 87% of the variation in quality and plant overall performance. This study is a first step in understanding the complexity of the physiological, metabolic, and molecular changes in coffee production, which will be useful for the improvement of coffee cultivars.

Strategic performance management: development of a performance measurement system at the Mayo Clinic.

PubMed

Curtright, J W; Stolp-Smith, S C; Edell, E S

2000-01-01

Managing and measuring performance become exceedingly complex as healthcare institutions evolve into integrated health systems comprised of hospitals, outpatient clinics and surgery centers, nursing homes, and home health services. Leaders of integrated health systems need to develop a methodology and system that align organizational strategies with performance measurement and management. To meet this end, multiple healthcare organizations embrace the performance-indicators reporting system known as a "balanced scorecard" or a "dashboard report." This discrete set of macrolevel indicators gives senior management a fast but comprehensive glimpse of the organization's performance in meeting its quality, operational, and financial goals. The leadership of outpatient operations for Mayo Clinic in Rochester, Minnesota built on this concept by creating a performance management and measurement system that monitors and reports how well the organization achieves its performance goals. Internal stakeholders identified metrics to measure performance in each key category. Through these metrics, the organization links Mayo Clinic's vision, primary value, core principles, and day-to-day operations by monitoring key performance indicators on a weekly, monthly, or quarterly basis.

Do senior management cultures affect performance? Evidence from Italian public healthcare organizations.

PubMed

Prenestini, Anna; Lega, Federico

2013-01-01

Healthcare organizations are often characterized by diffuse power, ambiguous goals, and a plurality of actors. In this complex and pluralistic context, senior healthcare managers are expected to provide strategic direction and lead their organizations toward their goals and performance targets. The present work explores the relationship between senior management team culture and performance by investigating Italian public healthcare organizations in the Tuscany region. Our assessment of senior management culture was accomplished through the use of an established framework and a corresponding tool, the competing values framework, which supports the idea that specific aspects of performance are related to a dominant management culture. Organizational performance was assessed using a wide range of measures collected by a multidimensional performance evaluation system, which was developed in Tuscany to measure the performance of its 12 local health authorities (LHAs) and four teaching hospitals (THs). Usable responses were received from 80 senior managers of 11 different healthcare organizations (two THs and nine LHAs). Our findings show that Tuscan healthcare organizations are characterized by various dominant cultures: developmental, clan, rational, and hierarchical. These variations in dominant culture were associated with performance measures. The implications for management theory, professional practice, and public policy are discussed.

Learning to manage a complex ecosystem: adaptive management and the Northwest Forest Plan.

Treesearch

George H. Stankey; Roger N. Clark; Bernard T. Bormann

2006-01-01

The Northwest Forest Plan (the Plan) identifies adaptive management as a central strategy for effective implementation. Despite this, there has been a lack of any systematic evaluation of its performance. This study is based on an extensive literature review, 50 interviews with resource managers and scientists involved with the Plan’s implementation, and a survey of...

University management nurse: a grounded theory.

PubMed

Cunha, Kamylla Santos da; Andrade, Selma Regina de; Erdmann, Alacoque Lorenzini

2018-03-08

to understand the meaning of the university management performed by nurses managers of the nursing undergraduate course of a public university. this is a qualitative research, based on the grounded theory. Data collection took place between May and September 2016, with open interviews, in the scenario of a federal public university. The technique of constant comparative analysis of the data was followed, obtaining a theoretical sample with 19 nurses, in two sample groups. there were three categories emerged that shaped the phenomenon: Articulating complex collectives through university management for the qualified training of new nurses. The categories included: a) conditions, defined by perceiving the commitment to the collective, previous experiences, and training for health management, as motivations to be a teacher manager; b) actions/interactions, delimited by Knowing and recognizing, in practice, the university management process, limits and possibilities in the coordination of complex collective subjects; and, c) consequences, such as Improving teaching work and taking responsibility for university education. the nurses teaching managers to explain university management as a set of individual and collective actions that, articulated in a complex social environment, promote conditions for the training of critical and reflexive nurses with the demands of society.

Surgical Management of Complex Lower-Extremity Trauma With a Long Hindfoot Fusion Nail: A Case Report.

PubMed

Jain, Nickul S; Lopez, Gregory D; Bederman, S Samuel; Wirth, Garrett A; Scolaro, John A

2016-08-01

High-energy injuries can result in complete or partial loss of the talus. Ipsilateral fractures to the lower limb increase the complexity of surgical management, and treatment is guided by previous case reports of similar injuries. A case of complex lower-extremity trauma with extruded and missing talar body and ipsilateral type IIIB open tibia fracture is presented. Surgical limb reconstruction and salvage was performed successfully with a single orthopaedic implant in a manner not described previously in the literature. The purpose of this case report is to present the novel use of a single orthopaedic implant for treatment of a complex, open traumatic injury. Previous case reports in the literature have described the management of complete or partial talar loss. We describe the novel use of a long hindfoot fusion nail and staged bone grafting to achieve tibiocalcaneal arthrodesis for the treatment of complex lower-extremity trauma. Therapeutic, Level IV: Case study. © 2015 The Author(s).

Performance Analysis of Hospital Managers Using Fuzzy AHP and Fuzzy TOPSIS: Iranian Experience.

PubMed

Shafii, Milad; Hosseini, Seyed Mostafa; Arab, Mohammad; Asgharizadeh, Ezzatollah; Farzianpour, Fereshteh

2015-06-12

Hospitals are complex organizations that require strong and effective management. The success of such organizations depends on the performance of managers. This study provides a comprehensive set of indicators to assess the performance of hospital managers in Iranian Ministry of Health owned hospitals. This research was a cross-sectional study. First, reviewing the literature and using experts' viewpoints and convening a panel of experts, the dimensions of performance have been selected and came in the form of a performance model. Then, using Fuzzy Analytic Hierarchy Process (FAHP), the chosen dimensions were weighted. Finally, based on the weighted performance dimensions, a questionnaire was designed and after confirming the reliability and validity, through a census, 407 senior and middle managers from 10 hospitals in Yazd, Iran completed it and performance of CEOs in these hospitals was evaluated using the Fuzzy Technique for Order Preference by Similarity Ideal Solution (FTOPSIS). To measure the performance of hospital managers, a performance assessment model consisted of 19 sub-dimensions in 5 main dimensions (Functional, Professional, Organizational, Individual and Human) was developed. The functional area had the most weight and the individual area had the least weight, as well. The hospital managers had different performance levels in each category and sub-dimensions. In terms of overall performance, the hospital managers C and H had the best and the worst performance, respectively. The use of appropriate dimensions for performance, prioritizing them and evaluating the performance of hospital managers using appropriate techniques, can play an effective role in the selection of qualified managers, identifying strengths and weaknesses in performance and continuous improvement of them.

Laboratory complex for simulation of navigation signals of pseudosatellites

NASA Astrophysics Data System (ADS)

Ratushniak, V. N.; Gladyshev, A. B.; Sokolovskiy, A. V.; Mikhov, E. D.

2018-05-01

In the article, features of the organization, structure and questions of formation of navigation signals of pseudosatellites of the short - range navigation system based on the hardware-software complex National Instruments are considered. A software model that performs the formation and management of a pseudo-random sequence of a navigation signal and the formation and management of the format transmitted pseudosatellite navigation information is presented. The variant of constructing the transmitting equipment of the pseudosatellite base stations is provided.

Building on the EGIPPS performance assessment: the multipolar framework as a heuristic to tackle the complexity of performance of public service oriented health care organisations.

PubMed

Marchal, Bruno; Hoerée, Tom; da Silveira, Valéria Campos; Van Belle, Sara; Prashanth, Nuggehalli S; Kegels, Guy

2014-04-17

Performance of health care systems is a key concern of policy makers and health service managers all over the world. It is also a major challenge, given its multidimensional nature that easily leads to conceptual and methodological confusion. This is reflected by a scarcity of models that comprehensively analyse health system performance. In health, one of the most comprehensive performance frameworks was developed by the team of Leggat and Sicotte. Their framework integrates 4 key organisational functions (goal attainment, production, adaptation to the environment, and values and culture) and the tensions between these functions.We modified this framework to better fit the assessment of the performance of health organisations in the public service domain and propose an analytical strategy that takes it into the social complexity of health organisations. The resulting multipolar performance framework (MPF) is a meta-framework that facilitates the analysis of the relations and interactions between the multiple actors that influence the performance of health organisations. Using the MPF in a dynamic reiterative mode not only helps managers to identify the bottlenecks that hamper performance, but also the unintended effects and feedback loops that emerge. Similarly, it helps policymakers and programme managers at central level to better anticipate the potential results and side effects of and required conditions for health policies and programmes and to steer their implementation accordingly.

Affective Change at the Defense Equal Opportunity Management Institute: Studies of Assessment and of Symbolic Racism

DTIC Science & Technology

1988-09-30

the symbolic racism research has directly assessed value attributions or measured their relation - ship to attitudes or behavior , which seems to be a...of attitude , evaluation, or emotion, while others involve the abil- ity to make complex Judgments, perform complex behaviors , or be characterized by a...adequate choice of the proper behavior to perform. Attitudes , values. Attitudes are evaluations of things, including people, objects, or behaviors

[Medico-ecological approaches to the integrated management of water resources].

PubMed

El'piner, L I

2012-01-01

The necessity of taking into account the interests of public health care informing and implementing solutions for water management has been substantiated. Scientific frameworks and regulatory sanitary legislative documents relating to various areas of water management have been considered. The possibilities and the importance of performing complex territory medical ecological forecasts of effects of changes in hydrological situation have been demonstrated.

TMT approach to observatory software development process

NASA Astrophysics Data System (ADS)

Buur, Hanne; Subramaniam, Annapurni; Gillies, Kim; Dumas, Christophe; Bhatia, Ravinder

2016-07-01

The purpose of the Observatory Software System (OSW) is to integrate all software and hardware components of the Thirty Meter Telescope (TMT) to enable observations and data capture; thus it is a complex software system that is defined by four principal software subsystems: Common Software (CSW), Executive Software (ESW), Data Management System (DMS) and Science Operations Support System (SOSS), all of which have interdependencies with the observatory control systems and data acquisition systems. Therefore, the software development process and plan must consider dependencies to other subsystems, manage architecture, interfaces and design, manage software scope and complexity, and standardize and optimize use of resources and tools. Additionally, the TMT Observatory Software will largely be developed in India through TMT's workshare relationship with the India TMT Coordination Centre (ITCC) and use of Indian software industry vendors, which adds complexity and challenges to the software development process, communication and coordination of activities and priorities as well as measuring performance and managing quality and risk. The software project management challenge for the TMT OSW is thus a multi-faceted technical, managerial, communications and interpersonal relations challenge. The approach TMT is using to manage this multifaceted challenge is a combination of establishing an effective geographically distributed software team (Integrated Product Team) with strong project management and technical leadership provided by the TMT Project Office (PO) and the ITCC partner to manage plans, process, performance, risk and quality, and to facilitate effective communications; establishing an effective cross-functional software management team composed of stakeholders, OSW leadership and ITCC leadership to manage dependencies and software release plans, technical complexities and change to approved interfaces, architecture, design and tool set, and to facilitate effective communications; adopting an agile-based software development process across the observatory to enable frequent software releases to help mitigate subsystem interdependencies; defining concise scope and work packages for each of the OSW subsystems to facilitate effective outsourcing of software deliverables to the ITCC partner, and to enable performance monitoring and risk management. At this stage, the architecture and high-level design of the software system has been established and reviewed. During construction each subsystem will have a final design phase with reviews, followed by implementation and testing. The results of the TMT approach to the Observatory Software development process will only be preliminary at the time of the submittal of this paper, but it is anticipated that the early results will be a favorable indication of progress.

A fuzzy logic control in adjustable autonomy of a multi-agent system for an automated elderly movement monitoring application.

PubMed

Mostafa, Salama A; Mustapha, Aida; Mohammed, Mazin Abed; Ahmad, Mohd Sharifuddin; Mahmoud, Moamin A

2018-04-01

Autonomous agents are being widely used in many systems, such as ambient assisted-living systems, to perform tasks on behalf of humans. However, these systems usually operate in complex environments that entail uncertain, highly dynamic, or irregular workload. In such environments, autonomous agents tend to make decisions that lead to undesirable outcomes. In this paper, we propose a fuzzy-logic-based adjustable autonomy (FLAA) model to manage the autonomy of multi-agent systems that are operating in complex environments. This model aims to facilitate the autonomy management of agents and help them make competent autonomous decisions. The FLAA model employs fuzzy logic to quantitatively measure and distribute autonomy among several agents based on their performance. We implement and test this model in the Automated Elderly Movements Monitoring (AEMM-Care) system, which uses agents to monitor the daily movement activities of elderly users and perform fall detection and prevention tasks in a complex environment. The test results show that the FLAA model improves the accuracy and performance of these agents in detecting and preventing falls. Copyright © 2018 Elsevier B.V. All rights reserved.

Performance Analysis of Hospital Managers Using Fuzzy AHP and Fuzzy TOPSIS: Iranian Experience

PubMed Central

Shafii, Milad; Hosseini, Seyed Mostafa; Arab, Mohammad; Asgharizadeh, Ezzatollah; Farzianpour, Fereshteh

2016-01-01

Background and Objectives: Hospitals are complex organizations that require strong and effective management. The success of such organizations depends on the performance of managers. This study provides a comprehensive set of indicators to assess the performance of hospital managers in Iranian Ministry of Health owned hospitals. Methods: This research was a cross-sectional study. First, reviewing the literature and using experts’ viewpoints and convening a panel of experts, the dimensions of performance have been selected and came in the form of a performance model. Then, using Fuzzy Analytic Hierarchy Process (FAHP), the chosen dimensions were weighted. Finally, based on the weighted performance dimensions, a questionnaire was designed and after confirming the reliability and validity, through a census, 407 senior and middle managers from 10 hospitals in Yazd, Iran completed it and performance of CEOs in these hospitals was evaluated using the Fuzzy Technique for Order Preference by Similarity Ideal Solution (FTOPSIS). Results: To measure the performance of hospital managers, a performance assessment model consisted of 19 sub-dimensions in 5 main dimensions (Functional, Professional, Organizational, Individual and Human) was developed. The functional area had the most weight and the individual area had the least weight, as well. The hospital managers had different performance levels in each category and sub-dimensions. In terms of overall performance, the hospital managers C and H had the best and the worst performance, respectively. Conclusions: The use of appropriate dimensions for performance, prioritizing them and evaluating the performance of hospital managers using appropriate techniques, can play an effective role in the selection of qualified managers, identifying strengths and weaknesses in performance and continuous improvement of them. PMID:26383216

Information retrieval and display system

NASA Technical Reports Server (NTRS)

Groover, J. L.; King, W. L.

1977-01-01

Versatile command-driven data management system offers users, through simplified command language, a means of storing and searching data files, sorting data files into specified orders, performing simple or complex computations, effecting file updates, and printing or displaying output data. Commands are simple to use and flexible enough to meet most data management requirements.

Adaptive capacity and community-based natural resource management.

PubMed

Armitage, Derek

2005-06-01

Why do some community-based natural resource management strategies perform better than others? Commons theorists have approached this question by developing institutional design principles to address collective choice situations, while other analysts have critiqued the underlying assumptions of community-based resource management. However, efforts to enhance community-based natural resource management performance also require an analysis of exogenous and endogenous variables that influence how social actors not only act collectively but do so in ways that respond to changing circumstances, foster learning, and build capacity for management adaptation. Drawing on examples from northern Canada and Southeast Asia, this article examines the relationship among adaptive capacity, community-based resource management performance, and the socio-institutional determinants of collective action, such as technical, financial, and legal constraints, and complex issues of politics, scale, knowledge, community and culture. An emphasis on adaptive capacity responds to a conceptual weakness in community-based natural resource management and highlights an emerging research and policy discourse that builds upon static design principles and the contested concepts in current management practice.

Deep Space Network equipment performance, reliability, and operations management information system

NASA Technical Reports Server (NTRS)

Cooper, T.; Lin, J.; Chatillon, M.

2002-01-01

The Deep Space Mission System (DSMS) Operations Program Office and the DeepSpace Network (DSN) facilities utilize the Discrepancy Reporting Management System (DRMS) to collect, process, communicate and manage data discrepancies, equipment resets, physical equipment status, and to maintain an internal Station Log. A collaborative effort development between JPL and the Canberra Deep Space Communication Complex delivered a system to support DSN Operations.

The value of information for woodland management: Updating a state–transition model

USGS Publications Warehouse

Morris, William K.; Runge, Michael C.; Vesk, Peter A.

2017-01-01

Value of information (VOI) analyses reveal the expected benefit of reducing uncertainty to a decision maker. Most ecological VOI analyses have focused on population models rarely addressing more complex community models. We performed a VOI analysis for a complex state–transition model of Box-Ironbark Forest and Woodland management. With three management alternatives (limited harvest/firewood removal (HF), ecological thinning (ET), and no management), managing the system optimally (for 150 yr) with the original information would, on average, increase the amount of forest in a desirable state from 19% to 35% (a 16-percentage point increase). Resolving all uncertainty would, on average, increase the final percentage to 42% (a 19-percentage point increase). However, only resolving the uncertainty for a single parameter was worth almost two-thirds the value of resolving all uncertainty. We found the VOI to depend on the number of management options, increasing as the management flexibility increased. Our analyses show it is more cost-effective to monitor low-density regrowth forest than other states and more cost-effective to experiment with the no-management alternative than the other management alternatives. Importantly, the most cost-effective strategies did not include either the most desired forest states or the least understood management strategy, ET. This implies that managers cannot just rely on intuition to tell them where the most VOI will lie, as critical uncertainties in a complex system are sometimes cryptic.

Radioactive Waste Management Complex low-level waste radiological performance assessment

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

Maheras, S.J.; Rood, A.S.; Magnuson, S.O.

This report documents the projected radiological dose impacts associated with the disposal of radioactive low-level waste at the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory. This radiological performance assessment was conducted to evaluate compliance with applicable radiological criteria of the US Department of Energy and the US Environmental Protection Agency for protection of the public and the environment. The calculations involved modeling the transport of radionuclides from buried waste, to surface soil and subsurface media, and eventually to members of the public via air, groundwater, and food chain pathways. Projections of doses were made for both offsitemore » receptors and individuals inadvertently intruding onto the site after closure. In addition, uncertainty and sensitivity analyses were performed. The results of the analyses indicate compliance with established radiological criteria and provide reasonable assurance that public health and safety will be protected.« less

Building on the EGIPPS performance assessment: the multipolar framework as a heuristic to tackle the complexity of performance of public service oriented health care organisations

PubMed Central

2014-01-01

Background Performance of health care systems is a key concern of policy makers and health service managers all over the world. It is also a major challenge, given its multidimensional nature that easily leads to conceptual and methodological confusion. This is reflected by a scarcity of models that comprehensively analyse health system performance. Discussion In health, one of the most comprehensive performance frameworks was developed by the team of Leggat and Sicotte. Their framework integrates 4 key organisational functions (goal attainment, production, adaptation to the environment, and values and culture) and the tensions between these functions. We modified this framework to better fit the assessment of the performance of health organisations in the public service domain and propose an analytical strategy that takes it into the social complexity of health organisations. The resulting multipolar performance framework (MPF) is a meta-framework that facilitates the analysis of the relations and interactions between the multiple actors that influence the performance of health organisations. Summary Using the MPF in a dynamic reiterative mode not only helps managers to identify the bottlenecks that hamper performance, but also the unintended effects and feedback loops that emerge. Similarly, it helps policymakers and programme managers at central level to better anticipate the potential results and side effects of and required conditions for health policies and programmes and to steer their implementation accordingly. PMID:24742181

Managing Scientific Software Complexity with Bocca and CCA

DOE PAGES

Allan, Benjamin A.; Norris, Boyana; Elwasif, Wael R.; ...

2008-01-01

In high-performance scientific software development, the emphasis is often on short time to first solution. Even when the development of new components mostly reuses existing components or libraries and only small amounts of new code must be created, dealing with the component glue code and software build processes to obtain complete applications is still tedious and error-prone. Component-based software meant to reduce complexity at the application level increases complexity to the extent that the user must learn and remember the interfaces and conventions of the component model itself. To address these needs, we introduce Bocca, the first tool to enablemore » application developers to perform rapid component prototyping while maintaining robust software-engineering practices suitable to HPC environments. Bocca provides project management and a comprehensive build environment for creating and managing applications composed of Common Component Architecture components. Of critical importance for high-performance computing (HPC) applications, Bocca is designed to operate in a language-agnostic way, simultaneously handling components written in any of the languages commonly used in scientific applications: C, C++, Fortran, Python and Java. Bocca automates the tasks related to the component glue code, freeing the user to focus on the scientific aspects of the application. Bocca embraces the philosophy pioneered by Ruby on Rails for web applications: start with something that works, and evolve it to the user's purpose.« less

Early decision framework for integrating sustainable risk management for complex remediation sites: Drivers, barriers, and performance metrics.

PubMed

Harclerode, Melissa A; Macbeth, Tamzen W; Miller, Michael E; Gurr, Christopher J; Myers, Teri S

2016-12-15

As the environmental remediation industry matures, remaining sites often have significant underlying technical challenges and financial constraints. More often than not, significant remediation efforts at these "complex" sites have not achieved stringent, promulgated cleanup goals. Decisions then have to be made about whether and how to commit additional resources towards achieving those goals, which are often not achievable nor required to protect receptors. Guidance on cleanup approaches focused on evaluating and managing site-specific conditions and risks, rather than uniformly meeting contaminant cleanup criteria in all media, is available to aid in this decision. Although these risk-based cleanup approaches, such as alternative endpoints and adaptive management strategies, have been developed, they are under-utilized due to environmental, socio-economic, and risk perception barriers. Also, these approaches are usually implemented late in the project life cycle after unsuccessful remedial attempts to achieve stringent cleanup criteria. In this article, we address these barriers by developing an early decision framework to identify if site characteristics support sustainable risk management, and develop performance metrics and tools to evaluate and implement successful risk-based cleanup approaches. In addition, we address uncertainty and risk perception challenges by aligning risk-based cleanup approaches with the concepts of risk management and sustainable remediation. This approach was developed in the context of lessons learned from implementing remediation at complex sites, but as a framework can, and should, be applied to all sites undergoing remediation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quality Management and Key Performance Indicators in Oncologic Esophageal Surgery.

PubMed

Gockel, Ines; Ahlbrand, Constantin Johannes; Arras, Michael; Schreiber, Elke Maria; Lang, Hauke

2015-12-01

Ranking systems and comparisons of quality and performance indicators will be of increasing relevance for complex "high-risk" procedures such as esophageal cancer surgery. The identification of evidence-based standards relevant for key performance indicators in esophageal surgery is essential for establishing monitoring systems and furthermore a requirement to enhance treatment quality. In the course of this review, we analyze the key performance indicators case volume, radicality of resection, and postoperative morbidity and mortality, leading to continuous quality improvement. Ranking systems established on this basis will gain increased relevance in highly complex procedures within the national and international comparison and furthermore improve the treatment of patients with esophageal carcinoma.

Usefulness of 64-detector computed tomography in the diagnosis and management of patients with congenital heart disease.

PubMed

Bret-Zurita, Montserrat; Cuesta, Emilio; Cartón, Antonio; Díez, Jesús; Aroca, Ángel; Oliver, José M; Gutiérrez-Larraya, Federico

2014-11-01

Although congenital heart defects are the most common major congenital abnormalities, the associated mortality has been decreasing due to improvements in their diagnosis and treatment. We assessed the usefulness of 64-multidetector computed tomography in the diagnosis and management of these patients. This 5-year observational, analytical, retrospective, cohort study included a total of 222 tomographic studies of patients with congenital heart disease. Computed tomography scans were read twice and medical records were reviewed. We assessed the complexity of the disease, patient, and radiological technique, and evaluated the contribution of new data in relation to clinical suspicion and diagnostic change. A confidence interval was set at 95% and a P value of<.05 was used as the cutoff for statistical significance. In 35.1% of patients, the treatment procedure was performed after computed tomography without other tests. Additional diagnostic catheterization was performed in 12.5% of patients. There were new findings in 77% of patients (82.9% with complex disease), which prompted a change in patient management in 35.6%. All unexpected reports described new findings. No significant differences were found by age, sex, study period, urgency of the test order, patient complexity, or difficulty of the technique. Use of 64-detector computed tomography yields good diagnostic performance in congenital heart disease, prompts changes in management in more than one-third of patients, and reveals new findings in relation to the presumed diagnosis in 77% of patients. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Complexity Management Using Metrics for Trajectory Flexibility Preservation and Constraint Minimization

NASA Technical Reports Server (NTRS)

Idris, Husni; Shen, Ni; Wing, David J.

2011-01-01

The growing demand for air travel is increasing the need for mitigating air traffic congestion and complexity problems, which are already at high levels. At the same time new surveillance, navigation, and communication technologies are enabling major transformations in the air traffic management system, including net-based information sharing and collaboration, performance-based access to airspace resources, and trajectory-based rather than clearance-based operations. The new system will feature different schemes for allocating tasks and responsibilities between the ground and airborne agents and between the human and automation, with potential capacity and cost benefits. Therefore, complexity management requires new metrics and methods that can support these new schemes. This paper presents metrics and methods for preserving trajectory flexibility that have been proposed to support a trajectory-based approach for complexity management by airborne or ground-based systems. It presents extensions to these metrics as well as to the initial research conducted to investigate the hypothesis that using these metrics to guide user and service provider actions will naturally mitigate traffic complexity. The analysis showed promising results in that: (1) Trajectory flexibility preservation mitigated traffic complexity as indicated by inducing self-organization in the traffic patterns and lowering traffic complexity indicators such as dynamic density and traffic entropy. (2)Trajectory flexibility preservation reduced the potential for secondary conflicts in separation assurance. (3) Trajectory flexibility metrics showed potential application to support user and service provider negotiations for minimizing the constraints imposed on trajectories without jeopardizing their objectives.

Dynamics of safety performance and culture: a group model building approach.

PubMed

Goh, Yang Miang; Love, Peter E D; Stagbouer, Greg; Annesley, Chris

2012-09-01

The management of occupational health and safety (OHS) including safety culture interventions is comprised of complex problems that are often hard to scope and define. Due to the dynamic nature and complexity of OHS management, the concept of system dynamics (SD) is used to analyze accident prevention. In this paper, a system dynamics group model building (GMB) approach is used to create a causal loop diagram of the underlying factors influencing the OHS performance of a major drilling and mining contractor in Australia. While the organization has invested considerable resources into OHS their disabling injury frequency rate (DIFR) has not been decreasing. With this in mind, rich individualistic knowledge about the dynamics influencing the DIFR was acquired from experienced employees with operations, health and safety and training background using a GMB workshop. Findings derived from the workshop were used to develop a series of causal loop diagrams that includes a wide range of dynamics that can assist in better understanding the causal influences OHS performance. The causal loop diagram provides a tool for organizations to hypothesize the dynamics influencing effectiveness of OHS management, particularly the impact on DIFR. In addition the paper demonstrates that the SD GMB approach has significant potential in understanding and improving OHS management. Copyright © 2011 Elsevier Ltd. All rights reserved.

Web Exclusive--Is the Sky the Limit to Educational Improvement?

ERIC Educational Resources Information Center

Schleicher, Andreas

2012-01-01

Today, education systems need to enable people to become lifelong learners, to manage complex ways of thinking and complex ways of working that computers can't take over easily. The task for educators and policy makers is to ensure that countries rise to this challenge. High performing education systems like Finland's and Singapore's tend to…

Cooperating Expert Systems For Space Station Power Distribution Management

NASA Astrophysics Data System (ADS)

Nguyen, T. A.; Chiou, W. C.

1987-02-01

In a complex system such as the manned Space Station, it is deem necessary that many expert systems must perform tasks in a concurrent and cooperative manner. An important question arise is: what cooperative-task-performing models are appropriate for multiple expert systems to jointly perform tasks. The solution to this question will provide a crucial automation design criteria for the Space Station complex systems architecture. Based on a client/server model for performing tasks, we have developed a system that acts as a front-end to support loosely-coupled communications between expert systems running on multiple Symbolics machines. As an example, we use two ART*-based expert systems to demonstrate the concept of parallel symbolic manipulation for power distribution management and dynamic load planner/scheduler in the simulated Space Station environment. This on-going work will also explore other cooperative-task-performing models as alternatives which can evaluate inter and intra expert system communication mechanisms. It will be served as a testbed and a bench-marking tool for other Space Station expert subsystem communication and information exchange.

Bronchoscopic Treatment in the Management of Benign Tracheal Stenosis: Choices for Simple and Complex Tracheal Stenosis.

PubMed

Dalar, Levent; Karasulu, Levent; Abul, Yasin; Özdemir, Cengiz; Sökücü, Sinem Nedime; Tarhan, Merve; Altin, Sedat

2016-04-01

Bronchoscopic treatment is 1 of the treatment choices for both palliative and definitive treatment of benign tracheal stenosis. There is no consensus on the management of these patients, however, especially patients having complex stenoses. The aim of the present study was to assess, in the largest group of patients with complex stenoses yet reported, which types of tracheal stenosis are amenable to optimal management by bronchoscopic treatment. The present study was a retrospective cohort study including 132 consecutive patients with benign tracheal stenoses diagnosed between August 2005 and January 2013. The mean age of the study population was 52 ± 18 years; 62 (47%) were women and 70 (53%) were men. Their lesions were classified as simple and complex stenoses. Simple stenoses (n = 6) were treated with 12 rigid and flexible bronchoscopic procedures (mean of 2 per patient); 5 stents were placed. The total success rate was 100%. Among the 124 complex stenoses, 4 were treated directly with surgical intervention. In total, 481 rigid and 487 flexible bronchoscopic procedures were performed in these patients. In this group, the success rate was 69.8%. From the present study, we propose that after accurate classification, interventional bronchoscopic management may have an important role in the treatment of benign tracheal stenosis. Bronchoscopic treatment should be considered as first-line therapy for simple stenoses, whereas complex stenoses need a multidisciplinary approach and often require surgical intervention. However, bronchoscopic treatment may be a valid conservative approach in the management of patients with complex tracheal stenosis who are not eligible for operative treatment. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

A review of human factors challenges of complex adaptive systems: discovering and understanding chaos in human performance.

PubMed

Karwowski, Waldemar

2012-12-01

In this paper, the author explores a need for a greater understanding of the true nature of human-system interactions from the perspective of the theory of complex adaptive systems, including the essence of complexity, emergent properties of system behavior, nonlinear systems dynamics, and deterministic chaos. Human performance, more often than not, constitutes complex adaptive phenomena with emergent properties that exhibit nonlinear dynamical (chaotic) behaviors. The complexity challenges in the design and management of contemporary work systems, including service systems, are explored. Examples of selected applications of the concepts of nonlinear dynamics to the study of human physical performance are provided. Understanding and applications of the concepts of theory of complex adaptive and dynamical systems should significantly improve the effectiveness of human-centered design efforts of a large system of systems. Performance of many contemporary work systems and environments may be sensitive to the initial conditions and may exhibit dynamic nonlinear properties and chaotic system behaviors. Human-centered design of emergent human-system interactions requires application of the theories of nonlinear dynamics and complex adaptive system. The success of future human-systems integration efforts requires the fusion of paradigms, knowledge, design principles, and methodologies of human factors and ergonomics with those of the science of complex adaptive systems as well as modern systems engineering.

Role of robotics in managing mesh and suture complications of prior pelvic organ prolapse surgery.

PubMed

Wilkinson, Michael N; O'Sullivan, Orfhlaith E; O'Reilly, Barry A

2017-03-01

Robotic surgery is proving essential in providing a minimally invasive approach to complex urogynaecological cases. This video highlights the diversity and complexity of cases performed using the robot-assisted approach. The robot-assisted approach was utilised for excellent effect in two complex urogynaecological cases. In the first case the entire left arm of an intravesically placed TVT was removed using a combined vaginal and robotic approach. The second case involved removing four paravaginal sutures, one of which breeched the bladder and was encrusted with calculus. These were placed during a laparoscopic paravaginal repair 2 years previously. She had a concomitant vaginal hysterectomy, Mc Calls culdoplasty and anterior wall repair. The robot-assisted approach allows for excellent access to the pelvis and retropubic space facilitating the surgical management of complex urogynaecology cases.

Surgical management of congenital heart disease: contribution of the Aristotle complexity score to planning and budgeting in the German diagnosis-related groups system.

PubMed

Sinzobahamvya, Nicodème; Photiadis, Joachim; Kopp, Thorsten; Arenz, Claudia; Haun, Christoph; Schindler, Ehrenfried; Hraska, Viktor; Asfour, Boulos

2012-01-01

Planning and budgeting for congenital heart surgery depend primarily on how closely reimbursement matches costs and on the number and complexity of the surgical procedures. Aristotle complexity scores for the year 2010 were correlated with hospital costs and with reimbursement according to the German diagnosis-related groups (DRG) system. Unit surgical performance was estimated as surgical performance (complexity score × hospital survival) times the number of primary procedures. This study investigated how this performance evolved during years 2006 to 2010. Hospital costs and reimbursements correlated highly with Aristotle comprehensive complexity levels (Spearman r = 1). Mean costs and reimbursement reached 35,050 ± 32,665 and 31,283 ± 34,732, respectively, for an underfunding of 10.7%. Basic and comprehensive unit surgical performances were respectively 3036 ± 1009 and 3891 ± 1591 points in 2006. Both performances increased in sigmoid fashion to reach 3883 ± 1344 and 5335 ± 1314 points, respectively, in 2010. Top performances would be achieved in year 2011, and extrapolated costs would comprise about 19,434,094.92 (95% confidence interval, 11,961,491.22-22,495,764.42). The current underfunding of congenital heart surgery needs correction. The Aristotle score can help to adjust reimbursement according to complexity of procedures. Unit surgical performance allows accurate budgeting in the current German DRG system.

Are our dynamic water quality models too complex? A comparison of a new parsimonious phosphorus model, SimplyP, and INCA-P

NASA Astrophysics Data System (ADS)

Jackson-Blake, L. A.; Sample, J. E.; Wade, A. J.; Helliwell, R. C.; Skeffington, R. A.

2017-07-01

Catchment-scale water quality models are increasingly popular tools for exploring the potential effects of land management, land use change and climate change on water quality. However, the dynamic, catchment-scale nutrient models in common usage are complex, with many uncertain parameters requiring calibration, limiting their usability and robustness. A key question is whether this complexity is justified. To explore this, we developed a parsimonious phosphorus model, SimplyP, incorporating a rainfall-runoff model and a biogeochemical model able to simulate daily streamflow, suspended sediment, and particulate and dissolved phosphorus dynamics. The model's complexity was compared to one popular nutrient model, INCA-P, and the performance of the two models was compared in a small rural catchment in northeast Scotland. For three land use classes, less than six SimplyP parameters must be determined through calibration, the rest may be based on measurements, while INCA-P has around 40 unmeasurable parameters. Despite substantially simpler process-representation, SimplyP performed comparably to INCA-P in both calibration and validation and produced similar long-term projections in response to changes in land management. Results support the hypothesis that INCA-P is overly complex for the study catchment. We hope our findings will help prompt wider model comparison exercises, as well as debate among the water quality modeling community as to whether today's models are fit for purpose. Simpler models such as SimplyP have the potential to be useful management and research tools, building blocks for future model development (prototype code is freely available), or benchmarks against which more complex models could be evaluated.

An Integrated Approach Is Needed for Ecosystem Based Fisheries Management: Insights from Ecosystem-Level Management Strategy Evaluation

PubMed Central

Fulton, Elizabeth A.; Smith, Anthony D. M.; Smith, David C.; Johnson, Penelope

2014-01-01

An ecosystem approach is widely seen as a desirable goal for fisheries management but there is little consensus on what strategies or measures are needed to achieve it. Management strategy evaluation (MSE) is a tool that has been widely used to develop and test single species fisheries management strategies and is now being extended to support ecosystem based fisheries management (EBFM). We describe the application of MSE to investigate alternative strategies for achieving EBFM goals for a complex multispecies fishery in southeastern Australia. The study was undertaken as part of a stakeholder driven process to review and improve the ecological, economic and social performance of the fishery. An integrated management strategy, involving combinations of measures including quotas, gear controls and spatial management, performed best against a wide range of objectives and this strategy was subsequently adopted in the fishery, leading to marked improvements in performance. Although particular to one fishery, the conclusion that an integrated package of measures outperforms single focus measures we argue is likely to apply widely in fisheries that aim to achieve EBFM goals. PMID:24454722

Narrative Balance Management in an Intelligent Biosafety Training Application for Improving User Performance

ERIC Educational Resources Information Center

Alvarez, Nahum; Sanchez-Ruiz, Antonio; Cavazza, Marc; Shigematsu, Mika; Prendinger, Helmut

2015-01-01

The use of three-dimensional virtual environments in training applications supports the simulation of complex scenarios and realistic object behaviour. While these environments have the potential to provide an advanced training experience to students, it is difficult to design and manage a training session in real time due to the number of…

The Management of Change and Improvement in Academic Library Performance.

ERIC Educational Resources Information Center

Webster, Duane

As academic libraries increase in size and become more complex, their organization tends to become more bureaucratic in nature and resistant to change. This paper describes a range of both internal and external strategies which have been used to introduce constructive change into the management of academic libraries in North America and the major…

The relationship between energy information management and energy management performance in higher education sector in Thailand, considering from resource and process based views

NASA Astrophysics Data System (ADS)

Mongkolsawat, Darunee

The performance of energy management is usually considered through the energy reduction result however this does not sufficient for managing facility's energy in the long term. In combination to that, this study decides to investigate the relationship between the effectiveness of energy information management and the energy management performance. The interested sector is higher education institutions in Thailand due to their complex organisation both in management and property aspects. By not focusing on quantitative energy reduction as centre, the study seeks to establish a framework or tool in helping to understand such relationship qualitatively through organisation resource and process based view. Additionally, energy management structure is also accounted as initial factor. In relation to such framework, the performance of energy management is considered on its primary results concerning the issues of the data available, analysis results, and energy action. After the investigation, it is found that between the concerned factors and primary performance there are various specific relationships. For example, some tend to have direct connections as relations between the energy management structure and implemented actions, and between the investment in organisation resources and data available. While some have flexible relations as between data collection and results of analysed data. Furthermore, the load of energy management has been found influencing on organisation's motivation to invest in energy management. At the end of the paper, further application to the study is also proposed.

Process mining is an underutilized clinical research tool in transfusion medicine.

PubMed

Quinn, Jason G; Conrad, David M; Cheng, Calvino K

2017-03-01

To understand inventory performance, transfusion services commonly use key performance indicators (KPIs) as summary descriptors of inventory efficiency that are graphed, trended, and used to benchmark institutions. Here, we summarize current limitations in KPI-based evaluation of blood bank inventory efficiency and propose process mining as an ideal methodology for application to inventory management research to improve inventory flows and performance. The transit of a blood product from inventory receipt to final disposition is complex and relates to many internal and external influences, and KPIs may be inadequate to fully understand the complexity of the blood supply chain and how units interact with its processes. Process mining lends itself well to analysis of blood bank inventories, and modern laboratory information systems can track nearly all of the complex processes that occur in the blood bank. Process mining is an analytical tool already used in other industries and can be applied to blood bank inventory management and research through laboratory information systems data using commercial applications. Although the current understanding of real blood bank inventories is value-centric through KPIs, it potentially can be understood from a process-centric lens using process mining. © 2017 AABB.

Confronting uncertainty in wildlife management: performance of grizzly bear management.

PubMed

Artelle, Kyle A; Anderson, Sean C; Cooper, Andrew B; Paquet, Paul C; Reynolds, John D; Darimont, Chris T

2013-01-01

Scientific management of wildlife requires confronting the complexities of natural and social systems. Uncertainty poses a central problem. Whereas the importance of considering uncertainty has been widely discussed, studies of the effects of unaddressed uncertainty on real management systems have been rare. We examined the effects of outcome uncertainty and components of biological uncertainty on hunt management performance, illustrated with grizzly bears (Ursus arctos horribilis) in British Columbia, Canada. We found that both forms of uncertainty can have serious impacts on management performance. Outcome uncertainty alone--discrepancy between expected and realized mortality levels--led to excess mortality in 19% of cases (population-years) examined. Accounting for uncertainty around estimated biological parameters (i.e., biological uncertainty) revealed that excess mortality might have occurred in up to 70% of cases. We offer a general method for identifying targets for exploited species that incorporates uncertainty and maintains the probability of exceeding mortality limits below specified thresholds. Setting targets in our focal system using this method at thresholds of 25% and 5% probability of overmortality would require average target mortality reductions of 47% and 81%, respectively. Application of our transparent and generalizable framework to this or other systems could improve management performance in the presence of uncertainty.

Human resource management practices in a medical complex in the Eastern Cape, South Africa: assessing their impact on the retention of doctors.

PubMed

Longmore, Bruce; Ronnie, Linda

2014-03-26

Human resource management (HRM) practices have the potential to influence the retention of doctors in the public health sector. To explore the key human resource (HR) practices affecting doctors in a medical complex in the Eastern Cape, South Africa. We used an open-ended questionnaire to gather data from 75 doctors in this setting. The most important HR practices were paying salaries on time and accurately, the management of documentation, communication, HR staff showing that they respected and valued the doctors, and reimbursement for conferences and special leave requests. All these practices were judged to be poorly administered. Essential HR characteristics were ranked in the following order: task competence of HR staff, accountability, general HR efficiency, occupation-specific dispensation adjustments and performance management and development system efficiency, and availability of HR staff. All these characteristics were judged to be poor. HRM practices in this Eastern Cape medical complex were inadequate and a source of frustration. This lack of efficiency could lead to further problems with regard to retaining doctors in public sector service.

Systems Engineering and Integration for Advanced Life Support System and HST

NASA Technical Reports Server (NTRS)

Kamarani, Ali K.

2005-01-01

Systems engineering (SE) discipline has revolutionized the way engineers and managers think about solving issues related to design of complex systems: With continued development of state-of-the-art technologies, systems are becoming more complex and therefore, a systematic approach is essential to control and manage their integrated design and development. This complexity is driven from integration issues. In this case, subsystems must interact with one another in order to achieve integration objectives, and also achieve the overall system's required performance. Systems engineering process addresses these issues at multiple levels. It is a technology and management process dedicated to controlling all aspects of system life cycle to assure integration at all levels. The Advanced Integration Matrix (AIM) project serves as the systems engineering and integration function for the Human Support Technology (HST) program. AIM provides means for integrated test facilities and personnel for performance trade studies, analyses, integrated models, test results, and validated requirements of the integration of HST. The goal of AIM is to address systems-level integration issues for exploration missions. It will use an incremental systems integration approach to yield technologies, baselines for further development, and possible breakthrough concepts in the areas of technological and organizational interfaces, total information flow, system wide controls, technical synergism, mission operations protocols and procedures, and human-machine interfaces.

Employee performance in the knowledge economy: Capturing the keys to success

PubMed Central

Fauth, Rebecca; Bevan, Stephen; Mills, Peter

2009-01-01

The present study examines the key determinants of employee performance in a knowledge-intensive service firm located in the UK. Using data from a pilot study, we mapped eight performance-related behaviors to two measures of global performance to isolate the strongest predictors of the latter. We also examined the degree to which these associations varied depending on whether employees or their managers reported on performance as well as according to the degree of complexity (eg, ongoing learning, multitasking, problem solving, etc.) present in workers’ jobs. Findings revealed that more traditional employee performance-related behaviors (eg, dependability) as well as behaviors that have likely increased in importance in the knowledge economy (eg, sharing ideas and information) accounted for the most variance in reported global performance. Sharing ideas and information was a particularly important predictor for workers in complex jobs. When the performance-related behaviors were regressed on the organization’s annual employee appraisal ratings, only dependability and time management behaviors were significantly associated with the outcome. As organizational success increasingly is dependent on intangible inputs stemming from the ideas, innovations and creativity of its workforce, organizations need to ensure that they are capturing the full range of behaviors that help to define their success. Further research with a diverse range of organizations will help define this further. PMID:22110316

Older Patients’ Perspectives on Managing Complexity in CKD Self-Management

PubMed Central

Vandenberg, Ann E.; Phillips, Lawrence S.; McClellan, William M.; Johnson, Theodore M.; Echt, Katharina V.

2017-01-01

Background and objectives Patients with CKD are asked to perform self-management tasks including dietary changes, adhering to medications, avoiding nephrotoxic drugs, and self-monitoring hypertension and diabetes. Given the effect of aging on functional capacity, self-management may be especially challenging for older patients. However, little is known about the specific challenges older adults face maintaining CKD self-management regimens. Design, setting, participants, & measurements We conducted an exploratory qualitative study designed to understand the relationship among factors facilitating or impeding CKD self-management in older adults. Six focus groups (n=30) were held in August and September of 2014 with veterans≥70 years old with moderate-to-severe CKD receiving nephrology care at the Atlanta Veterans Affairs Medical Center. Grounded theory with a constant comparative method was used to collect, code, and analyze data. Results Participants had a mean age (range) of 75.1 (70.1–90.7) years, 60% were black, and 96.7% were men. The central organizing concept that emerged from these data were managing complexity. Participants typically did not have just one chronic condition, CKD, but a number of commonly co-occurring conditions. Recommendations for CKD self-management therefore occurred within a complex regimen of recommendations for managing other diseases. Participants identified overtly discordant treatment recommendations across chronic conditions (e.g., arthritis and CKD). Prioritization emerged as one effective strategy for managing complexity (e.g., focusing on BP control). Some patients arrived at the conclusion that they could group concordant recommendations to simplify their regimens (e.g., protein restriction for both gout and CKD). Conclusions Among older veterans with moderate-to-severe CKD, multimorbidity presents a major challenge for CKD self-management. Because virtually all older adults with CKD have multimorbidity, an integrated treatment approach that supports self-management across commonly occurring conditions may be necessary to meet the needs of these patients. PMID:28389529

Older Patients' Perspectives on Managing Complexity in CKD Self-Management.

PubMed

Bowling, C Barrett; Vandenberg, Ann E; Phillips, Lawrence S; McClellan, William M; Johnson, Theodore M; Echt, Katharina V

2017-04-03

Patients with CKD are asked to perform self-management tasks including dietary changes, adhering to medications, avoiding nephrotoxic drugs, and self-monitoring hypertension and diabetes. Given the effect of aging on functional capacity, self-management may be especially challenging for older patients. However, little is known about the specific challenges older adults face maintaining CKD self-management regimens. We conducted an exploratory qualitative study designed to understand the relationship among factors facilitating or impeding CKD self-management in older adults. Six focus groups ( n =30) were held in August and September of 2014 with veterans≥70 years old with moderate-to-severe CKD receiving nephrology care at the Atlanta Veterans Affairs Medical Center. Grounded theory with a constant comparative method was used to collect, code, and analyze data. Participants had a mean age (range) of 75.1 (70.1-90.7) years, 60% were black, and 96.7% were men. The central organizing concept that emerged from these data were managing complexity. Participants typically did not have just one chronic condition, CKD, but a number of commonly co-occurring conditions. Recommendations for CKD self-management therefore occurred within a complex regimen of recommendations for managing other diseases. Participants identified overtly discordant treatment recommendations across chronic conditions ( e.g., arthritis and CKD). Prioritization emerged as one effective strategy for managing complexity ( e.g. , focusing on BP control). Some patients arrived at the conclusion that they could group concordant recommendations to simplify their regimens ( e.g. , protein restriction for both gout and CKD). Among older veterans with moderate-to-severe CKD, multimorbidity presents a major challenge for CKD self-management. Because virtually all older adults with CKD have multimorbidity, an integrated treatment approach that supports self-management across commonly occurring conditions may be necessary to meet the needs of these patients. Copyright © 2017 by the American Society of Nephrology.

Study of the Performance of Faculty Members According to Talent Management Approach in Higher Education

ERIC Educational Resources Information Center

Moghtadaie, Leila; Taji, Maryam

2016-01-01

Nowadays, the success of any organization depends on the shaping of policies tailored to the needs of human resources; otherwise, it will lose the ability to adapt to today's complex environment and the ability to use the effectiveness of human resources. For this reason, Talent Management can help to attract, nurture and develop the next…

Information Dynamics as Foundation for Network Management

DTIC Science & Technology

2014-12-04

developed to adapt to channel dynamics in a mobile network environment. We devise a low- complexity online scheduling algorithm integrated with the...has been accepted for the Journal on Network and Systems Management in 2014. - RINC programmable platform for Infrastructure -as-a-Service public... backend servers. Rather than implementing load balancing in dedicated appliances, commodity SDN switches can perform this function. We design

Exploring managers' views on span of control: more than a headcount.

PubMed

Wong, Carol A; Elliott-Miller, Pat; Laschinger, Heather; Cuddihy, Michael; Meyer, Raquel M; Keatings, Margaret; Burnett, Camille; Szudy, Natalie

2014-03-01

The purpose of this qualitative study was to explore front-line managers' (FLMs') perceptions of their span of control (SOC) and how they manage it. As part of a larger quantitative study examining relationships between FLMs' SOC and performance outcomes, 10 manager focus groups were conducted by teleconference, involving 48 managers from 14 academic healthcare organizations. Themes and subthemes were identified according to (a) perceptions of the size and scope of SOC; (b) factors influencing the complexity of SOC; (c) supports needed to manage SOC; (d) changing leadership style; and (e) ways of coping with role overload. Participants described system demands as a significant contributor to their work responsibilities and a sense of role overload. About half of managers stated their SOC was unreasonable and that they lacked the necessary supports to manage it. Many managers who described their SOC as reasonable still expressed concerns about internal and external workload pressures that contributed to changing leadership style and role overload. Findings reinforce the importance of organizational strategies to create regular dialogue with FLMs regarding the size, complexity and appropriateness of current spans and to provide the resource supports necessary to ensure they can manage their SOC effectively.

Alternatives to relational databases in precision medicine: Comparison of NoSQL approaches for big data storage using supercomputers

NASA Astrophysics Data System (ADS)

Velazquez, Enrique Israel

Improvements in medical and genomic technologies have dramatically increased the production of electronic data over the last decade. As a result, data management is rapidly becoming a major determinant, and urgent challenge, for the development of Precision Medicine. Although successful data management is achievable using Relational Database Management Systems (RDBMS), exponential data growth is a significant contributor to failure scenarios. Growing amounts of data can also be observed in other sectors, such as economics and business, which, together with the previous facts, suggests that alternate database approaches (NoSQL) may soon be required for efficient storage and management of big databases. However, this hypothesis has been difficult to test in the Precision Medicine field since alternate database architectures are complex to assess and means to integrate heterogeneous electronic health records (EHR) with dynamic genomic data are not easily available. In this dissertation, we present a novel set of experiments for identifying NoSQL database approaches that enable effective data storage and management in Precision Medicine using patients' clinical and genomic information from the cancer genome atlas (TCGA). The first experiment draws on performance and scalability from biologically meaningful queries with differing complexity and database sizes. The second experiment measures performance and scalability in database updates without schema changes. The third experiment assesses performance and scalability in database updates with schema modifications due dynamic data. We have identified two NoSQL approach, based on Cassandra and Redis, which seems to be the ideal database management systems for our precision medicine queries in terms of performance and scalability. We present NoSQL approaches and show how they can be used to manage clinical and genomic big data. Our research is relevant to the public health since we are focusing on one of the main challenges to the development of Precision Medicine and, consequently, investigating a potential solution to the progressively increasing demands on health care.

Cyber Fighter Associate

DTIC Science & Technology

2016-01-01

accomplish a patch- management mission while securing a critical path. As a first proof of concept a simulation with a network of 10 nodes and 4...software-agility walk of the “PERFORMANCE Each Threat Managed ” tree is slightly more complex than the network -agility walk. The original design of the...CyFiA was tested to accomplish a patch- management mission while securing a critical path. As a first proof of concept a simulation with a network of 10

Service quality and maturity of health care organizations through the lens of Complexity Leadership Theory.

PubMed

Horvat, Ana; Filipovic, Jovan

2018-02-01

This research focuses on Complexity Leadership Theory and the relationship between leadership-examined through the lens of Complexity Leadership Theory-and organizational maturity as an indicator of the performance of health organizations. The research adopts a perspective that conceptualizes organizations as complex adaptive systems and draws upon a survey of opinion of 189 managers working in Serbian health organizations. As the results indicate a dependency between functions of leadership and levels of the maturity of health organizations, we propose a model that connects the two. The study broadens our understanding of the implications of complexity thinking and its reflection on leadership functions and overall organizational performance. The correlations between leadership functions and maturity could have practical applications in policy processing, thus improving the quality of outcomes and the overall level of service quality. © 2017 John Wiley & Sons, Ltd.

GP pain management: what are the 'Ps' and 'As' of pain management?

PubMed

Wan, Aston

2014-08-01

Pain is one common reason for clinical encounters in primary care. The complex nature of chronic pain syndromes can make assessment and management daunting at times. This article presents an easy scheme to help general practitioners efficiently assess, manage and review/follow up patients with chronic pain. The mnemonic presented for assessment is the '4Ps' (pain, other pathology/past medical history, performance/function and psychological/psychiatric status). For management, we can also use '4Ps' (physical, psychological, pharmacological and procedural) and for review there are the '6As' (activities, analgesia, adverse effects, aberrance behaviours, affects and adequate documentation).

Findings from an Organizational Network Analysis to Support Local Public Health Management

PubMed Central

Caldwell, Michael; Rockoff, Maxine L.; Gebbie, Kristine; Carley, Kathleen M.; Bakken, Suzanne

2008-01-01

We assessed the feasibility of using organizational network analysis in a local public health organization. The research setting was an urban/suburban county health department with 156 employees. The goal of the research was to study communication and information flow in the department and to assess the technique for public health management. Network data were derived from survey questionnaires. Computational analysis was performed with the Organizational Risk Analyzer. Analysis revealed centralized communication, limited interdependencies, potential knowledge loss through retirement, and possible informational silos. The findings suggested opportunities for more cross program coordination but also suggested the presences of potentially efficient communication paths and potentially beneficial social connectedness. Managers found the findings useful to support decision making. Public health organizations must be effective in an increasingly complex environment. Network analysis can help build public health capacity for complex system management. PMID:18481183

A Project Manager’s Personal Attributes as Predictors for Success

DTIC Science & Technology

2007-03-01

Northouse (2004) explains that leadership is highly a researched topic with much written. Yet, a definitive description of this phenomenon is difficult to...express because of its complexity. Even though leadership has varied descriptions and conceptualizations, Northouse states that the concept of...characteristic of leadership is not an accurate predictor of performance. Leadership is a complex, multi-faceted attribute ( Northouse , 2004) and specific

Practice variability in the management of complex febrile seizures by pediatric emergency physicians and fellows.

PubMed

Sales, Justin W; Bulloch, Blake; Hostetler, Mark A

2011-05-01

Febrile seizures are the most common type of childhood seizure and are categorized as simple or complex. Complex febrile seizures (CFSs) are defined as events that are focal, prolonged (> 15 minutes), or recurrent. The management of CFS is poorly defined. The objective of this study was to determine the degree of variability in the emergency department evaluation of children with CFSs. An online survey questionnaire was developed and sent to physicians identified via the listserv of the emergency medicine section of the American Academy of Pediatrics and the pediatric emergency medicine discussion list. The questionnaire consisted of five hypothetical case vignettes describing children under 5 years of age presenting with a CFS. Following review of the first four vignettes, participants were asked if they would (1) obtain blood and urine for evaluation; (2) perform a lumbar puncture; (3) perform neurologic imaging while the child was in the emergency department; (4) admit the child to the hospital; or (5) discharge with follow-up as an outpatient, with either the primary care provider or a neurologist. The final vignette determined if antiepileptic medication would be prescribed by the physician on discharge. Of the 353 physicians who participated, 293 (83%) were pediatric emergency medicine attending physicians and 60 (17%) were pediatric emergency medicine fellows. Overall, 54% of participants indicated that they would obtain blood for evaluation, 62% would obtain urine, 34% would perform a lumbar puncture, and 36% would perform neurologic imaging. The overall hypothetical admission rate for the case vignettes was 42%. This study indicates that extensive variability exists in the emergency department approach to patients with CFS. Our findings suggest that optimal management for CFS remains unclear and support the potential benefit of future prospective studies on this subject.

Rigid bronchoscopy and silicone stents in the management of central airway obstruction

PubMed Central

Yarmus, Lonny

2015-01-01

The field of interventional pulmonology has grown significantly over the past several decades now including the diagnosis and therapeutic treatment of complex airway disease. Rigid bronchoscopy is an invaluable tool in the diagnosis and management of several malignant and non-malignant causes of central airway obstruction (CAO) and has become integral after the inception of airway stenting. The management of CAO can be a complicated endeavor with significant risks making the understanding of basic rigid bronchoscopy techniques, ablative technologies, anesthetic care and stenting of utmost importance in the care of these complex patients. This review article will focus on the history of rigid bronchoscopy, the technical aspects of performing a rigid bronchoscopy as well as the use of silicone stents their indications, complications and placement techniques. PMID:26807283

FRIEDA: Flexible Robust Intelligent Elastic Data Management Framework

DOE PAGES

Ghoshal, Devarshi; Hendrix, Valerie; Fox, William; ...

2017-02-01

Scientific applications are increasingly using cloud resources for their data analysis workflows. However, managing data effectively and efficiently over these cloud resources is challenging due to the myriad storage choices with different performance, cost trade-offs, complex application choices and complexity associated with elasticity, failure rates in these environments. The different data access patterns for data-intensive scientific applications require a more flexible and robust data management solution than the ones currently in existence. FRIEDA is a Flexible Robust Intelligent Elastic Data Management framework that employs a range of data management strategies in cloud environments. FRIEDA can manage storage and data lifecyclemore » of applications in cloud environments. There are four different stages in the data management lifecycle of FRIEDA – (i) storage planning, (ii) provisioning and preparation, (iii) data placement, and (iv) execution. FRIEDA defines a data control plane and an execution plane. The data control plane defines the data partition and distribution strategy, whereas the execution plane manages the execution of the application using a master-worker paradigm. FRIEDA also provides different data management strategies, either to partition the data in real-time, or predetermine the data partitions prior to application execution.« less

FRIEDA: Flexible Robust Intelligent Elastic Data Management Framework

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

Ghoshal, Devarshi; Hendrix, Valerie; Fox, William

Scientific applications are increasingly using cloud resources for their data analysis workflows. However, managing data effectively and efficiently over these cloud resources is challenging due to the myriad storage choices with different performance, cost trade-offs, complex application choices and complexity associated with elasticity, failure rates in these environments. The different data access patterns for data-intensive scientific applications require a more flexible and robust data management solution than the ones currently in existence. FRIEDA is a Flexible Robust Intelligent Elastic Data Management framework that employs a range of data management strategies in cloud environments. FRIEDA can manage storage and data lifecyclemore » of applications in cloud environments. There are four different stages in the data management lifecycle of FRIEDA – (i) storage planning, (ii) provisioning and preparation, (iii) data placement, and (iv) execution. FRIEDA defines a data control plane and an execution plane. The data control plane defines the data partition and distribution strategy, whereas the execution plane manages the execution of the application using a master-worker paradigm. FRIEDA also provides different data management strategies, either to partition the data in real-time, or predetermine the data partitions prior to application execution.« less

Disciplinary processes and the management of poor performance among UK nurses: bad apple or systemic failure? A scoping study.

PubMed

Traynor, Michael; Stone, Katie; Cook, Hannah; Gould, Dinah; Maben, Jill

2014-03-01

The rise of managerialism within healthcare systems has been noted globally. This paper uses the findings of a scoping study to investigate the management of poor performance among nurses and midwives in the United Kingdom within this context. The management of poor performance among clinicians in the NHS has been seen as a significant policy problem. There has been a profound shift in the distribution of power between professional and managerial groups in many health systems globally. We examined literature published between 2000 and 10 to explore aspects of poor performance and its management. We used Web of Science, CINAHL, MEDLINE, British Nursing Index, HMIC, Cochrane Library and PubMed. Empirical data are limited but indicate that nurses and midwives are the clinical groups most likely to be suspended and that poor performance is often represented as an individual deficit. A focus on the individual as a source of trouble can serve as a distraction from more complex systematic problems. © 2013 John Wiley & Sons Ltd.

Chasing the silver bullet: measuring driver fatigue using simple and complex tasks.

PubMed

Baulk, S D; Biggs, S N; Reid, K J; van den Heuvel, C J; Dawson, D

2008-01-01

Driver fatigue remains a significant cause of motor-vehicle accidents worldwide. New technologies are increasingly utilised to improve road safety, but there are no effective on-road measures for fatigue. While simulated driving tasks are sensitive, and simple performance tasks have been used in industrial fatigue management systems (FMS) to quantify risk, little is known about the relationship between such measures. Establishing a simple, on-road measure of fatigue, as a fitness-to-drive tool, is an important issue for road safety and accident prevention, particularly as many fatigue related accidents are preventable. This study aimed to measure fatigue-related performance decrements using a simple task (reaction time - RT) and a complex task (driving simulation), and to determine the potential for a link between such measures, thus improving FMS success. Fifteen volunteer participants (7 m, 8 f) aged 22-56 years (mean 33.6 years), underwent 26 h of supervised wakefulness before an 8h recovery sleep opportunity. Participants were tested using a 30-min interactive driving simulation test, bracketed by a 10-min psychomotor vigilance task (PVT) at 4, 8, 18 and 24h of wakefulness, and following recovery sleep. Extended wakefulness caused significant decrements in PVT and driving performance. Although these measures are clearly linked, our analyses suggest that driving simulation cannot be replaced by a simple PVT. Further research is needed to closely examine links between performance measures, and to facilitate accurate management of fitness to drive, which requires more complex assessments of performance than RT alone.

[Controlling systems for operating room managers].

PubMed

Schüpfer, G; Bauer, M; Scherzinger, B; Schleppers, A

2005-08-01

Management means developing, shaping and controlling of complex, productive and social systems. Therefore, operating room managers also need to develop basic skills in financial and managerial accounting as a basis for operative and strategic controlling which is an essential part of their work. A good measurement system should include financial and strategic concepts for market position, innovation performance, productivity, attractiveness, liquidity/cash flow and profitability. Since hospitals need to implement a strategy to reach their business objectives, the performance measurement system has to be individually adapted to the strategy of the hospital. In this respect the navigation system developed by Gälweiler is compared to the "balanced score card" system of Kaplan and Norton.

Results and Lessons Learned from a Coupled Social and Physical Hydrology Model: Testing Alternative Water Management Policies and Institutional Structures Using Agent-Based Modeling and Regional Hydrology

NASA Astrophysics Data System (ADS)

Murphy, J.; Lammers, R. B.; Prousevitch, A.; Ozik, J.; Altaweel, M.; Collier, N. T.; Kliskey, A. D.; Alessa, L.

2015-12-01

Water Management in the U.S. Southwest is under increasing scrutiny as many areas endure persistent drought. The impact of these prolonged dry conditions is a product of regional climate and hydrological conditions, but also of a highly engineered water management infrastructure and a complex web of social arrangements whereby water is allocated, shared, exchanged, used, re-used, and finally consumed. We coupled an agent-based model with a regional hydrological model to understand the dynamics in one richly studied and highly populous area: southern Arizona, U.S.A., including metropolitan Phoenix and Tucson. There, multiple management entities representing an array of municipalities and other water providers and customers, including private companies and Native American tribes are enmeshed in a complex legal and economic context in which water is bought, leased, banked, and exchanged in a variety of ways and on multiple temporal and physical scales. A recurrent question in the literature of adaptive management is the impact of management structure on overall system performance. To explore this, we constructed an agent-based model to capture this social complexity, and coupled this with a physical hydrological model that we used to drive the system under a variety of water stress scenarios and to assess the regional impact of the social system's performance. We report the outcomes of ensembles of runs in which varieties of alternative policy constraints and management strategies are considered. We hope to contribute to policy discussions in this area and connected and legislatively similar areas (such as California) as current conditions change and existing legal and policy structures are revised. Additionally, we comment on the challenges of integrating models that ostensibly are in different domains (physical and social) but that independently represent a system in which physical processes and human actions are closely intertwined and difficult to disentangle.

Managing bond proceeds improves financial performance.

PubMed

Mates, W J

1989-04-01

Healthcare organizations must actively manage tax-exempt bond proceeds after they are initially invested at the time of financing or refinancing. The Tax Reform Act of 1986 imposes serious penalties on issuers who fail to comply with its complex requirements. An active program of bond proceeds management enables organizations to avoid this pitfall and take advantage of legal investment opportunities. Such a program must start with a set of clear guidelines on permitted investments, target rates of return, acceptable levels of risk, and liquidity requirements.

Assessing forest vegetation and fire simulation model performance after the Cold Springs wildfire, Washington USA

Treesearch

Susan Hummel; Maureen Kennedy; E. Ashley Steel

2012-01-01

Given that resource managers rely on computer simulation models when it is difficult or expensive to obtain vital information directly, it is important to evaluate how well a particular model satisfies applications for which it is designed. The Forest Vegetation Simulator (FVS) is used widely for forest management in the US, and its scope and complexity continue to...

EMDS 3.0: A modeling framework for coping with complexity in environmental assessment and planning.

Treesearch

K.M. Reynolds

2006-01-01

EMDS 3.0 is implemented as an ArcMap® extension and integrates the logic engine of NetWeaver® to perform landscape evaluations, and the decision modeling engine of Criterium DecisionPlus® for evaluating management priorities. Key features of the system's evaluation component include abilities to (1) reason about large, abstract, multifaceted ecosystem management...

Ixcatec ethnoecology: plant management and biocultural heritage in Oaxaca, Mexico.

PubMed

Rangel-Landa, Selene; Casas, Alejandro; Rivera-Lozoya, Erandi; Torres-García, Ignacio; Vallejo-Ramos, Mariana

2016-07-20

Studying motives of plant management allows understanding processes that originated agriculture and current forms of traditional technology innovation. Our work analyses the role of native plants in the Ixcatec subsistence, management practices, native plants biocultural importance, and motivations influencing management decisions. Cultural and ecological importance and management complexity may differ among species according with their use value and availability. We hypothesized that decreasing risk in availability of resources underlies the main motives of management, but curiosity, aesthetic, and ethical values may also be determinant. Role of plants in subsistence strategies, forms of use and management was documented through 130 semi-structured interviews and participant observation. Free listing interviews to 38 people were used to estimate the cognitive importance of species used as food, medicine, fuel, fodder, ornament and ceremonial. Species ecological importance was evaluated through sampling vegetation in 22 points. Principal Components Analysis were performed to explore the relation between management, cultural and ecological importance and estimating the biocultural importance of native species. We recorded 627 useful plant species, 589 of them native. Livelihood strategies of households rely on agriculture, livestock and multiple use of forest resources. At least 400 species are managed, some of them involving artificial selection. Management complexity is the main factor reflecting the biocultural importance of plant species, and the weight of ecological importance and cultural value varied among use types. Management strategies aim to ensure resources availability, to have them closer, to embellish human spaces or satisfying ethical principles. Decisions about plants management are influenced by perception of risk to satisfy material needs, but immaterial principles are also important. Studying such relation is crucial for understanding past and present technological innovation processes and understand the complex process of developing biocultural legacy.

Large Variability in the Diversity of Physiologically Complex Surgical Procedures Exists Nationwide Among All Hospitals Including Among Large Teaching Hospitals.

PubMed

Dexter, Franklin; Epstein, Richard H; Thenuwara, Kokila; Lubarsky, David A

2017-11-22

Multiple previous studies have shown that having a large diversity of procedures has a substantial impact on quality management of hospital surgical suites. At hospitals with substantial diversity, unless sophisticated statistical methods suitable for rare events are used, anesthesiologists working in surgical suites will have inaccurate predictions of surgical blood usage, case durations, cost accounting and price transparency, times remaining in late running cases, and use of intraoperative equipment. What is unknown is whether large diversity is a feature of only a few very unique set of hospitals nationwide (eg, the largest hospitals in each state or province). The 2013 United States Nationwide Readmissions Database was used to study heterogeneity among 1981 hospitals in their diversities of physiologically complex surgical procedures (ie, the procedure codes). The diversity of surgical procedures performed at each hospital was quantified using a summary measure, the number of different physiologically complex surgical procedures commonly performed at the hospital (ie, 1/Herfindahl). A total of 53.9% of all hospitals commonly performed <10 physiologically complex procedures (lower 99% confidence limit [CL], 51.3%). A total of 14.2% (lower 99% CL, 12.4%) of hospitals had >3-fold larger diversity (ie, >30 commonly performed physiologically complex procedures). Larger hospitals had greater diversity than the small- and medium-sized hospitals (P < .0001). Teaching hospitals had greater diversity than did the rural and urban nonteaching hospitals (P < .0001). A total of 80.0% of the 170 large teaching hospitals commonly performed >30 procedures (lower 99% CL, 71.9% of hospitals). However, there was considerable variability among the large teaching hospitals in their diversity (interquartile range of the numbers of commonly performed physiologically complex procedures = 19.3; lower 99% CL, 12.8 procedures). The diversity of procedures represents a substantive differentiator among hospitals. Thus, the usefulness of statistical methods for operating room management should be expected to be heterogeneous among hospitals. Our results also show that "large teaching hospital" alone is an insufficient description for accurate prediction of the extent to which a hospital sustains the operational and financial consequences of performing a wide diversity of surgical procedures. Future research can evaluate the extent to which hospitals with very large diversity are indispensable in their catchment area.

Localized heating/bonding techniques in MEMS packaging

NASA Astrophysics Data System (ADS)

Mabesa, J. R., Jr.; Scott, A. J.; Wu, X.; Auner, G. W.

2005-05-01

Packaging is used to protect and enable intelligent sensor systems utilized in manned/unmanned ground vehicle systems/subsystems. Because Micro electro mechanical systems (MEMS) are used often in these sensor or actuation products, it must interact with the surrounding environment, which may be in direct conflict with the desire to isolate the electronics for improved reliability/durability performance. For some very simple devices, performance requirements may allow a high degree of isolation from the environment (e.g., stints and accelerometers). Other more complex devices (i.e. chemical and biological analysis systems, particularly in vivo systems) present extremely complex packaging requirements. Power and communications to MEMS device arrays are also extremely problematic. The following describes the research being performed at the U.S. Army Research, Development, and Engineering Command (RDECOM) Tank and Automotive Research, Development, and Engineering Center (TARDEC), in collaboration with Wayne State University, in Detroit, MI. The focus of the packaging research is limited to six main categories: a) provision for feed-through for electrical, optical, thermal, and fluidic interfaces; b) environmental management including atmosphere, hermiticity, and temperature; c) control of stress and mechanical durability; d) management of thermal properties to minimize absorption and/or emission; e) durability and structural integrity; and f) management of RF/magnetic/electrical and optical interference and/or radiation properties and exposure.

Research on Interactive Acquisition and Use of Knowledge.

DTIC Science & Technology

1983-11-01

complex and challenging endeavor. Computer scientists faced with the problem of managing software complexity have de - veloped strict design disciplines...handle most-indeed, probably all-- phenomena in the syntax and semantics of natural language. It has also turned out to be well suited for the classes of...Semantics The previous grammar performs a de facto coordination of syntax and semantics by requiring that the (syntactically) preverbal NP play the

Can action research strengthen district health management and improve health workforce performance? A research protocol.

PubMed

Mshelia, C; Huss, R; Mirzoev, T; Elsey, H; Baine, S O; Aikins, M; Kamuzora, P; Bosch-Capblanch, X; Raven, J; Wyss, K; Green, A; Martineau, T

2013-08-30

The single biggest barrier for countries in sub-Saharan Africa (SSA) to scale up the necessary health services for addressing the three health-related Millennium Development Goals and achieving Universal Health Coverage is the lack of an adequate and well-performing health workforce. This deficit needs to be addressed both by training more new health personnel and by improving the performance of the existing and future health workforce. However, efforts have mostly been focused on training new staff and less on improving the performance of the existing health workforce. The purpose of this paper is to disseminate the protocol for the PERFORM project and reflect on the key challenges encountered during the development of this methodology and how they are being overcome. The overall aim of the PERFORM project is to identify ways of strengthening district management in order to address health workforce inadequacies by improving health workforce performance in SSA. The study will take place in three districts each in Ghana, Tanzania and Uganda using an action research approach. With the support of the country research teams, the district health management teams (DHMTs) will lead on planning, implementation, observation, reflection and redefinition of the activities in the study. Taking into account the national and local human resource (HR) and health systems (HS) policies and practices already in place, 'bundles' of HR/HS strategies that are feasible within the context and affordable within the districts' budget will be developed by the DHMTs to strengthen priority areas of health workforce performance. A comparative analysis of the findings from the three districts in each country will add new knowledge on the effects of these HR/HS bundles on DHMT management and workforce performance and the impact of an action research approach on improving the effectiveness of the DHMTs in implementing these interventions. Different challenges were faced during the development of the methodology. These include the changing context in the study districts, competing with other projects and duties for the time of district managers, complexity of the study design, maintaining the anonymity and confidentiality of study participants as well as how to record the processes during the study. We also discuss how these challenges are being addressed. The dissemination of this research protocol is intended to generate interest in the PERFORM project and also stimulate discussion on the use of action research in complex studies such as this on strengthening district health management to improve health workforce performance.

MemAxes: Visualization and Analytics for Characterizing Complex Memory Performance Behaviors.

PubMed

Gimenez, Alfredo; Gamblin, Todd; Jusufi, Ilir; Bhatele, Abhinav; Schulz, Martin; Bremer, Peer-Timo; Hamann, Bernd

2018-07-01

Memory performance is often a major bottleneck for high-performance computing (HPC) applications. Deepening memory hierarchies, complex memory management, and non-uniform access times have made memory performance behavior difficult to characterize, and users require novel, sophisticated tools to analyze and optimize this aspect of their codes. Existing tools target only specific factors of memory performance, such as hardware layout, allocations, or access instructions. However, today's tools do not suffice to characterize the complex relationships between these factors. Further, they require advanced expertise to be used effectively. We present MemAxes, a tool based on a novel approach for analytic-driven visualization of memory performance data. MemAxes uniquely allows users to analyze the different aspects related to memory performance by providing multiple visual contexts for a centralized dataset. We define mappings of sampled memory access data to new and existing visual metaphors, each of which enabling a user to perform different analysis tasks. We present methods to guide user interaction by scoring subsets of the data based on known performance problems. This scoring is used to provide visual cues and automatically extract clusters of interest. We designed MemAxes in collaboration with experts in HPC and demonstrate its effectiveness in case studies.

Alternative Architectures for Distributed Cooperative Problem-Solving in the National Airspace System

NASA Technical Reports Server (NTRS)

Smith, Phillip J.; Billings, Charles; McCoy, C. Elaine; Orasanu, Judith

1999-01-01

The air traffic management system in the United States is an example of a distributed problem solving system. It has elements of both cooperative and competitive problem-solving. This system includes complex organizations such as Airline Operations Centers (AOCs), the FAA Air Traffic Control Systems Command Center (ATCSCC), and traffic management units (TMUs) at enroute centers and TRACONs, all of which have a major focus on strategic decision-making. It also includes individuals concerned more with tactical decisions (such as air traffic controllers and pilots). The architecture for this system has evolved over time to rely heavily on the distribution of tasks and control authority in order to keep cognitive complexity manageable for any one individual operator, and to provide redundancy (both human and technological) to serve as a safety net to catch the slips or mistakes that any one person or entity might make. Currently, major changes are being considered for this architecture, especially with respect to the locus of control, in an effort to improve efficiency and safety. This paper uses a series of case studies to help evaluate some of these changes from the perspective of system complexity, and to point out possible alternative approaches that might be taken to improve system performance. The paper illustrates the need to maintain a clear understanding of what is required to assure a high level of performance when alternative system architectures and decompositions are developed.

Management of complex pediatric laryngotracheal stenosis with skin graft reconstruction.

PubMed

Bowe, Sarah N; Wentland, Carissa J; Sandhu, G S; Hartnick, Christopher J

2018-05-01

For pediatric patients with laryngotracheal stenosis, the ultimate goal is creation of a safe, functional airway. Unfortunately, wound healing in a hollow structure can complicate repair attempts, leading to restenosis. Herein, we present our experience using skin-grafting techniques in two complex pediatric laryngotracheal stenosis cases, leading to successful decannulation or speech production. A chart review was performed examining the evaluation and management of two pediatric patients with laryngotracheal stenosis despite prior reconstructive attempts. Patient history, bronchoscopic evaluation, intra-operative technique, post-operative management, treatment outcomes, and complications were noted. Harvesting and preparation of the split-thickness skin grafts (STSG) proceeded in a similar manner for each case. Stenting material varied based on the clinical scenario. Using this technique, our patient with a Type 3 glottic web achieved substantial improvement in exercise tolerance, as well as vocal strength and quality. In addition, our aphonic patient could vocalize for the first time since her laryngotracheal injury. Temporary endoluminal stenting with skin graft lining can reproduce epithelial continuity and provide "biological inhibition" to enhance the wound healing process. When previous reconstructive efforts have failed, use of STSG can be considered in the management of complex pediatric laryngotracheal stenosis. Copyright © 2018. Published by Elsevier B.V.

Managing health care organizations in an age of rapid change.

PubMed

Benjamin, S; al-Alaiwat, S

1998-03-01

Health care managers find their work increasingly difficult, due in part to rapid environmental change that plagues organizational life. Management practices and attitudes that may have been appropriate in previous eras are ineffective today. A study was conducted among managers in the Ministry of Health, State of Bahrain, seeking information about current trends in the macro or external environment that affect the Ministry of Health, as well as internal environmental pressures that may be similar or different. This article provides a clear picture of the context in which managers perform their work and offers recommendations for coping with change in dynamic, complex organizations.

Evidence-informed physical therapy management of performance-related musculoskeletal disorders in musicians

PubMed Central

Chan, Cliffton; Ackermann, Bronwen

2014-01-01

Playing a musical instrument at an elite level is a highly complex motor skill. The regular daily training loads resulting from practice, rehearsals and performances place great demands on the neuromusculoskeletal systems of the body. As a consequence, performance-related musculoskeletal disorders (PRMDs) are globally recognized as common phenomena amongst professional orchestral musicians. These disorders create a significant financial burden to individuals and orchestras as well as lead to serious consequences to the musicians’ performance and ultimately their career. Physical therapists are experts in treating musculoskeletal injuries and are ideally placed to apply their skills to manage PRMDs in this hyper-functioning population, but there is little available evidence to guide specific injury management approaches. An Australia-wide survey of professional orchestral musicians revealed that the musicians attributed excessively high or sudden increase in playing-load as major contributors to their PRMDs. Therefore, facilitating musicians to better manage these loads should be a cornerstone of physical therapy management. The Sound Practice orchestral musicians work health and safety project used formative and process evaluation approaches to develop evidence-informed and clinically applicable physical therapy interventions, ultimately resulting in favorable outcomes. After these methodologies were employed, the intervention studies were conducted with a national cohort of professional musicians including: health education, onsite injury management, cross-training exercise regimes, performance postural analysis, and music performance biomechanics feedback. The outcomes of all these interventions will be discussed alongside a focussed review on the existing literature of these management strategies. Finally, a framework for best-practice physical therapy management of PRMDs in musicians will be provided. PMID:25071671

A randomized controlled trial on errorless learning in goal management training: study rationale and protocol

PubMed Central

2013-01-01

Background Many brain-injured patients referred for outpatient rehabilitation have executive deficits, notably difficulties with planning, problem-solving and goal directed behaviour. Goal Management Training (GMT) has proven to be an efficacious cognitive treatment for these problems. GMT entails learning and applying an algorithm, in which daily tasks are subdivided into multiple steps. Main aim of the present study is to examine whether using an errorless learning approach (preventing the occurrence of errors during the acquisition phase of learning) contributes to the efficacy of Goal Management Training in the performance of complex daily tasks. Methods/Design The study is a double blind randomized controlled trial, in which the efficacy of Goal Management Training with an errorless learning approach will be compared with conventional Goal Management Training, based on trial and error learning. In both conditions 32 patients with acquired brain injury of mixed etiology will be examined. Main outcome measure will be the performance on two individually chosen everyday-tasks before and after treatment, using a standardized observation scale and goal attainment scaling. Discussion This is the first study that introduces errorless learning in Goal Management Training. It is expected that the GMT-errorless learning approach will improve the execution of complex daily tasks in brain-injured patients with executive deficits. The study can contribute to a better treatment of executive deficits in cognitive rehabilitation. Trial registration (Dutch Trial Register): http://NTR3567 PMID:23786651

Perceived task complexity of trunk stability exercises.

PubMed

McPhee, Megan; Tucker, Kylie J; Wan, Alan; MacDonald, David A

2017-02-01

Perceived task complexity can impact participation in an exercise programme and the level of skill acquisition resulting from participation. Although trunk stability exercises are commonly included in the management of people with low back pain, potential differences in perceived task complexity between those exercises have not been investigated previously. To investigate the perceived task complexity following first time instruction of two common stability exercises: the abdominal brace and abdominal hollow. Cross-sectional. Twenty-four naïve healthy participants received instruction in the performance of an abdominal brace and an abdominal hollow with feedback. Participants rated their perceived task complexity (mental, physical, and temporal demand, performance, effort, frustration) for each exercise on the NASA-Task Load Index. The abdominal hollow was associated with higher perceived mental demand than the abdominal brace (p = 0.01), and required more time to learn (p < 0.01). The abdominal brace was associated with greater mental demand and frustration when performed after the abdominal hollow than before. This study has provided the first evidence for differences in perceived task complexity between two commonly used trunk stability exercises. Those differences in perceived task complexity may influence the selection of exercises intended to enhance the robustness of spinal stability. Copyright © 2016 Elsevier Ltd. All rights reserved.

vvtools v. 1.0

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

Drake, Richard R.

Vvtools is a suite of testing tools, with a focus on reproducible verification and validation. They are written in pure Python, and contain a test harness and an automated process management tool. Users of vvtools can develop suites of verification and validation tests and run them on small to large high performance computing resources in an automated and reproducible way. The test harness enables complex processes to be performed in each test and even supports a one-level parent/child dependency between tests. It includes a built in capability to manage workloads requiring multiple processors and platforms that use batch queueing systems.

Education research: a case-based bioethics curriculum for neurology residents.

PubMed

Tolchin, Benjamin; Willey, Joshua Z; Prager, Kenneth

2015-03-31

In 2012, the American Academy of Neurology (AAN) updated and expanded its ethics curriculum into Practical Ethics in Clinical Neurology, a case-based ethics curriculum for neurologists. We piloted a case-based bioethics curriculum for neurology residents using the framework and topics recommended by the AAN, matched to clinical cases drawn from Columbia's neurologic services. Our primary outcome was residents' ability to analyze and manage ethically complex cases as measured on precurriculum and postcurriculum multiple-choice quizzes. Secondary outcomes included precurriculum and postcurriculum self-assessed comfort in discussing and managing ethically complex cases, as well as attendance at ethics discussion sessions as compared to attendance at other didactic sessions. Resident performance on quizzes improved from 75.8% to 86.7% (p = 0.02). Comfort in discussing ethically complex cases improved from 6.4 to 7.4 on a 10-point scale (p = 0.03). Comfort in managing such cases trended toward improvement but did not reach statistical significance. Attendance was significantly better at ethics discussions (73.5%) than at other didactic sessions (61.7%, p = 0.04). Our formal case-based ethics curriculum for neurology residents, based on core topics drawn from the AAN's published curricula, was successfully piloted. Our study showed a statistically significant improvement in residents' ability to analyze and manage ethically complex cases as measured by multiple-choice tests and self-assessments. © 2015 American Academy of Neurology.

Are we under-utilizing the talents of primary care personnel? A job analytic examination

PubMed Central

Hysong, Sylvia J; Best, Richard G; Moore, Frank I

2007-01-01

Background Primary care staffing decisions are often made unsystematically, potentially leading to increased costs, dissatisfaction, turnover, and reduced quality of care. This article aims to (1) catalogue the domain of primary care tasks, (2) explore the complexity associated with these tasks, and (3) examine how tasks performed by different job titles differ in function and complexity, using Functional Job Analysis to develop a new tool for making evidence-based staffing decisions. Methods Seventy-seven primary care personnel from six US Department of Veterans Affairs (VA) Medical Centers, representing six job titles, participated in two-day focus groups to generate 243 unique task statements describing the content of VA primary care. Certified job analysts rated tasks on ten dimensions representing task complexity, skills, autonomy, and error consequence. Two hundred and twenty-four primary care personnel from the same clinics then completed a survey indicating whether they performed each task. Tasks were catalogued using an adaptation of an existing classification scheme; complexity differences were tested via analysis of variance. Results Objective one: Task statements were categorized into four functions: service delivery (65%), administrative duties (15%), logistic support (9%), and workforce management (11%). Objective two: Consistent with expectations, 80% of tasks received ratings at or below the mid-scale value on all ten scales. Objective three: Service delivery and workforce management tasks received higher ratings on eight of ten scales (multiple functional complexity dimensions, autonomy, human error consequence) than administrative and logistic support tasks. Similarly, tasks performed by more highly trained job titles received higher ratings on six of ten scales than tasks performed by lower trained job titles. Contrary to expectations, the distribution of tasks across functions did not significantly vary by job title. Conclusion Primary care personnel are not being utilized to the extent of their training; most personnel perform many tasks that could reasonably be performed by personnel with less training. Primary care clinics should use evidence-based information to optimize job-person fit, adjusting clinic staff mix and allocation of work across staff to enhance efficiency and effectiveness. PMID:17397534

Functional Coherence in the State Education Agency: A Structure for Performance Management. Solutions. Issue No. 4

ERIC Educational Resources Information Center

Redding, Sam; Nafziger, Dean

2013-01-01

The purpose of the state education agency (SEA) is to focus the entire education system on helping students become capable in college and career in an increasingly complex world. One of the most vexing problems facing SEAs today is how to meet increasing demands for performance while adjusting to significant resource reductions. Meeting that…

The Fishery Performance Indicators: A Management Tool for Triple Bottom Line Outcomes

PubMed Central

Anderson, James L.; Anderson, Christopher M.; Chu, Jingjie; Meredith, Jennifer; Asche, Frank; Sylvia, Gil; Smith, Martin D.; Anggraeni, Dessy; Arthur, Robert; Guttormsen, Atle; McCluney, Jessica K.; Ward, Tim; Akpalu, Wisdom; Eggert, Håkan; Flores, Jimely; Freeman, Matthew A.; Holland, Daniel S.; Knapp, Gunnar; Kobayashi, Mimako; Larkin, Sherry; MacLauchlin, Kari; Schnier, Kurt; Soboil, Mark; Tveteras, Sigbjorn; Uchida, Hirotsugu; Valderrama, Diego

2015-01-01

Pursuit of the triple bottom line of economic, community and ecological sustainability has increased the complexity of fishery management; fisheries assessments require new types of data and analysis to guide science-based policy in addition to traditional biological information and modeling. We introduce the Fishery Performance Indicators (FPIs), a broadly applicable and flexible tool for assessing performance in individual fisheries, and for establishing cross-sectional links between enabling conditions, management strategies and triple bottom line outcomes. Conceptually separating measures of performance, the FPIs use 68 individual outcome metrics—coded on a 1 to 5 scale based on expert assessment to facilitate application to data poor fisheries and sectors—that can be partitioned into sector-based or triple-bottom-line sustainability-based interpretative indicators. Variation among outcomes is explained with 54 similarly structured metrics of inputs, management approaches and enabling conditions. Using 61 initial fishery case studies drawn from industrial and developing countries around the world, we demonstrate the inferential importance of tracking economic and community outcomes, in addition to resource status. PMID:25946194

48 CFR 50.205-1 - SAFETY Act Considerations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CONTRACT MANAGEMENT EXTRAORDINARY CONTRACTUAL ACTIONS AND THE SAFETY ACT Support Anti-terrorism by... performance characteristics are addressed. This is important because the processing times for issuing... applications to DHS and the technical complexity of individual applications. (c) Industry outreach. When...

Lessons from Philippines MPA Management: Social Ecological Interactions, Participation, and MPA Performance

NASA Astrophysics Data System (ADS)

Twichell, Julia; Pollnac, Richard; Christie, Patrick

2018-06-01

International interest in increasing marine protected area (MPA) coverage reflects broad recognition of the MPA as a key tool for marine ecosystems and fisheries management. Nevertheless, effective management remains a significant challenge. The present study contributes to enriching an understanding of best practices for MPA management through analysis of archived community survey data collected in the Philippines by the Learning Project (LP), a collaboration with United States Coral Triangle Initiative (USCTI), United States Agency for International Development (USAID), and partners. We evaluate stakeholder participation and social ecological interactions among resource users in MPA programs in the Palawan, Occidental Mindoro, and Batangas provinces in the Philippines. Analysis indicates that a complex suite of social ecological factors, including demographics, conservation beliefs, and scientifically correct knowledge influence participation, which in turn is related to perceived MPA performance. Findings indicate positive feedbacks within the system that have potential to strengthen perceptions of MPA success. The results of this evaluation provide empirical reinforcement to current inquiries concerning the role of participation in influencing MPA performance.

Evaluating the Impact of Classroom Education on the Management of Septic Shock Using Human Patient Simulation.

PubMed

Lighthall, Geoffrey K; Bahmani, Dona; Gaba, David

2016-02-01

Classroom lectures are the mainstay of imparting knowledge in a structured manner and have the additional goals of stimulating critical thinking, lifelong learning, and improvements in patient care. The impact of lectures on patient care is difficult to examine in critical care because of the heterogeneity in patient conditions and personnel as well as confounders such as time pressure, interruptions, fatigue, and nonstandardized observation methods. The critical care environment was recreated in a simulation laboratory using a high-fidelity mannequin simulator, where a mannequin simulator with a standardized script for septic shock was presented to trainees. The reproducibility of this patient and associated conditions allowed the evaluation of "clinical performance" in the management of septic shock. In a previous study, we developed and validated tools for the quantitative analysis of house staff managing septic shock simulations. In the present analysis, we examined whether measures of clinical performance were improved in those cases where a lecture on the management of shock preceded a simulated exercise on the management of septic shock. The administration of the septic shock simulations allowed for performance measurements to be calculated for both medical interns and for subsequent management by a larger resident-led team. The analysis revealed that receiving a lecture on shock before managing a simulated patient with septic shock did not produce scores higher than for those who did not receive the previous lecture. This result was similar for both interns managing the patient and for subsequent management by a resident-led team. We failed to find an immediate impact on clinical performance in simulations of septic shock after a lecture on the management of this syndrome. Lectures are likely not a reliable sole method for improving clinical performance in the management of complex disease processes.

Iranian Expert Opinion about Necessary Criteria for Hospitals Management Performance Assessments

PubMed Central

Dadgar, Elham; Janati, Ali; Tabrizi, Jafar Sadegh; Asghari-Jafarabadi, Mohammad; Barati, Omid

2012-01-01

Background: Managers in the hospital should have enough managerial skill to be coordinated with the complex environment. Defining a competency framework assessment for hospital man-agement will help to establish core competencies for hospital managers. The aim of this study was to develop concrete and suitable performance assessment criteria using expert's view. Methods: In this qualitative study in total, 20 professionals participated in the interview and Fo¬cus Group Discussions (FGD). Two of informants were interviewed and 18 professionals par¬ticipants in three focus group discussions. Discussions and interviews were well planned, the FGD environments were suitable and after interviews completion the notes were checked with participant for completeness. Thematic analysis method was used for the analysis of qualitative data. Results: Findings from 3 FGDs and 2 semi structured interviews done with 20 professionals were categorized accordance to themes. The findings were classified in 7 major and 41 sub themes. The major themes include competency related to planning, organization and staff per-formance management, leadership, information management, and clinical governance and per-formance indicators. Conclusion: All participants had hospital administration experience; so their explanation impor¬tant in identifying the criteria and developing hospital managers’ performance assessment tool. In addition to professional perspectives and studies done in other countries, in order to design this kind of tools, it is necessary to adopt the obtained findings to the local hospital conditions. PMID:24688938

Performance assessment in complex individual and team tasks

NASA Technical Reports Server (NTRS)

Eddy, Douglas R.

1992-01-01

Described here is an eclectic, performance based approach to assessing cognitive performance from multiple perspectives. The experience gained from assessing the effects of antihistamines and scenario difficulty on C (exp 2) decision making performance in Airborne Warning and Control Systems (AWACS) weapons director (WD) teams can serve as a model for realistic simulations in space operations. Emphasis is placed on the flexibility of measurement, hierarchical organization of measurement levels, data collection from multiple perspectives, and the difficulty of managing large amounts of data.

Performance assessment and optimisation of a large information system by combined customer relationship management and resilience engineering: a mathematical programming approach

NASA Astrophysics Data System (ADS)

Azadeh, A.; Foroozan, H.; Ashjari, B.; Motevali Haghighi, S.; Yazdanparast, R.; Saberi, M.; Torki Nejad, M.

2017-10-01

ISs and ITs play a critical role in large complex gas corporations. Many factors such as human, organisational and environmental factors affect IS in an organisation. Therefore, investigating ISs success is considered to be a complex problem. Also, because of the competitive business environment and the high amount of information flow in organisations, new issues like resilient ISs and successful customer relationship management (CRM) have emerged. A resilient IS will provide sustainable delivery of information to internal and external customers. This paper presents an integrated approach to enhance and optimise the performance of each component of a large IS based on CRM and resilience engineering (RE) in a gas company. The enhancement of the performance can help ISs to perform business tasks efficiently. The data are collected from standard questionnaires. It is then analysed by data envelopment analysis by selecting the optimal mathematical programming approach. The selected model is validated and verified by principle component analysis method. Finally, CRM and RE factors are identified as influential factors through sensitivity analysis for this particular case study. To the best of our knowledge, this is the first study for performance assessment and optimisation of large IS by combined RE and CRM.

The paradox of intragroup conflict: a meta-analysis.

PubMed

de Wit, Frank R C; Greer, Lindred L; Jehn, Karen A

2012-03-01

Since the meta-analysis by De Dreu and Weingart (2003b) on the effects of intragroup conflict on group outcomes, more than 80 new empirical studies of conflict have been conducted, often investigating more complex, moderated relationships between conflict and group outcomes, as well as new types of intragroup conflict, such as process conflict. To explore the trends in this new body of literature, we conducted a meta-analysis of 116 empirical studies of intragroup conflict (n = 8,880 groups) and its relationship with group outcomes. To address the heterogeneity across the studies included in the meta-analysis, we also investigated a number of moderating variables. Stable negative relationships were found between relationship and process conflict and group outcomes. In contrast to the results of De Dreu and Weingart, we did not find a strong and negative association between task conflict and group performance. Analyses of main effects as well as moderator analyses revealed a more complex picture. Task conflict and group performance were more positively related among studies where the association between task and relationship conflict was relatively weak, in studies conducted among top management teams rather than non-top management teams, and in studies where performance was measured in terms of financial performance or decision quality rather than overall performance.

Self-management support by final year nursing students: A correlational study of performance and person-related associated factors.

PubMed

Duprez, Veerle; Beeckman, Dimitri; Verhaeghe, Sofie; Van Hecke, Ann

2017-09-01

Chronic conditions put a heavy burden on healthcare in every country. Supporting persons with a chronic illness to take an active role in the management of their condition is a core component in the Chronic Care Model. It implies confidence and good skills from professionals. To date, there is no evidence on final year nursing students' performance in supporting patients' self-management, nor on factors associated with this performance. To explore self-reported performance of supporting patients' self-management by final year nursing students, and person-related factors associated with this performance. A correlational multi-centre study of final year nursing students (N=256) from eight nursing schools. Students were recruited from a convenience sample of eight nursing schools. All final year students were invited to participate. Data were collected between January 2015 and May 2016 using self-administered validated questionnaires. Theoretical behavioural frameworks were used to select hypothesized associated factors for self-management support: self-efficacy to perform self-management support and socio-structural factors (Social Cognitive Theory); needs for autonomy, competence and relatedness, and patient-invested contingent self-esteem (Self-Determination Theory); and attitudes towards supporting patients' self-management (Theory of Planned Behaviour). Final year nursing students (N=256) reported an overall low level of performance in delivering self-management support during internship. Students lacked mainly competencies in collaborative goal setting and shared decision making. Students reported a significant gap between their confidence and their actual performance in self-management support (p<0.001). About 33% of the variance in students' performance is predicted by four person-related factors, i.e. self-efficacy to perform self-management support, general feeling of competency on internship, belief on patients' knowledge about condition management, and contingency of a student's professional self-esteem upon patients' achievements. Final year nursing students are actually not ready to support patients' self-management even though they will soon be in practice as qualified nurses. Nursing curricula should be further attuned to the complex competencies of self-management support. Special attention is needed to broaden the perspective on self-management support. Learning opportunities can be introduced in classroom activities and on internship. Copyright © 2017 Elsevier Ltd. All rights reserved.

Molecular Cloning Designer Simulator (MCDS): All-in-one molecular cloning and genetic engineering design, simulation and management software for complex synthetic biology and metabolic engineering projects.

PubMed

Shi, Zhenyu; Vickers, Claudia E

2016-12-01

Molecular Cloning Designer Simulator (MCDS) is a powerful new all-in-one cloning and genetic engineering design, simulation and management software platform developed for complex synthetic biology and metabolic engineering projects. In addition to standard functions, it has a number of features that are either unique, or are not found in combination in any one software package: (1) it has a novel interactive flow-chart user interface for complex multi-step processes, allowing an integrated overview of the whole project; (2) it can perform a user-defined workflow of cloning steps in a single execution of the software; (3) it can handle multiple types of genetic recombineering, a technique that is rapidly replacing classical cloning for many applications; (4) it includes experimental information to conveniently guide wet lab work; and (5) it can store results and comments to allow the tracking and management of the whole project in one platform. MCDS is freely available from https://mcds.codeplex.com.

Modelling and performance analysis of clinical pathways using the stochastic process algebra PEPA.

PubMed

Yang, Xian; Han, Rui; Guo, Yike; Bradley, Jeremy; Cox, Benita; Dickinson, Robert; Kitney, Richard

2012-01-01

Hospitals nowadays have to serve numerous patients with limited medical staff and equipment while maintaining healthcare quality. Clinical pathway informatics is regarded as an efficient way to solve a series of hospital challenges. To date, conventional research lacks a mathematical model to describe clinical pathways. Existing vague descriptions cannot fully capture the complexities accurately in clinical pathways and hinders the effective management and further optimization of clinical pathways. Given this motivation, this paper presents a clinical pathway management platform, the Imperial Clinical Pathway Analyzer (ICPA). By extending the stochastic model performance evaluation process algebra (PEPA), ICPA introduces a clinical-pathway-specific model: clinical pathway PEPA (CPP). ICPA can simulate stochastic behaviours of a clinical pathway by extracting information from public clinical databases and other related documents using CPP. Thus, the performance of this clinical pathway, including its throughput, resource utilisation and passage time can be quantitatively analysed. A typical clinical pathway on stroke extracted from a UK hospital is used to illustrate the effectiveness of ICPA. Three application scenarios are tested using ICPA: 1) redundant resources are identified and removed, thus the number of patients being served is maintained with less cost; 2) the patient passage time is estimated, providing the likelihood that patients can leave hospital within a specific period; 3) the maximum number of input patients are found, helping hospitals to decide whether they can serve more patients with the existing resource allocation. ICPA is an effective platform for clinical pathway management: 1) ICPA can describe a variety of components (state, activity, resource and constraints) in a clinical pathway, thus facilitating the proper understanding of complexities involved in it; 2) ICPA supports the performance analysis of clinical pathway, thereby assisting hospitals to effectively manage time and resources in clinical pathway.

Integrated health management and control of complex dynamical systems

NASA Astrophysics Data System (ADS)

Tolani, Devendra K.

2005-11-01

A comprehensive control and health management strategy for human-engineered complex dynamical systems is formulated for achieving high performance and reliability over a wide range of operation. Results from diverse research areas such as Probabilistic Robust Control (PRC), Damage Mitigating/Life Extending Control (DMC), Discrete Event Supervisory (DES) Control, Symbolic Time Series Analysis (STSA) and Health and Usage Monitoring System (HUMS) have been employed to achieve this goal. Continuous-domain control modules at the lower level are synthesized by PRC and DMC theories, whereas the upper-level supervision is based on DES control theory. In the PRC approach, by allowing different levels of risk under different flight conditions, the control system can achieve the desired trade off between stability robustness and nominal performance. In the DMC approach, component damage is incorporated in the control law to reduce the damage rate for enhanced structural durability. The DES controller monitors the system performance and, based on the mission requirements (e.g., performance metrics and level of damage mitigation), switches among various lower-level controllers. The core idea is to design a framework where the DES controller at the upper-level, mimics human intelligence and makes appropriate decisions to satisfy mission requirements, enhance system performance and structural durability. Recently developed tools in STSA have been used for anomaly detection and failure prognosis. The DMC deals with the usage monitoring or operational control part of health management, where as the issue of health monitoring is addressed by the anomaly detection tools. The proposed decision and control architecture has been validated on two test-beds, simulating the operations of rotorcraft dynamics and aircraft propulsion.

Discrete Event Simulation of Distributed Team Communication

DTIC Science & Technology

2012-03-22

performs, and auditory information that is provided through multiple audio devices with speech response. This paper extends previous discrete event workload...2008, pg. 1) notes that “Architecture modeling furnishes abstrac- tions for use in managing complexities, allowing engineers to visualise the proposed

Gold-Collar Workers. ERIC Digest.

ERIC Educational Resources Information Center

Wonacott, Michael E.

The gold-collar worker has problem-solving abilities, creativity, talent, and intelligence; performs non-repetitive and complex work difficult to evaluate; and prefers self management. Gold-collar information technology workers learn continually from experience; recognize the synergy of teams; can demonstrate leadership; and are strategic thinkers…

Hanford science and technology needs statements, 2000

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

BERLIN, G.T.

In the aftermath of the Cold War, the United States has begun addressing the environmental consequences of five decades of nuclear weapons production. In November 1989, DOE established the Office of Environmental Restoration and Waste Management (EM) as the central authority for cleaning up the DOE weapons complex legacy of pollution, for preventing further environmental contamination, and for instituting responsible environmental management. While performing its tasks, EM found that many aspects of its large and complex mission could not be achieved using existing science and technology or without incurring unreasonable costs, risks, or schedule impacts. Consequently, a process was developedmore » to solicit needs from around the DOE complex and focus the science and technology resources of EM-50, the National Laboratories, private industry, and colleges and universities on those needs. This document describes those needs that the Hanford Site has identified as requiring additional science or technology to complete.« less

Hanford science and technology needs statements, 1999

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

Berlin, G.T.

In the aftermath of the Cold War, the US has begun addressing the environmental consequences of five decades of nuclear weapons production. In November 1989, DOE established the Office of Environmental Restoration and Waste Management (EM) as the central authority for cleaning up the DOE weapons complex legacy of pollution, for preventing further environmental contamination, and for instituting responsible environmental management. While performing its tasks, EM found that many aspects of its large and complex decisions could not be achieved using existing science and technology or without incurring unreasonable costs, risks, or schedule impacts. Consequently, a process was developed tomore » solicit needs from around the DOE complex and focus the science and technology resources of EM-50, the National Laboratories, private industry, and collages and universities on those needs. This document describes those needs which the Hanford Site has identified as requiring additional science or technology to complete.« less

An Evolutionary Complex Systems Decision-Support Tool for the Management of Operations

NASA Astrophysics Data System (ADS)

Baldwin, J. S.; Allen, P. M.; Ridgway, K.

2011-12-01

This research aimed to add both to the development of complex systems thinking in the subject area of Operations and Production Management and to the limited number of applications of computational models and simulations from the science of complex systems. The latter potentially offer helpful decision-support tools for operations and production managers. A mechanical engineering firm was used as a case study where a combined qualitative and quantitative methodological approach was employed to extract the required data from four senior managers. Company performance measures as well as firm technologies, practices and policies, and their relation and interaction with one another, were elicited. The data were subjected to an evolutionary complex systems model resulting in a series of simulations. The findings included both reassuring and some unexpected results. The simulation based on the CEO's opinions led the most cohesive and synergistic collection of practices describing the firm, closely followed by the Marketing and R&D Managers. The Manufacturing Manager's responses led to the most extreme evolutionary trajectory where the integrity of the entire firm came into question particularly when considering how employees were utilised. By drawing directly from the opinions and views of managers rather than from logical 'if-then' rules and averaged mathematical representations of agents that characterise agent-based and other self-organisational models, this work builds on previous applications by capturing a micro-level description of diversity and a learning effect that has been problematical not only in terms of theory but also in application. This approach can be used as a decision-support tool for operations and other managers providing a forum with which to explore a) the strengths, weaknesses and consequences of different decision-making capacities within the firm; b) the introduction of new manufacturing technologies, practices and policies; and, c) the different evolutionary trajectories that a firm can take.

Complexity theory in the management of communicable diseases.

PubMed

Simmons, Mike

2003-06-01

In nature, apparently complex behavioural patterns are the result of repetitive simple rules. Complexity science studies the application of these rules and looks for applications in society. Complexity management opportunities have developed from this science and are providing a revolutionary approach in the constantly changing workplace. This article discusses how complexity management techniques have already been applied to communicable disease management in Wales and suggests further developments. A similar approach is recommended to others in the field, while complexity management probably has wider applications in the NHS, not least in relation to the developing managed clinical networks.

Biologically-Inspired Concepts for Self-Management of Complexity

NASA Technical Reports Server (NTRS)

Sterritt, Roy; Hinchey, G.

2006-01-01

Inherent complexity in large-scale applications may be impossible to eliminate or even ameliorate despite a number of promising advances. In such cases, the complexity must be tolerated and managed. Such management may be beyond the abilities of humans, or require such overhead as to make management by humans unrealistic. A number of initiatives inspired by concepts in biology have arisen for self-management of complex systems. We present some ideas and techniques we have been experimenting with, inspired by lesser-known concepts in biology that show promise in protecting complex systems and represent a step towards self-management of complexity.

The role of personal models in clinical management: Exploring health care providers' beliefs about psoriasis.

PubMed

Chisholm, Anna; Nelson, Pauline A; Pearce, Christina J; Keyworth, Chris; Griffiths, Christopher E M; Cordingley, Lis; Bundy, Christine

2016-02-01

Individuals' illness representations, including beliefs about psoriasis (a complex immune-mediated condition), and their emotional responses to the condition guide self-management behaviour. It is also plausible that health care providers' illness representations guide their own management of psoriasis. Patients commonly report poor health care experiences related to psoriasis, and the role of health care providers' beliefs, emotions, as well as their knowledge, experiences and behaviours ('personal models') in this is unexplored. This study aimed explore health care providers' personal models of psoriasis. Qualitative analysis of 23 semi-structured interviews with health care professionals providing care for psoriasis patients was performed. Purposive sampling achieved maximum variation regarding participant discipline, level of experience, gender and age. The self-regulatory/common sense model informed data collection and initial data analysis. Principles of framework analysis were used to generate predetermined and emergent key issues related to practitioners' personal models. Three types of personal model emerged. Sophisticated-Linear Model: 70% of practitioners recognized psoriasis as a complex condition but managed it as a skin condition. Mixed Model: 17% of practitioners recognized/managed some elements of psoriasis as complex and some as a skin condition. Sophisticated-Sophisticated Model: 13% recognized and managed psoriasis as a complex condition. Across the data set, five themes emerged illustrating key patterns underpinning these different models including (1) Recognising complexity, (2) Putting skin first, (3) Taking on the complexities of psoriasis with the patient, (4) Aiming for clearance, and (5) Affective experiences within psoriasis consultations. Health care providers recognized psoriasis as a complex condition but commonly reported managing psoriasis as a simple skin condition. Providers' beliefs and management approaches varied in the extent to which they were consistent with one another; and their emotional experiences during consultations may vary depending upon their personal model. Findings could inform future dermatology training programmes by highlighting the role of health care providers' illness representations in clinical management of the condition. What is already known on this subject? Health behaviour is predicted by underlying beliefs and emotions associated with an illness and its treatment. Few studies have examined health care providers' beliefs and emotions about the illnesses they manage in clinical practice. Many patients are dissatisfied with dermatology consultations and wish to be treated holistically. What does this study add? Qualitative exploration of health care providers' beliefs/emotions revealed their personal models of psoriasis. Providers' personal models of psoriasis vary in coherence and are often skin rather than whole person focused. Further investigation of health care providers' models of psoriasis and their impact on health outcomes is needed. © 2015 The British Psychological Society.

Recent Advances and Developments in Knee Surgery: Principles of Periprosthetic Knee Fracture Management

PubMed Central

Chimutengwende-Gordon, Mukai; Khan, Wasim; Johnstone, David

2012-01-01

The management of distal femoral, tibial and patellar fractures after total knee arthroplasty can be complex. The incidence of these fractures is increasing as the number of total knee arthroplasties being performed and patient longevity is increasing. There is a wide range of treatment options including revision arthroplasty for loose implants. This review article discusses the epidemiology, risk factors, classification and treatment of these fractures. PMID:22888380

VA Disability Benefits: Additional Planning Would Enhance Efforts to Improve the Timeliness of Appeals Decisions

DTIC Science & Technology

2017-03-01

manage risks and help ensure successful implementation of significant institutional change. VA officials told GAO that pilot testing—which would...Organization: How Do I Implement Complex Change at Scale? Dallas, TX: McKinsey & Company, May 2011, and Project Management Institute , Inc. A Guide to...options compared in its analysis. We conducted this performance audit from February 2016 to March 2017 in accordance with generally accepted government

Warranty Guidebook: A Reference for Use by DoD Managers in Developing, Applying and Administering Warranties

DTIC Science & Technology

1992-10-01

germane and perplexing questions persist: "* How should complex weapon system essential performance characteristics be warranted? "" What should a...conditions be developed? "• Who will administer the warranty and how? "* Under what conditions are such warranties inappropriate? The Department of...warranties define what is to be warranted, the warranty duration, accertable conditions, and the supplier’s liability. However, program managers should not

A thematic review of life cycle assessment (LCA) applied to pig production

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

McAuliffe, Graham A., E-mail: g.a.mcauliffe@umail.ucc.ie; School of Biological, Earth and Environmental Sciences, University College Cork, Distillery Fields, North Mall, Cork; Chapman, Deborah V.

Commercial livestock production is known to have significant impacts on the environment. Pig production is a complex system which involves the production of animal feed, transportation, animal rearing and waste management. One tool for assessing the environmental performance of such complex systems is life cycle assessment (LCA). LCA has been applied to pig production considerably to date. This paper provides a chronological review of state-of-the-art pig production LCAs under three themes: feed production; entire-system livestock rearing; and waste management. The study considers how LCA applications have addressed technological improvements in animal husbandry, and highlights methodological limitations, particularly related to cross-studymore » comparisons. Recent research demonstrates crude protein reduction in feed and anaerobic treatment of pig excreta resulting in bioenergy production are the key targets for environmental performance improvements related to pig production. - Highlights: • An extensive review of LCA applied to pig production is provided chronologically over the past decade. • Individual studies have been categorised into feed, whole-system pig production and waste management themes. • We consider how LCAs have addressed state-of-the-art pig husbandry. • We offer a discussion on key findings, limitations and future research.« less

Drivers of coral reef marine protected area performance

PubMed Central

Hargreaves-Allen, Venetia Alexa; Mourato, Susana; Milner-Gulland, Eleanor Jane

2017-01-01

Coral reefs are severely threatened and a principal strategy for their conservation is marine protected areas (MPAs). However the drivers of MPA performance are complex and there are likely to be trade-offs between different types of performance (e.g. conservation or welfare related outcomes). We compiled a global dataset from expert knowledge for 76 coral reef MPAs in 33 countries and identified a set of performance measures reflecting ecological and socio-economic outcomes, achievement of aims and reduction of threats, using spatial or temporal comparisons wherever possible. We wanted to test the extent to which distinct types of performance occurred simultaneously, understood as win-win outcomes. Although certain performance measures were correlated, most were not, suggesting trade-offs that limit the usefulness of composite performance scores. Hypotheses were generated as to the impact of MPA features, aims, location, management and contextual variables on MPA performance from the literature. A multivariate analysis was used to test hypotheses as to the relative importance of these “drivers” on eight uncorrelated performance measures. The analysis supported some hypotheses (e.g. benefit provision for the local community improved performance), but not others (e.g. higher overall budget and more research activity did not). Factors endogenous to the MPA (such as size of the no-take area) were generally more significant drivers of performance than exogenous ones (such as national GDP). Different types of performance were associated with different drivers, exposing the trade-offs inherent in management decisions. The study suggests that managers are able to influence MPA performance in spite of external threats and could inform adaptive management by providing an approach to test for the effects of MPA features and management actions in different contexts and so to inform decisions for allocation of effort or funds to achieve specific goals. PMID:28644890

Morphometric study of third-instar larvae from five morphotypes of the Anastrepha fraterculus cryptic species complex (Diptera, Tephritidae)

PubMed Central

Canal, Nelson A.; Hernández-Ortiz, Vicente; Salas, Juan O. Tigrero; Selivon, Denise

2015-01-01

Abstract The occurrence of cryptic species among economically important fruit flies strongly affects the development of management tactics for these pests. Tools for studying cryptic species not only facilitate evolutionary and systematic studies, but they also provide support for fruit fly management and quarantine activities. Previous studies have shown that the South American fruit fly, Anastrepha fraterculus, is a complex of cryptic species, but few studies have been performed on the morphology of its immature stages. An analysis of mandible shape and linear morphometric variability was applied to third-instar larvae of five morphotypes of the Anastrepha fraterculus complex: Mexican, Andean, Ecuadorian, Peruvian and Brazilian-1. Outline geometric morphometry was used to study the mouth hook shape and linear morphometry analysis was performed using 24 linear measurements of the body, cephalopharyngeal skeleton, mouth hook and hypopharyngeal sclerite. Different morphotypes were grouped accurately using canonical discriminant analyses of both the geometric and linear morphometry. The shape of the mandible differed among the morphotypes, and the anterior spiracle length, number of tubules of the anterior spiracle, length and height of the mouth hook and length of the cephalopharyngeal skeleton were the most significant variables in the linear morphometric analysis. Third-instar larvae provide useful characters for studies of cryptic species in the Anastrepha fraterculus complex. PMID:26798253

Strategic management: a new dimension of the nurse executive's role.

PubMed

Johnson, L J

1990-09-01

The growth of corporate orientation for health care structures, with a focus on bottom-line management, has radically altered the role of nurse executives. With the organization's emphasis on performance, productivity, and results, successful nurse executives are now integrating the management of the delivery of nursing care with the management of complex corporate structures and relationships. The editor of Executive Development discusses the rapidly changing expectations and demands of the contemporary nurse executive's work. The nurse executive's role can be viewed from many perspectives: its scope, its value, its structure, its content. Content--"What does the nurse executive do that makes a real difference?"--is the focus here.

Development of performance indicators for municipal solid waste management (PIMS): A review.

PubMed

Sanjeevi, V; Shahabudeen, P

2015-12-01

The aim of this paper is to review papers on municipal solid waste management (SWM) systems, especially on performance indicators (PIs), and suggest practical methods to manage the same by administrators. Worldwide, about 4 billion metric tons of solid waste (SW) is generated annually; the management of SW across cities is increasingly getting more complex and the funds available for providing service to citizens are shrinking. Analysis of the non-technical research papers shows that focus areas on SW can be grouped into 18 types, one being PIs. Historically, PIs for municipal SWM (PIMS) commenced with the publication of guidelines by various government agencies, starting in 1969. This was followed by a few benchmarking studies, commencing in 1998, by various international institutions. Many published comparative studies also disseminated good practices across the cities. From the 1990s onwards, research work started defining PIMS. These initiatives by various researchers took multiple dimensions and are reviewed in this paper. In almost all studies, the PIMS is measured in terms of investment decisions, public acceptance levels, social participation and environmental needs. The multiple indicators are complex, however, and managers of cities need simple tools to use. To make it simple, five-factor PIs are arrived at, considering simplicity and covering all the factors. A research agenda is outlined for future directions in the areas of cost reduction, citizens' services, citizen involvement and environmental impact. © The Author(s) 2015.

An adaptive framework to differentiate receiving water quality impacts on a multi-scale level.

PubMed

Blumensaat, F; Tränckner, J; Helm, B; Kroll, S; Dirckx, G; Krebs, P

2013-01-01

The paradigm shift in recent years towards sustainable and coherent water resources management on a river basin scale has changed the subject of investigations to a multi-scale problem representing a great challenge for all actors participating in the management process. In this regard, planning engineers often face an inherent conflict to provide reliable decision support for complex questions with a minimum of effort. This trend inevitably increases the risk to base decisions upon uncertain and unverified conclusions. This paper proposes an adaptive framework for integral planning that combines several concepts (flow balancing, water quality monitoring, process modelling, multi-objective assessment) to systematically evaluate management strategies for water quality improvement. As key element, an S/P matrix is introduced to structure the differentiation of relevant 'pressures' in affected regions, i.e. 'spatial units', which helps in handling complexity. The framework is applied to a small, but typical, catchment in Flanders, Belgium. The application to the real-life case shows: (1) the proposed approach is adaptive, covers problems of different spatial and temporal scale, efficiently reduces complexity and finally leads to a transparent solution; and (2) water quality and emission-based performance evaluation must be done jointly as an emission-based performance improvement does not necessarily lead to an improved water quality status, and an assessment solely focusing on water quality criteria may mask non-compliance with emission-based standards. Recommendations derived from the theoretical analysis have been put into practice.

Gastrointestinal surgery in cystic fibrosis: a 20-year review.

PubMed

Farrelly, Paul J; Charlesworth, Caroline; Lee, Sophie; Southern, Kevin W; Baillie, Colin T

2014-02-01

The purpose of this study was to evaluate outcomes of the surgical management for meconium ileus (MI) and Distal Intestinal Obstruction Syndrome (DIOS) in Cystic Fibrosis (CF). Children born between 1990 and 2010 were identified using a regional CF database. Retrospective case note analysis was performed. Outcome measures for MI were mortality, relaparotomy rate, length of stay (LOS), time on parental nutrition (TP), and time to full feeds (TFF). Outcome measures for DIOS were: age of onset, number of episodes, and need for laparotomy. Seventy-five of 376 neonates presented with MI. Fifty-four (92%) required laparotomy. Contrast enema decompression was attempted in nineteen. There were no post-operative deaths. Thirty-nine (72%) neonates with MI were managed with stomas. LOS was longer in those managed with stomas (p=0.001) and in complex MI (p=0.002). Thirty-five patients were treated for DIOS. Twenty-five patients were managed with gastrograffin. Ten patients underwent surgical management of DIOS. Overall, MI did not predispose to later development of DIOS. There was a significantly greater incidence of laparotomy for DIOS in children who had MI. The proportion of neonates with complex meconium ileus was high (49%) and may explain the infrequent utilisation of radiological decompression. Complex MI or management with stomas both significantly increase LOS. Re-laparotomy rate is high (22%) in MI irrespective of the type of management. DIOS is not a benign condition, particularly when the child has had previous abdominal surgery. Early referral to a surgical team is essential in these children. Copyright © 2014 Elsevier Inc. All rights reserved.

Data management system performance modeling

NASA Technical Reports Server (NTRS)

Kiser, Larry M.

1993-01-01

This paper discusses analytical techniques that have been used to gain a better understanding of the Space Station Freedom's (SSF's) Data Management System (DMS). The DMS is a complex, distributed, real-time computer system that has been redesigned numerous times. The implications of these redesigns have not been fully analyzed. This paper discusses the advantages and disadvantages for static analytical techniques such as Rate Monotonic Analysis (RMA) and also provides a rationale for dynamic modeling. Factors such as system architecture, processor utilization, bus architecture, queuing, etc. are well suited for analysis with a dynamic model. The significance of performance measures for a real-time system are discussed.

Fault Management Architectures and the Challenges of Providing Software Assurance

NASA Technical Reports Server (NTRS)

Savarino, Shirley; Fitz, Rhonda; Fesq, Lorraine; Whitman, Gerek

2015-01-01

Fault Management (FM) is focused on safety, the preservation of assets, and maintaining the desired functionality of the system. How FM is implemented varies among missions. Common to most missions is system complexity due to a need to establish a multi-dimensional structure across hardware, software and spacecraft operations. FM is necessary to identify and respond to system faults, mitigate technical risks and ensure operational continuity. Generally, FM architecture, implementation, and software assurance efforts increase with mission complexity. Because FM is a systems engineering discipline with a distributed implementation, providing efficient and effective verification and validation (V&V) is challenging. A breakout session at the 2012 NASA Independent Verification & Validation (IV&V) Annual Workshop titled "V&V of Fault Management: Challenges and Successes" exposed this issue in terms of V&V for a representative set of architectures. NASA's Software Assurance Research Program (SARP) has provided funds to NASA IV&V to extend the work performed at the Workshop session in partnership with NASA's Jet Propulsion Laboratory (JPL). NASA IV&V will extract FM architectures across the IV&V portfolio and evaluate the data set, assess visibility for validation and test, and define software assurance methods that could be applied to the various architectures and designs. This SARP initiative focuses efforts on FM architectures from critical and complex projects within NASA. The identification of particular FM architectures and associated V&V/IV&V techniques provides a data set that can enable improved assurance that a system will adequately detect and respond to adverse conditions. Ultimately, results from this activity will be incorporated into the NASA Fault Management Handbook providing dissemination across NASA, other agencies and the space community. This paper discusses the approach taken to perform the evaluations and preliminary findings from the research.

Fault Management Architectures and the Challenges of Providing Software Assurance

NASA Technical Reports Server (NTRS)

Savarino, Shirley; Fitz, Rhonda; Fesq, Lorraine; Whitman, Gerek

2015-01-01

The satellite systems Fault Management (FM) is focused on safety, the preservation of assets, and maintaining the desired functionality of the system. How FM is implemented varies among missions. Common to most is system complexity due to a need to establish a multi-dimensional structure across hardware, software and operations. This structure is necessary to identify and respond to system faults, mitigate technical risks and ensure operational continuity. These architecture, implementation and software assurance efforts increase with mission complexity. Because FM is a systems engineering discipline with a distributed implementation, providing efficient and effective verification and validation (VV) is challenging. A breakout session at the 2012 NASA Independent Verification Validation (IVV) Annual Workshop titled VV of Fault Management: Challenges and Successes exposed these issues in terms of VV for a representative set of architectures. NASA's IVV is funded by NASA's Software Assurance Research Program (SARP) in partnership with NASA's Jet Propulsion Laboratory (JPL) to extend the work performed at the Workshop session. NASA IVV will extract FM architectures across the IVV portfolio and evaluate the data set for robustness, assess visibility for validation and test, and define software assurance methods that could be applied to the various architectures and designs. This work focuses efforts on FM architectures from critical and complex projects within NASA. The identification of particular FM architectures, visibility, and associated VVIVV techniques provides a data set that can enable higher assurance that a satellite system will adequately detect and respond to adverse conditions. Ultimately, results from this activity will be incorporated into the NASA Fault Management Handbook providing dissemination across NASA, other agencies and the satellite community. This paper discusses the approach taken to perform the evaluations and preliminary findings from the research including identification of FM architectures, visibility observations, and methods utilized for VVIVV.

Patient ratings of case managers in a medical home: associations with patient satisfaction and health care utilization.

PubMed

Jubelt, Lindsay E; Graham, Jove; Maeng, Daniel D; Li, Huilin; Epstein, Andrew J; Metlay, Joshua P

2014-11-18

Case managers are employed in medical homes to coordinate care for clinically complex patients. To measure the association of patient perceptions of case manager performance with overall satisfaction and subsequent health care utilization. Retrospective cohort study. Integrated health system in Pennsylvania. Members of the health system-owned health plan who 1) received primary care in the health system's clinics, 2) were exposed to clinic-embedded case managers, and 3) completed a survey of satisfaction with care. Survey assessment of case manager performance and overall satisfaction with care and claims-based assessment of case manager performance and subsequent hospitalizations or emergency department visits. Survey measures were dichotomized into very good versus less than very good. A total of 1755 patients (44%) completed the survey and 1415 met study criteria. Survey respondents who reported very good ratings of case manager performance across all items had a higher probability of reporting very good overall satisfaction with care (92.2% vs. 62.5%; P < 0.001) and had a lower incidence of subsequent emergency department visits (incidence rate ratio, 0.79 [95% CI, 0.64 to 0.98]; P = 0.029) but not hospitalizations (incidence rate ratio, 0.92 [CI, 0.75 to 1.11]; P = 0.37) up to 2 years after the survey compared with survey respondents who reported less-than-very good case manager performance on 1 or more questions on the survey. Satisfaction data demonstrated substantial ceiling effects. Survey nonresponse may have introduced bias in the results. Patients' favorable perceptions of case managers are associated with higher overall satisfaction with care and may lower risk for future acute care use. Robert Wood Johnson Foundation and the U.S. Department of Veterans Affairs.

The effectiveness of virtual simulation in improving student nurses' knowledge and performance during patient deterioration: A pre and post test design.

PubMed

Borg Sapiano, Alexis; Sammut, Roberta; Trapani, Josef

2018-03-01

Preparing nursing students to perform competently in complex emergency situations, such as during rapid patient deterioration, is challenging. Students' active engagement in such scenarios cannot be ensured, due to the unexpected nature of such infrequent events. Many students may consequently not experience and integrate the management of patient deterioration into their knowledge and practical competency by the end of their studies, making them unprepared to manage such situations as practicing nurses. This study investigated the effectiveness of virtual simulation in improving performance during rapid patient deterioration. To investigate the effectiveness of virtual simulation in improving student nurses' knowledge and performance during rapid patient deterioration. A pre- and post-test design was used. Nursing students at a university in Malta were invited to participate in a virtual simulation program named FIRST 2 ACTWeb™, using their own computer devices. A total of 166 (response rate=50%) second and third year diploma and degree nursing students participated in the study. The simulation included three scenarios (Cardiac-Shock-Respiratory) portraying deteriorating patients. Performance feedback was provided at the end of each scenario. Students completed pre- and post-scenario knowledge tests and performance during each scenario was recorded automatically on a database. Findings showed a significant improvement in the students' post-scenario knowledge (z=-6.506, p<0.001). Highest mean performance scores were obtained in the last scenario (M=19.7, median: 20.0, s.d. 3.41) indicating a learning effect. Knowledge was not a predictor of students' performance in the scenarios. This study supports virtual simulation as an effective learning tool for pre-registration nursing students in different programs. Simulation improves both knowledge about and performance during patient deterioration. Virtual simulation of rare events should be a key component of undergraduate nurse education, to prepare students to manage complex situations as practicing nurses. Copyright © 2018 Elsevier Ltd. All rights reserved.

Automated campaign system

NASA Astrophysics Data System (ADS)

Vondran, Gary; Chao, Hui; Lin, Xiaofan; Beyer, Dirk; Joshi, Parag; Atkins, Brian; Obrador, Pere

2006-02-01

To run a targeted campaign involves coordination and management across numerous organizations and complex process flows. Everything from market analytics on customer databases, acquiring content and images, composing the materials, meeting the sponsoring enterprise brand standards, driving through production and fulfillment, and evaluating results; all processes are currently performed by experienced highly trained staff. Presented is a developed solution that not only brings together technologies that automate each process, but also automates the entire flow so that a novice user could easily run a successful campaign from their desktop. This paper presents the technologies, structure, and process flows used to bring this system together. Highlighted will be how the complexity of running a targeted campaign is hidden from the user through technologies, all while providing the benefits of a professionally managed campaign.

Pathology consultation on urine compliance testing and drug abuse screening.

PubMed

Ward, Michael B; Hackenmueller, Sarah A; Strathmann, Frederick G

2014-11-01

Compliance testing in pain management requires a distinct approach compared with classic clinical toxicology testing. Differences in the patient populations and clinical expectations require modifications to established reporting cutoffs, assay performance expectations, and critical review of how best to apply the available testing methods. Although other approaches to testing are emerging, immunoassay screening followed by mass spectrometry confirmation remains the most common testing workflow for pain management compliance and drug abuse testing. A case-based approach was used to illustrate the complexities inherent to and uniqueness of pain management compliance testing for both clinicians and laboratories. A basic understanding of the inherent strengths and weaknesses of immunoassays and mass spectrometry provides the clinician a better understanding of how best to approach pain management compliance testing. Pain management compliance testing is a textbook example of an emerging field requiring open communication between physician and performing laboratory to fully optimize patient care. Copyright© by the American Society for Clinical Pathology.

Evaluation of Currently Used Dental Management Indicators and Development of New Management and Performance Indicators.

DTIC Science & Technology

1981-07-01

for selected procedures g. Pericdontal Procedures Per Dentist Formula: Number of Perio Procedures Comr’.neted* Nunber of Dentists Assigned *See appendi...02336 - Resin, Complex A-2 Selected Endodontic Procedures for Endo teeth per assigned DDS ratio: 03311 - Anterior, 1 Canal Filled 03312 - Anterior, 2 or...04271 - Free Soft Tissue Graft 04272 - Vestibulo.-lasty 04340 - Perio Scale and Root Planning *Some or these procedures are not end-item entities as are

Senior Laboratory Animal Technician | Center for Cancer Research

Cancer.gov

PROGRAM DESCRIPTION The Laboratory Animal Sciences Program (LASP) provides exceptional quality animal care and technical support services for animal research performed at the National Cancer Institute at the Frederick National Laboratory for Cancer Research. LASP executes this mission by providing a broad spectrum of state-of-the-art technologies and services that are focused on the design, generation, characterization and application of genetically engineered and biological animal models of human disease, which are aimed at the development of targeted diagnostics and therapies. LASP contributes to advancing human health, developing new treatments, and improving existing treatments for cancer and other diseases while ensuring safe and humane treatment of animals. KEY ROLES/RESPONSIBILITIES The Senior Laboratory Animal Technician will be responsible for: Daily tasks associated with the care, breeding and treatment of research animals for experimental purposes Management of rodent breeding colonies consisting of multiple, genetically complex strains and associated record keeping and database management Colony management procedures including: tail clipping, animal identification, weaning Data entry consistent with complex colony management Collection of routine diagnostic samples Coordinating shipment of live animals and specimens Performing rodent experimental procedures including basic necropsy and blood collection Observation and recording of physical signs of animal health Knowledge of safe working practices using chemical carcinogen and biological hazards Work schedule may include weekend and holiday hours This position is in support of the Center for Cancer Research (CCR).

The operative management of children with complex perianal Crohn's disease.

PubMed

Seemann, Natashia M; King, Sebastian K; Elkadri, Abdul; Walters, Thomas; Fish, Joel; Langer, Jacob C

2016-12-01

Perianal Crohn's disease (PCD) can affect both quality of life and psychological wellbeing. A subset of pediatric patients with complex PCD require surgical intervention, although appropriate timing and treatment regimens remain unclear. This study aimed to describe a large pediatric cohort in a tertiary center to determine the range of surgical management in children with complex PCD. A retrospective review of children requiring operative intervention for PCD over 13 years (2002-2014) was performed. PCD was divided into simple and complex based on the type of surgical procedure, and the two groups were compared. The 57 children were divided into two groups: the simple group (N=43) underwent abscess drainage ± seton insertion alone, and the complex group (N=14) underwent loop ileostomy ± more extensive surgery. In the complex group, females were more predominant (57% of complex vs 30% of simple), and the average age at diagnosis was lower. Anti-TNF therapy was utilized in 79.1% of simple and 100% of complex PCD. All 14 complex patients underwent a defunctioning ileostomy, with 7 requiring further operations (subtotal colectomy=4, proctocolectomy ± anal sparing=5, plastic surgery reconstruction with perineal flap/graft=4). Complex PCD represents a small but challenging subset of patients in which major surgical intervention may be necessary to alleviate the symptoms of this debilitating condition. retrospective case study with no control group - level IV. Copyright © 2016 Elsevier Inc. All rights reserved.

An Investigation of Unified Memory Access Performance in CUDA

PubMed Central

Landaverde, Raphael; Zhang, Tiansheng; Coskun, Ayse K.; Herbordt, Martin

2015-01-01

Managing memory between the CPU and GPU is a major challenge in GPU computing. A programming model, Unified Memory Access (UMA), has been recently introduced by Nvidia to simplify the complexities of memory management while claiming good overall performance. In this paper, we investigate this programming model and evaluate its performance and programming model simplifications based on our experimental results. We find that beyond on-demand data transfers to the CPU, the GPU is also able to request subsets of data it requires on demand. This feature allows UMA to outperform full data transfer methods for certain parallel applications and small data sizes. We also find, however, that for the majority of applications and memory access patterns, the performance overheads associated with UMA are significant, while the simplifications to the programming model restrict flexibility for adding future optimizations. PMID:26594668

How to use MPI communication in highly parallel climate simulations more easily and more efficiently.

NASA Astrophysics Data System (ADS)

Behrens, Jörg; Hanke, Moritz; Jahns, Thomas

2014-05-01

In this talk we present a way to facilitate efficient use of MPI communication for developers of climate models. Exploitation of the performance potential of today's highly parallel supercomputers with real world simulations is a complex task. This is partly caused by the low level nature of the MPI communication library which is the dominant communication tool at least for inter-node communication. In order to manage the complexity of the task, climate simulations with non-trivial communication patterns often use an internal abstraction layer above MPI without exploiting the benefits of communication aggregation or MPI-datatypes. The solution for the complexity and performance problem we propose is the communication library YAXT. This library is built on top of MPI and takes high level descriptions of arbitrary domain decompositions and automatically derives an efficient collective data exchange. Several exchanges can be aggregated in order to reduce latency costs. Examples are given which demonstrate the simplicity and the performance gains for selected climate applications.

Using global sensitivity analysis to understand higher order interactions in complex models: an application of GSA on the Revised Universal Soil Loss Equation (RUSLE) to quantify model sensitivity and implications for ecosystem services management in Costa Rica

NASA Astrophysics Data System (ADS)

Fremier, A. K.; Estrada Carmona, N.; Harper, E.; DeClerck, F.

2011-12-01

Appropriate application of complex models to estimate system behavior requires understanding the influence of model structure and parameter estimates on model output. To date, most researchers perform local sensitivity analyses, rather than global, because of computational time and quantity of data produced. Local sensitivity analyses are limited in quantifying the higher order interactions among parameters, which could lead to incomplete analysis of model behavior. To address this concern, we performed a GSA on a commonly applied equation for soil loss - the Revised Universal Soil Loss Equation. USLE is an empirical model built on plot-scale data from the USA and the Revised version (RUSLE) includes improved equations for wider conditions, with 25 parameters grouped into six factors to estimate long-term plot and watershed scale soil loss. Despite RUSLE's widespread application, a complete sensitivity analysis has yet to be performed. In this research, we applied a GSA to plot and watershed scale data from the US and Costa Rica to parameterize the RUSLE in an effort to understand the relative importance of model factors and parameters across wide environmental space. We analyzed the GSA results using Random Forest, a statistical approach to evaluate parameter importance accounting for the higher order interactions, and used Classification and Regression Trees to show the dominant trends in complex interactions. In all GSA calculations the management of cover crops (C factor) ranks the highest among factors (compared to rain-runoff erosivity, topography, support practices, and soil erodibility). This is counter to previous sensitivity analyses where the topographic factor was determined to be the most important. The GSA finding is consistent across multiple model runs, including data from the US, Costa Rica, and a synthetic dataset of the widest theoretical space. The three most important parameters were: Mass density of live and dead roots found in the upper inch of soil (C factor), slope angle (L and S factor), and percentage of land area covered by surface cover (C factor). Our findings give further support to the importance of vegetation as a vital ecosystem service provider - soil loss reduction. Concurrent, progress is already been made in Costa Rica, where dam managers are moving forward on a Payment for Ecosystem Services scheme to help keep private lands forested and to improve crop management through targeted investments. Use of complex watershed models, such as RUSLE can help managers quantify the effect of specific land use changes. Moreover, effective land management of vegetation has other important benefits, such as bundled ecosystem services (e.g. pollination, habitat connectivity, etc) and improvements of communities' livelihoods.

Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects.

PubMed

Mwencha, Marasi; Rosen, James E; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

2017-09-27

To address challenges in public health supply chain performance, Tanzania invested in a national logistics management unit (LMU) and a national electronic logistics management information system (eLMIS). This evaluation examined the impact of those 2 key management upgrades approximately 1 year after they were introduced. We used a nonexperimental pre-post study design to compare the previous system with the upgraded management system. We collected baseline data from August to November 2013. We conducted round 1 of post-implementation data collection during April and May 2015, about 1 year after implementation of the upgrades. We evaluated key indicators of data use and reporting; supply chain management practices such as storage and supervision; supply chain performance including stock-out and expiry rates; and supply chain cost and savings. We analyzed the data using a range of techniques including statistical testing of baseline and round-1 results, and cost, cost-effectiveness, and return on investment analysis. The upgrades were associated with improvements in data use, accessibility, visibility, and transparency; planning, control, and monitoring; support for quantification; stock-out rates; stock-out duration; commodity expiry; and forecast error. The upgraded system was more costly, but it was also more efficient, particularly when adjusting for the performance improvements. The upgrades also generated substantial savings that defrayed some, but not all, of the investment costs. Upgrades to Tanzania's supply chain management systems created multiple and complex pathways to impact. One year after implementation, the LMU and eLMIS brought about performance improvements through better data use and through improvements in some, but not all, management practices. Furthermore, the upgrades-while not inexpensive-contributed to greater system efficiency and modest savings. © Mwencha et al.

Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects

PubMed Central

Mwencha, Marasi; Rosen, James E; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

2017-01-01

ABSTRACT Background: To address challenges in public health supply chain performance, Tanzania invested in a national logistics management unit (LMU) and a national electronic logistics management information system (eLMIS). This evaluation examined the impact of those 2 key management upgrades approximately 1 year after they were introduced. Methods: We used a nonexperimental pre-post study design to compare the previous system with the upgraded management system. We collected baseline data from August to November 2013. We conducted round 1 of post-implementation data collection during April and May 2015, about 1 year after implementation of the upgrades. We evaluated key indicators of data use and reporting; supply chain management practices such as storage and supervision; supply chain performance including stock-out and expiry rates; and supply chain cost and savings. We analyzed the data using a range of techniques including statistical testing of baseline and round-1 results, and cost, cost-effectiveness, and return on investment analysis. Results: The upgrades were associated with improvements in data use, accessibility, visibility, and transparency; planning, control, and monitoring; support for quantification; stock-out rates; stock-out duration; commodity expiry; and forecast error. The upgraded system was more costly, but it was also more efficient, particularly when adjusting for the performance improvements. The upgrades also generated substantial savings that defrayed some, but not all, of the investment costs. Conclusion: Upgrades to Tanzania's supply chain management systems created multiple and complex pathways to impact. One year after implementation, the LMU and eLMIS brought about performance improvements through better data use and through improvements in some, but not all, management practices. Furthermore, the upgrades—while not inexpensive—contributed to greater system efficiency and modest savings. PMID:28877933

Advanced dementia pain management protocols.

PubMed

Montoro-Lorite, Mercedes; Canalias-Reverter, Montserrat

Pain management in advanced dementia is complex because of neurological deficits present in these patients, and nurses are directly responsible for providing interventions for the evaluation, management and relief of pain for people suffering from this health problem. In order to facilitate and help decision-makers, pain experts recommend the use of standardized protocols to guide pain management, but in Spain, comprehensive pain management protocols have not yet been developed for advanced dementia. This article reflects the need for an integrated management of pain in advanced dementia. From the review and analysis of the most current and relevant studies in the literature, we performed an approximation of the scales for the determination of pain in these patients, with the observational scale PAINAD being the most recommended for the hospital setting. In addition, we provide an overview for comprehensive management of pain in advanced dementia through the conceptual framework «a hierarchy of pain assessment techniques by McCaffery and Pasero» for the development and implementation of standardized protocols, including a four-phase cyclical process (evaluation, planning/performance, revaluation and recording), which can facilitate the correct management of pain in these patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

HERCULES: A Pattern Driven Code Transformation System

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

Kartsaklis, Christos; Hernandez, Oscar R; Hsu, Chung-Hsing

2012-01-01

New parallel computers are emerging, but developing efficient scientific code for them remains difficult. A scientist must manage not only the science-domain complexity but also the performance-optimization complexity. HERCULES is a code transformation system designed to help the scientist to separate the two concerns, which improves code maintenance, and facilitates performance optimization. The system combines three technologies, code patterns, transformation scripts and compiler plugins, to provide the scientist with an environment to quickly implement code transformations that suit his needs. Unlike existing code optimization tools, HERCULES is unique in its focus on user-level accessibility. In this paper we discuss themore » design, implementation and an initial evaluation of HERCULES.« less

Supporting interruption management and multimodal interface design: three meta-analyses of task performance as a function of interrupting task modality.

PubMed

Lu, Sara A; Wickens, Christopher D; Prinet, Julie C; Hutchins, Shaun D; Sarter, Nadine; Sebok, Angelia

2013-08-01

The aim of this study was to integrate empirical data showing the effects of interrupting task modality on the performance of an ongoing visual-manual task and the interrupting task itself. The goal is to support interruption management and the design of multimodal interfaces. Multimodal interfaces have been proposed as a promising means to support interruption management.To ensure the effectiveness of this approach, their design needs to be based on an analysis of empirical data concerning the effectiveness of individual and redundant channels of information presentation. Three meta-analyses were conducted to contrast performance on an ongoing visual task and interrupting tasks as a function of interrupting task modality (auditory vs. tactile, auditory vs. visual, and single modality vs. redundant auditory-visual). In total, 68 studies were included and six moderator variables were considered. The main findings from the meta-analyses are that response times are faster for tactile interrupting tasks in case of low-urgency messages.Accuracy is higher with tactile interrupting tasks for low-complexity signals but higher with auditory interrupting tasks for high-complexity signals. Redundant auditory-visual combinations are preferable for communication tasks during high workload and with a small visual angle of separation. The three meta-analyses contribute to the knowledge base in multimodal information processing and design. They highlight the importance of moderator variables in predicting the effects of interruption task modality on ongoing and interrupting task performance. The findings from this research will help inform the design of multimodal interfaces in data-rich, event-driven domains.

Managing systems faults on the commercial flight deck: Analysis of pilots' organization and prioritization of fault management information

NASA Technical Reports Server (NTRS)

Rogers, William H.

1993-01-01

In rare instances, flight crews of commercial aircraft must manage complex systems faults in addition to all their normal flight tasks. Pilot errors in fault management have been attributed, at least in part, to an incomplete or inaccurate awareness of the fault situation. The current study is part of a program aimed at assuring that the types of information potentially available from an intelligent fault management aiding concept developed at NASA Langley called 'Faultfinde' (see Abbott, Schutte, Palmer, and Ricks, 1987) are an asset rather than a liability: additional information should improve pilot performance and aircraft safety, but it should not confuse, distract, overload, mislead, or generally exacerbate already difficult circumstances.

Autonomic Cluster Management System (ACMS): A Demonstration of Autonomic Principles at Work

NASA Technical Reports Server (NTRS)

Baldassari, James D.; Kopec, Christopher L.; Leshay, Eric S.; Truszkowski, Walt; Finkel, David

2005-01-01

Cluster computing, whereby a large number of simple processors or nodes are combined together to apparently function as a single powerful computer, has emerged as a research area in its own right. The approach offers a relatively inexpensive means of achieving significant computational capabilities for high-performance computing applications, while simultaneously affording the ability to. increase that capability simply by adding more (inexpensive) processors. However, the task of manually managing and con.guring a cluster quickly becomes impossible as the cluster grows in size. Autonomic computing is a relatively new approach to managing complex systems that can potentially solve many of the problems inherent in cluster management. We describe the development of a prototype Automatic Cluster Management System (ACMS) that exploits autonomic properties in automating cluster management.

Enduring the shipboard stressor complex: a systems approach.

PubMed

Comperatore, Carlos A; Rivera, Pik Kwan; Kingsley, Leonard

2005-06-01

A high incidence of physiological and psychological stressors characterizes the maritime work environment in many segments of the commercial maritime industry and in the military. Traditionally, crewmembers work embedded in a complex of stressors. Stressors rarely act independently because most occur concurrently, simultaneously taxing physical and mental resources. Stressors such as extreme environmental temperatures, long work hours, heavy mental and physical workload, authoritative leadership, isolation from family and loved ones, lack of exercise, and unhealthy diets often combine to degrade crewmember health and performance, particularly on long voyages. This complex system of interacting stressors affects the ability of maritime crewmembers to maintain adequate levels of alertness and performance. An analytical systems approach methodology is described here as a viable method to identify workplace stressors and track their systemic interactions. A systems-based program for managing the stressor complex is then offered, together with the empirical research supporting its efficacy. Included is an example implementation of a stressor-control program aboard a U.S. Coast Guard cutter.

Evaluation of Complex Human Performance: The Promise of Computer-Based Simulation

ERIC Educational Resources Information Center

Newsom, Robert S.; And Others

1978-01-01

For the training and placement of professional workers, multiple-choice instruments are the norm for wide-scale measurement and evaluation efforts. These instruments contain fundamental problems. Computer-based management simulations may provide solutions to these problems, appear scoreable and reliable, offer increased validity, and are better…

Performance of a distributed semi-conceptual hydrological model under tropical watershed conditions

USDA-ARS?s Scientific Manuscript database

Many hydrologic models have been developed to help manage natural resources all over the world. Nevertheless, most models have presented a high complexity in terms of data base requirements, as well as, many calibration parameters. This has resulted in serious difficulties to application in catchmen...

Teacher Supervision and Evaluation Challenges: Canadian Perspectives on Overall Instructional Leadership

ERIC Educational Resources Information Center

Brandon, Jim; Hollweck, Trista; Donlevy, James Kent; Whalen, Catherine

2018-01-01

This inquiry focuses on the "overall instructional leadership" approaches used by exemplary principals in three high performing Canadian provinces to overcome three persistent obstacles to effective teacher supervision and evaluation: (a) the management challenge, (b) the complexity challenge, and (c) the learning challenge. Analysis of…

Reconstruction of massive facial avulsive injury, secondary to animal bite.

PubMed

Motamed, Sadrollah; Niazi, Feizollah; Moosavizadeh, Seyed Mehdi; Gholizade Pasha, Abdolhamid; Motamed, Ali

2014-02-01

Management of facial soft tissue trauma requires complex reconstruction surgery. Animal bite on face is a common cause of facial tissue trauma with severe destruction. Evaluation of unit involvement is the first effort, followed by designation of reconstruction. In this case, we performed multiple reconstruction options.

Evaluation of an electronic nose for improved biosolids alkaline-stabilization treatment and odor management

USDA-ARS?s Scientific Manuscript database

Electronic nose sensors are designed to detect differences in complex air sample matrices. For example, they have been used in the food industry to monitor process performance and quality control. However, no information is available on the application of sensor arrays to monitor process performanc...

[Risk management in anesthesia and critical care medicine].

PubMed

Eisold, C; Heller, A R

2017-03-01

Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. A survey performed in Swiss hospitals identified a total of 169 hot spots which endanger patient safety. It turned out that there is a complex variety of possible errors that can only be tackled through consistent implementation of a safety culture. The key elements to reduce complications are continuing staff education, algorithms and standard operating procedures (SOP), working according to the principles of crisis resource management (CRM) and last but not least the continuous work-up of mistakes identified by critical incident reporting systems.

Environmental Cleanup of the East Tennessee Technology Park Year One - Execution with Certainty SM - 13120

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

Schubert, A.L.

2013-07-01

On August 1, 2011, URS - CH2M Oak Ridge LLC (UCOR) began its five-year, $1.4 billion cleanup of the East Tennessee Technology Park (ETTP), located on the U.S. Department of Energy's (DOE) Oak Ridge Reservation in Tennessee. UCOR will close out cleanup operations that began in 1998 under a previous contract. When the Contract Base scope of work [1] is completed in 2016, the K-25 gaseous diffusion building will have been demolished and all waste dispositioned, demolition will have started on the K-27 gaseous diffusion building, all contact-handled and remote-handled transuranic waste in inventory (approximately 500 cubic meters) will havemore » been transferred to the Transuranic Waste Processing Center, previously designated 'No-Path-To-Disposition Waste' will have been dispositioned to the extent possible, and UCOR will have managed DOE Office of Environmental Management (EM)- owned facilities at ETTP, Oak Ridge National Laboratory (ORNL), and the Y-12 National Security Complex in a safe and cost-effective manner. Since assuming its responsibilities as the ETTP cleanup contractor, UCOR has completed its life-cycle Performance Measurement Baseline; received its Earned Value Management System (EVMS) certification; advanced the deactivation and demolition (D and D) of the K-25 gaseous diffusion building; recovered and completed the Tank W-1A and K-1070-B Burial Ground remediation projects; characterized, packaged, and shipped contact-handled transuranic waste to the Transuranic Waste Processing Center; disposed of more than 90,000 cubic yards of cleanup waste while managing the Environmental Management Waste Management Facility (EMWMF); and provided operations, surveillance, and maintenance activities at DOE EM facilities at ETTP, ORNL, and the Y-12 National Security Complex. Project performance as of December 31, 2012 has been excellent: - Cost Performance Index - 1.06; - Schedule Performance Index - 1.02. At the same time, since safety is the foundation of all cleanup work, UCOR's safety record goes hand in hand with its excellent project performance. Through calendar year 2012, UCOR's recordable injury rate was 0.33, and the company has worked close to 4 million hours without a lost work day injury. UCOR's safety record is one of the best in the DOE EM Complex. This performance was due, in large part, to the people and processes URS and CH2M HILL, the parent companies of UCOR, brought to the project. Key approaches included: - Selected and deployed experienced staff in key leadership positions throughout the organization; - Approached 'Transition' as the 'true' beginning of the cleanup project - kicking off a number of project initiatives such as Partnering, PMB development, D and D Plan execution, etc. - Established a project baseline for performance measurement and obtained EVMS certification in record time; - Determined material differences and changed conditions that warranted contract change - then quickly addressed these changes with the DOE client; - Aligned the project and the contract within one year - also done in record time; - Implemented Safety Trained Supervisor and Safety Conscious Work Environment Programs, and kicked off the pursuit of certification under DOE's Voluntary Protection Program. (authors)« less

Fleet/TYCOM Level Survey of Armament Handling Problems - Task One of the Naval Aviation Armament Support Equipment Program Management Study

DTIC Science & Technology

1977-06-21

7. AUTHOR(#) 6. CONTRACT OR GRANT NUMBER(#) PILA /UDERIAN 9. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT, TASK...mechanically complex (i.e. contains an internal combustion engine) and/or comes in direct support of the aircraft is managed and maintained by the AIMD. The...an internal combustion engine. Accordingly, only the Aero 33D/E Trailer, Aero 51B Trailer, 21A/C Bomb Skid, and Aero 47A Weapons Loader are maintained

Managing patient deterioration: assessing teamwork and individual performance.

PubMed

Cooper, Simon; Cant, Robyn; Porter, Jo; Missen, Karen; Sparkes, Louise; McConnell-Henry, Tracy; Endacott, Ruth

2013-05-01

To assess the ability of rural Australian nurse teams to manage deteriorating patients. This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Knowledge in relation to patient deterioration management varied (mean 63%, range 27-100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17-83%, SD 14.03) with significantly higher levels in younger participants (r=-0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.

Towards sustainable infrastructure management: knowledge-based service-oriented computing framework for visual analytics

NASA Astrophysics Data System (ADS)

Vatcha, Rashna; Lee, Seok-Won; Murty, Ajeet; Tolone, William; Wang, Xiaoyu; Dou, Wenwen; Chang, Remco; Ribarsky, William; Liu, Wanqiu; Chen, Shen-en; Hauser, Edd

2009-05-01

Infrastructure management (and its associated processes) is complex to understand, perform and thus, hard to make efficient and effective informed decisions. The management involves a multi-faceted operation that requires the most robust data fusion, visualization and decision making. In order to protect and build sustainable critical assets, we present our on-going multi-disciplinary large-scale project that establishes the Integrated Remote Sensing and Visualization (IRSV) system with a focus on supporting bridge structure inspection and management. This project involves specific expertise from civil engineers, computer scientists, geographers, and real-world practitioners from industry, local and federal government agencies. IRSV is being designed to accommodate the essential needs from the following aspects: 1) Better understanding and enforcement of complex inspection process that can bridge the gap between evidence gathering and decision making through the implementation of ontological knowledge engineering system; 2) Aggregation, representation and fusion of complex multi-layered heterogeneous data (i.e. infrared imaging, aerial photos and ground-mounted LIDAR etc.) with domain application knowledge to support machine understandable recommendation system; 3) Robust visualization techniques with large-scale analytical and interactive visualizations that support users' decision making; and 4) Integration of these needs through the flexible Service-oriented Architecture (SOA) framework to compose and provide services on-demand. IRSV is expected to serve as a management and data visualization tool for construction deliverable assurance and infrastructure monitoring both periodically (annually, monthly, even daily if needed) as well as after extreme events.

Integrated design and management of complex and fast track projects

NASA Astrophysics Data System (ADS)

Mancini, Dario

2003-02-01

Modern scientific and technological projects are increasingly in competition over scientific aims, technological innovation, performance, time and cost. They require a dedicated and innovative organization able to satisfy contemporarily various technical and logistic constraints imposed by the final user, and guarantee the satisfaction of technical specifications, identified on the basis of scientific aims. In order to satisfy all the above, the management has to be strategically innovative and intuitive, by removing, first of all, the bottlenecks that are pointed out, usually only at the end of the projects, as the causes of general dissatisfaction. More than 30 years spent working on complex multidisciplinary systems and 20 years of formative experience in managing contemporarily both scientific, technological and industrial projects have given the author the possibility to study, test and validate strategies for parallel project management and integrated design, merged in a sort of unique optimized task, using the newly-coined word "Technomethodology". The paper highlights useful information to be taken into consideration during project organization to minimize the program deviations from the expected goals and describe some of the basic meanings of this new advanced method that is the key for parallel successful management of multiple and interdisciplinary activities.

Application of data mining in performance measures

NASA Astrophysics Data System (ADS)

Chan, Michael F. S.; Chung, Walter W.; Wong, Tai Sun

2001-10-01

This paper proposes a structured framework for exploiting data mining application for performance measures. The context is set in an airline company is illustrated for the use of such framework. The framework takes in consideration of how a knowledge worker interacts with performance information at the enterprise level to support them to make informed decision in managing the effectiveness of operations. A case study of applying data mining technology for performance data in an airline company is illustrated. The use of performance measures is specifically applied to assist in the aircraft delay management process. The increasingly dispersed and complex operations of airline operation put much strain on the part of knowledge worker in using search, acquiring and analyzing information to manage performance. One major problem faced with knowledge workers is the identification of root causes of performance deficiency. The large amount of factors involved in the analyze the root causes can be time consuming and the objective of applying data mining technology is to reduce the time and resources needed for such process. The increasing market competition for better performance management in various industries gives rises to need of the intelligent use of data. Because of this, the framework proposed here is very much generalizable to industries such as manufacturing. It could assist knowledge workers who are constantly looking for ways to improve operation effectiveness through new initiatives and the effort is required to be quickly done to gain competitive advantage in the marketplace.

[Management of children with headache in a Pediatric Emergency Department before and after the introduction of the Second International Classification of Headache Disorders (ICHD-II)].

PubMed

Gioachin, Anna; Fiumana, Elisa; Tarocco, Anna; Verzola, Adriano; Forini, Elena; Guerra, Valentina; Salani, Manuela; Faggioli, Raffaella

2013-03-01

The aim of this study was to evaluate how the management of children admitted with headache to a Pediatric Emergency Department, was modified by the introduction of the Second International Classification of Headache Disorders ( ICHD-II) published in 2004. The complexity and average costs of the services provided to patients in 2002 and 2011 were compared. The results revealed a decrease in the number of tests performed and in-hospital admissions. However, tests were more complex, and an increase in requests of specialist advice was observed. We hypothesized that this change may be related to the introduction of ICHD-II, which suggests a more rational approach to the child with headache and a better use of hospital resources.

Identifying competitive strategies to improve the performance of hospitals in a competitive environment.

PubMed

Chang, Chuan-Hui; Chiao, Yu-Ching; Tsai, Yafang

2017-11-21

This study is based on competitive dynamics theory, and discusses competitive actions (including their implementation requirements, strategic orientation, and action complexity) that influence hospitals' performance, while also meeting the requirements of Taiwan's "global budget" insurance payment policy. In order to investigate the possible actions of hospitals, the study was conducted in two stages. The first stage investigated the actions of hospitals from March 1 to May 31, 2009. Semi-structured questionnaires were used, which included in-depth interviews with senior supervisors of 10 medium- and large-scale hospitals in central Taiwan. This stage collected data related to the types of actions adopted by the hospitals in previous years. The second stage was based on the data collected from the first stage and on developed questionnaires, which were distributed from June 29 to November 1, 2009. The questionnaires were given to 20 superintendents, deputy superintendents, and supervisors responsible for the management of a hospital, and focused on medical centers and regional hospitals in central Taiwan in order to determine the types and number of competitive actions. First, the strategic orientation of an action has a significantly positive influence on subjective performance. Second, action complexity has a significantly positive influence on the subjective and the objective performance of a hospital. Third, the implementation requirements of actions do not have a significantly positive impact on the subjective or the objective performance of a hospital. Managers facing a competitive healthcare environment should adopt competitive strategies to improve the performance of the hospital.

Machine learning in heart failure: ready for prime time.

PubMed

Awan, Saqib Ejaz; Sohel, Ferdous; Sanfilippo, Frank Mario; Bennamoun, Mohammed; Dwivedi, Girish

2018-03-01

The aim of this review is to present an up-to-date overview of the application of machine learning methods in heart failure including diagnosis, classification, readmissions and medication adherence. Recent studies have shown that the application of machine learning techniques may have the potential to improve heart failure outcomes and management, including cost savings by improving existing diagnostic and treatment support systems. Recently developed deep learning methods are expected to yield even better performance than traditional machine learning techniques in performing complex tasks by learning the intricate patterns hidden in big medical data. The review summarizes the recent developments in the application of machine and deep learning methods in heart failure management.

Amplifying human ability through autonomics and machine learning in IMPACT

NASA Astrophysics Data System (ADS)

Dzieciuch, Iryna; Reeder, John; Gutzwiller, Robert; Gustafson, Eric; Coronado, Braulio; Martinez, Luis; Croft, Bryan; Lange, Douglas S.

2017-05-01

Amplifying human ability for controlling complex environments featuring autonomous units can be aided by learned models of human and system performance. In developing a command and control system that allows a small number of people to control a large number of autonomous teams, we employ an autonomics framework to manage the networks that represent mission plans and the networks that are composed of human controllers and their autonomous assistants. Machine learning allows us to build models of human and system performance useful for monitoring plans and managing human attention and task loads. Machine learning also aids in the development of tactics that human supervisors can successfully monitor through the command and control system.

Energy-aware Thread and Data Management in Heterogeneous Multi-core, Multi-memory Systems

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

Su, Chun-Yi

By 2004, microprocessor design focused on multicore scaling—increasing the number of cores per die in each generation—as the primary strategy for improving performance. These multicore processors typically equip multiple memory subsystems to improve data throughput. In addition, these systems employ heterogeneous processors such as GPUs and heterogeneous memories like non-volatile memory to improve performance, capacity, and energy efficiency. With the increasing volume of hardware resources and system complexity caused by heterogeneity, future systems will require intelligent ways to manage hardware resources. Early research to improve performance and energy efficiency on heterogeneous, multi-core, multi-memory systems focused on tuning a single primitivemore » or at best a few primitives in the systems. The key limitation of past efforts is their lack of a holistic approach to resource management that balances the tradeoff between performance and energy consumption. In addition, the shift from simple, homogeneous systems to these heterogeneous, multicore, multi-memory systems requires in-depth understanding of efficient resource management for scalable execution, including new models that capture the interchange between performance and energy, smarter resource management strategies, and novel low-level performance/energy tuning primitives and runtime systems. Tuning an application to control available resources efficiently has become a daunting challenge; managing resources in automation is still a dark art since the tradeoffs among programming, energy, and performance remain insufficiently understood. In this dissertation, I have developed theories, models, and resource management techniques to enable energy-efficient execution of parallel applications through thread and data management in these heterogeneous multi-core, multi-memory systems. I study the effect of dynamic concurrent throttling on the performance and energy of multi-core, non-uniform memory access (NUMA) systems. I use critical path analysis to quantify memory contention in the NUMA memory system and determine thread mappings. In addition, I implement a runtime system that combines concurrent throttling and a novel thread mapping algorithm to manage thread resources and improve energy efficient execution in multi-core, NUMA systems.« less

A robotic system for automation of logistics functions on the Space Station

NASA Technical Reports Server (NTRS)

Martin, J. C.; Purves, R. B.; Hosier, R. N.; Krein, B. A.

1988-01-01

Spacecraft inventory management is currently performed by the crew and as systems become more complex, increased crew time will be required to perform routine logistics activities. If future spacecraft are to function effectively as research labs and production facilities, the efficient use of crew time as a limited resource for performing mission functions must be employed. The use of automation and robotics technology, such as automated warehouse and materials handling functions, can free the crew from many logistics tasks and provide more efficient use of crew time. Design criteria for a Space Station Automated Logistics Inventory Management System is focused on through the design and demonstration of a mobile two armed terrestrial robot. The system functionally represents a 0 gravity automated inventory management system and the problems associated with operating in such an environment. Features of the system include automated storage and retrieval, item recognition, two armed robotic manipulation, and software control of all inventory item transitions and queries.

Environmental Assessment (EA) for Construct Base Civil Engineering Complex at McConnell AFB

DTIC Science & Technology

2003-07-14

Engineer Squadron (22 CES/ CEVA ),53000 Hutchinson Street, Suite 109,McConnell AFB,KS,67221-3617 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING...Command Air Refueling Group Air Refueling Squadron Air Refueling Wing Bird Aircraft Strike Hazard Base Civil Engineer Best Management Practices...1991, in an "Economic Analysis", performed by Wilson and Company , dated 14 October 1993, and a repeat "Economic Analysis", dated 10 February 2000

Don’t make cache too complex: A simple probability-based cache management scheme for SSDs

PubMed Central

Cho, Sangyeun; Choi, Jongmoo

2017-01-01

Solid-state drives (SSDs) have recently become a common storage component in computer systems, and they are fueled by continued bit cost reductions achieved with smaller feature sizes and multiple-level cell technologies. However, as the flash memory stores more bits per cell, the performance and reliability of the flash memory degrade substantially. To solve this problem, a fast non-volatile memory (NVM-)based cache has been employed within SSDs to reduce the long latency required to write data. Absorbing small writes in a fast NVM cache can also reduce the number of flash memory erase operations. To maximize the benefits of an NVM cache, it is important to increase the NVM cache utilization. In this paper, we propose and study ProCache, a simple NVM cache management scheme, that makes cache-entrance decisions based on random probability testing. Our scheme is motivated by the observation that frequently written hot data will eventually enter the cache with a high probability, and that infrequently accessed cold data will not enter the cache easily. Owing to its simplicity, ProCache is easy to implement at a substantially smaller cost than similar previously studied techniques. We evaluate ProCache and conclude that it achieves comparable performance compared to a more complex reference counter-based cache-management scheme. PMID:28358897

Don't make cache too complex: A simple probability-based cache management scheme for SSDs.

PubMed

Baek, Seungjae; Cho, Sangyeun; Choi, Jongmoo

2017-01-01

Solid-state drives (SSDs) have recently become a common storage component in computer systems, and they are fueled by continued bit cost reductions achieved with smaller feature sizes and multiple-level cell technologies. However, as the flash memory stores more bits per cell, the performance and reliability of the flash memory degrade substantially. To solve this problem, a fast non-volatile memory (NVM-)based cache has been employed within SSDs to reduce the long latency required to write data. Absorbing small writes in a fast NVM cache can also reduce the number of flash memory erase operations. To maximize the benefits of an NVM cache, it is important to increase the NVM cache utilization. In this paper, we propose and study ProCache, a simple NVM cache management scheme, that makes cache-entrance decisions based on random probability testing. Our scheme is motivated by the observation that frequently written hot data will eventually enter the cache with a high probability, and that infrequently accessed cold data will not enter the cache easily. Owing to its simplicity, ProCache is easy to implement at a substantially smaller cost than similar previously studied techniques. We evaluate ProCache and conclude that it achieves comparable performance compared to a more complex reference counter-based cache-management scheme.

Management of older single functioning ventricles with outlet obstruction due to a restricted "VSD" in double inlet left ventricle and in complex double outlet right ventricle.

PubMed

Lacour-Gayet, Francois

2009-01-01

The occurrence of a restriction of the bulbo-ventricular foramen (BVF) in older patient with double inlet left ventricle (DILV) or tricuspid atresia (TA) with ventriculo-arterial discordance is a well-known condition. Today, the surgical management is to perform a Damus-type operation at the time of the bi-directional Glenn or at the Fontan completion. The ventricular septal defect (VSD) enlargement, associated with muscular resection and a patch enlargement of the subaortic accessory ventricular chamber, is rarely performed but remains indicated in cases with pulmonary valve atresia or regurgitation. This condition is essentially prevented by doing an early Norwood-type operation in the presence of DILV/TA with transposition of the great arteries associated with an aortic arch obstruction. The palliative switch operation is an option that was abandoned because of poor control of the pulmonary blood flow. It is only in cases of large unobstructed BVF that pulmonary artery banding could be undertaken in neonates, followed by close echocardiographic follow-up. The occurrence of a restriction or a closure of the VSD in complex DORV following a Fontan operation is a dramatic event and is quite "new business." It has been recently recognized that the VSD becomes restricted in a number of patients with DORV-nc-VSD treated with a Fontan palliation. This new condition is not surprising knowing that 75% of the VSDs must be enlarged preventively in DORV-nc-VSD repair. In the setting of a Fontan circulation, the supra-systemic left ventricle has severe consequences the right ventricle performance. Attempts at surgical VSD enlargement or catheter-based procedures have resulted in almost constant recurrence. This recently reported complication is in favor of also performing a VSD enlargement at the time of the Fontan completion in complex DORV. It justifies the biventricular repair in complex DORV with two viable ventricles.

Three-stage management of complex pancreatic trauma with gastroduodenopancreatectomy: A case report.

PubMed

Damous, Sergio Henrique Bastos; Darce, George Felipe Bezerra; Leal, Renato Silveira; Costa, Adilson Rodrigues; Ferreira, Pedro Henrique Alves; de Oliveira Bernini, Celso; Utiyama, Edivaldo Massazo

2018-01-01

Severe injuries of the pancreatic head and duodenum in haemodynamically unstable patients are complex management. The purpose of this study is to report a case of complex pancreatic trauma induced by gunshot and managed with surgical approaches at three different times. Exploratory laparotomy was indicated after initial emergency room care, with findings of cloudy blood-tinged fluid and blood clots on the mesentery near the hepatic angle, on the region of the 2nd portion of the duodenum and at the pancreatic head. Gastroduodenopancreatectomy was performed with right hemicolectomy and the peritoneal cavity was temporarily closed by a vacuum peritoneostomy. Surgical reopening occurred on the fifth postoperative day, and the patient was subjected to single-loop reconstruction of the intestinal transit with telescoping pancreaticojejunal anastomosis, biliodigestive anastomosis with termino-lateral hepaticojejunal anastomosis with a Kehr drain and gastroenteroanastomosis in 2 planes. The terminal ileostomy was maintained. After 2 days, the patient was subjected to abdominal wall closure without complications, which required relaxing Gibson incisions and wound closure with polypropylene mesh placement in a pre-aponeurotic position closed with multiple stitches. The patient was discharged on the 40th post-trauma day without drains, with a functioning ileostomy and with a scheduled reconstruction of intestinal transit. In the presence of multiple associated injuries, hemodynamic instability and the need for an extensive surgical procedure such as duodenopancreatectomy, damage control surgery performed in stages as reported here enables the clinical stabilization of the patient for definitive treatment, achieving better survival results. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Decision-Making in Management of the Complex Trauma Patient: Changing the Mindset of the non-trauma Surgeon.

PubMed

Sonesson, Linda; Boffard, Kenneth; Lundberg, Lars; Rydmark, Martin; Karlgren, Klas

2018-01-16

European surgeons are frequently subspecialized and trained primarily in elective surgical techniques. As trauma leaders, they may occasionally have to deal with complex polytrauma, advanced management techniques, differing priorities, and the need for multidisciplinary care. There is a lack of expertise, experience, and a low trauma volume, as well as a lack of research, with limited support as to the decision-making and teaching challenges present. We studied what experienced trauma experts describe as the challenges that are specific to the advanced surgical decision-making required, whether civilian, humanitarian, or military. Design-based research using combined methods including interviews, reviews of authentic trauma cases, and video-recorded resuscitations performed at a high-volume civilian academic trauma center. Several educational dilemmas were identified: (1) thinking physiologically, (2) the application of damage control resuscitation and surgery, (3) differing priorities and time management, (4) impact of environment, (5) managing limited resources, (6) lack of general surgical skills, (7) different cultural behavior, and (8) ethical issues. The challenges presented, and the educational domains identified, constitute a basis for improved development of education and training in complex surgical decision-making. This study contributes new knowledge about the mindset required for decision-making in patients with complex multisystem trauma and competing priorities of care. This is, especially important in countries having a low intensity of trauma in both military and civilian environments, and consequential limited skills, and lack of expertise. Guidelines focused on the same decision-making process, using virtual patients and blended learning, can be developed.

Patients' Perspective on the Value of Medication Management Appointments.

PubMed

Cruz, Mario; Cruz, Robyn Flaum; Pincus, Harold Alan

2015-05-20

There is ongoing concern that psychiatric medication management appointments add little value to care. The present study attempted to address this concern by capturing depressed patients' views and opinions about the value of psychiatric medication management appointments. Seventy-eight semi-structured interviews were performed with white and African American depressed patients post medication management appointments. These interviews tapped patients' views and opinions about the value of attending medication management appointments. An iterative thematic analysis was performed. Patients reported greater appointment value when appointments included obtaining medications, discussing the need for medication changes or dose adjustments, and discussing the impact of medications on their illness. Additionally, greater appointment value was perceived by patients when there were non-medical conversations about life issues, immediate outcomes from the appointment such as motivation to continue in care, and specific qualities of providers that were appealing to patients. Patients' perceived value of psychiatric medication management appointments is complex. Though important patient outcomes are obtaining medicine and perceiving improvement in their mental health, there are other valued appointment and provider factors. Some of these other valued factors embedded within medication management appointments could have therapeutic properties. These findings have implications for future clinical research and service delivery.

A Classification System to Guide Physical Therapy Management in Huntington Disease: A Case Series.

PubMed

Fritz, Nora E; Busse, Monica; Jones, Karen; Khalil, Hanan; Quinn, Lori

2017-07-01

Individuals with Huntington disease (HD), a rare neurological disease, experience impairments in mobility and cognition throughout their disease course. The Medical Research Council framework provides a schema that can be applied to the development and evaluation of complex interventions, such as those provided by physical therapists. Treatment-based classifications, based on expert consensus and available literature, are helpful in guiding physical therapy management across the stages of HD. Such classifications also contribute to the development and further evaluation of well-defined complex interventions in this highly variable and complex neurodegenerative disease. The purpose of this case series was to illustrate the use of these classifications in the management of 2 individuals with late-stage HD. Two females, 40 and 55 years of age, with late-stage HD participated in this case series. Both experienced progressive declines in ambulatory function and balance as well as falls or fear of falling. Both individuals received daily care in the home for activities of daily living. Physical therapy Treatment-Based Classifications for HD guided the interventions and outcomes. Eight weeks of in-home balance training, strength training, task-specific practice of functional activities including transfers and walking tasks, and family/carer education were provided. Both individuals demonstrated improvements that met or exceeded the established minimal detectible change values for gait speed and Timed Up and Go performance. Both also demonstrated improvements on Berg Balance Scale and Physical Performance Test performance, with 1 of the 2 individuals exceeding the established minimal detectible changes for both tests. Reductions in fall risk were evident in both cases. These cases provide proof-of-principle to support use of treatment-based classifications for physical therapy management in individuals with HD. Traditional classification of early-, mid-, and late-stage disease progression may not reflect patients' true capabilities; those with late-stage HD may be as responsive to interventions as those at an earlier disease stage.Video Abstract available for additional insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A172).

A multi-service data management platform for scientific oceanographic products

NASA Astrophysics Data System (ADS)

D'Anca, Alessandro; Conte, Laura; Nassisi, Paola; Palazzo, Cosimo; Lecci, Rita; Cretì, Sergio; Mancini, Marco; Nuzzo, Alessandra; Mirto, Maria; Mannarini, Gianandrea; Coppini, Giovanni; Fiore, Sandro; Aloisio, Giovanni

2017-02-01

An efficient, secure and interoperable data platform solution has been developed in the TESSA project to provide fast navigation and access to the data stored in the data archive, as well as a standard-based metadata management support. The platform mainly targets scientific users and the situational sea awareness high-level services such as the decision support systems (DSS). These datasets are accessible through the following three main components: the Data Access Service (DAS), the Metadata Service and the Complex Data Analysis Module (CDAM). The DAS allows access to data stored in the archive by providing interfaces for different protocols and services for downloading, variables selection, data subsetting or map generation. Metadata Service is the heart of the information system of the TESSA products and completes the overall infrastructure for data and metadata management. This component enables data search and discovery and addresses interoperability by exploiting widely adopted standards for geospatial data. Finally, the CDAM represents the back-end of the TESSA DSS by performing on-demand complex data analysis tasks.

Prosthetic replacement for proximal humeral fractures.

PubMed

Kontakis, George; Tosounidis, Theodoros; Galanakis, Ioannis; Megas, Panagiotis

2008-12-01

The ideal management of complex proximal humeral fractures continues to be debatable. Evolution of proximal humeral fracture management, during the past decade, led to the implementation of many innovations in surgical treatment. Even though the pendulum of treatment seems to swing towards new trends such as locked plating, hemiarthroplasty remains a valid and reliable option that serves the patient's needs well. Hemiarthroplasty is indicated for complex proximal humeral fractures in elderly patients with poor bone stock and when internal fixation is difficult or unreliable. Hemiarthroplasty provides a better result when it is performed early post-injury. Stem height, retroversion and tuberosity positioning are technical aspects of utmost importance. Additionally reverse total shoulder arthroplasty is an alternative new modality that can be used as a primary solution in selected patients with proximal humeral fracture treatment. Failed hemiarthroplasty and fracture sequelae can be successfully managed with reverse total shoulder arthroplasty. Individual decision-making and tailored treatment that takes into consideration the personality of the fracture and the patient's characteristics should be used.

How can surgical training benefit from theories of skilled motor development, musical skill acquisition and performance psychology?

PubMed

McCaskie, Andrew W; Kenny, Dianna T; Deshmukh, Sandeep

2011-05-02

Trainee surgeons must acquire expert status in the context of reduced hours, reduced operating room time and the need to learn complex skills involving screen-mediated techniques, computers and robotics. Ever more sophisticated surgical simulation strategies have been helpful in providing surgeons with the opportunity to practise, but not all of these strategies are widely available. Similarities in the motor skills required in skilled musical performance and surgery suggest that models of music learning, and particularly skilled motor development, may be applicable in training surgeons. More attention should be paid to factors associated with optimal arousal and optimal performance in surgical training - lessons learned from helping anxious musicians optimise performance and manage anxiety may also be transferable to trainee surgeons. The ways in which the trainee surgeon moves from novice to expert need to be better understood so that this process can be expedited using current knowledge in other disciplines requiring the performance of complex fine motor tasks with high cognitive load under pressure.

Impact of Cognitive Abilities and Prior Knowledge on Complex Problem Solving Performance - Empirical Results and a Plea for Ecologically Valid Microworlds.

PubMed

Süß, Heinz-Martin; Kretzschmar, André

2018-01-01

The original aim of complex problem solving (CPS) research was to bring the cognitive demands of complex real-life problems into the lab in order to investigate problem solving behavior and performance under controlled conditions. Up until now, the validity of psychometric intelligence constructs has been scrutinized with regard to its importance for CPS performance. At the same time, different CPS measurement approaches competing for the title of the best way to assess CPS have been developed. In the first part of the paper, we investigate the predictability of CPS performance on the basis of the Berlin Intelligence Structure Model and Cattell's investment theory as well as an elaborated knowledge taxonomy. In the first study, 137 students managed a simulated shirt factory ( Tailorshop ; i.e., a complex real life-oriented system) twice, while in the second study, 152 students completed a forestry scenario ( FSYS ; i.e., a complex artificial world system). The results indicate that reasoning - specifically numerical reasoning (Studies 1 and 2) and figural reasoning (Study 2) - are the only relevant predictors among the intelligence constructs. We discuss the results with reference to the Brunswik symmetry principle. Path models suggest that reasoning and prior knowledge influence problem solving performance in the Tailorshop scenario mainly indirectly. In addition, different types of system-specific knowledge independently contribute to predicting CPS performance. The results of Study 2 indicate that working memory capacity, assessed as an additional predictor, has no incremental validity beyond reasoning. We conclude that (1) cognitive abilities and prior knowledge are substantial predictors of CPS performance, and (2) in contrast to former and recent interpretations, there is insufficient evidence to consider CPS a unique ability construct. In the second part of the paper, we discuss our results in light of recent CPS research, which predominantly utilizes the minimally complex systems (MCS) measurement approach. We suggest ecologically valid microworlds as an indispensable tool for future CPS research and applications.

Enhancing Effective Administration at Faculty Level through Shared Leadership

ERIC Educational Resources Information Center

Afful, Deborah

2015-01-01

We live in the world of knowledge, and knowledge keeps increasing in shape and complexity. As a result, no single individual has the repository of knowledge required to effectively manage an organisation all alone to affect organisational performance positively. This explains why administration is explained as doing things through the efforts of…

Learning Paramedic Science Skills from a First Person Point of View

ERIC Educational Resources Information Center

Lynch, Kathy; Barr, Nigel; Oprescu, Florin

2012-01-01

Paramedic students need to acquire knowledge and skills necessary to perform basic as well as complex clinical skills, to ensure patient safety, and to manage sophisticated equipment. Time and resource pressures on students, teaching staff and institutions have led health professional educators to develop and embrace alternative opportunities such…

An Integrative Social-Cognitive Developmental Model of Supervision for Substance Abuse Counselors-in-Training

ERIC Educational Resources Information Center

Sias, Shari M.; Lambie, Glenn W.

2008-01-01

Substance abuse counselors (SACs) at higher levels of social-cognitive maturity manage complex situations and perform counselor-related tasks more effectively than individuals at lower levels of development. This article presents an integrative clinical supervision model designed to promote the social-cognitive maturity (ego development;…

Business Plan for the Southwest Regional Spaceport: Executive Summary

NASA Technical Reports Server (NTRS)

1997-01-01

A proposal for a commercial, full-service launch, tracking, and recovery complex for Reusable Launch Vehicles in New Mexico is presented. Vision, mission, business definition, competitive advantages, and business approach are formulated. Management plan and team structure are detailed, and anticipated market is described. Finance and marketing plans are presented. Financial analysis is performed.

Using Web-Based Peer Benchmarking to Manage the Client-Based Project

ERIC Educational Resources Information Center

Raska, David; Keller, Eileen Weisenbach; Shaw, Doris

2013-01-01

The complexities of integrating client-based projects into marketing courses provide challenges for the instructor but produce richness of context and active learning for the student. This paper explains the integration of Web-based peer benchmarking as a means of improving student performance on client-based projects within a single semester in…

Information Technology Management in Higher Education: An Evidence-Based Approach to Improving Chief Information Officer Performance

ERIC Educational Resources Information Center

Weiss, Meredith L.

2010-01-01

It is critical to higher education institutions that chief information officers (CIOs) succeed since they control information and technology assets, oversee tremendous resources, and facilitate the accomplishments of institutions and their members. The CIO holds a complex and demanding position. Currently there is little quantitative research on…

A Rare Complication of TEVAR Performed for Complex Acute Stanford B Aortic Dissection.

PubMed

Awad, George; Zardo, Patrick; Baraki, Hassina; Kutschka, Ingo

2017-01-01

Management of aortic dissection with a novel endovascular technique known as thoracic endovascular aortic repair (TEVAR) paired with surgical debranching as a less invasive alternative to conventional repair has gained widespread acceptance. However, experience for complicated, Stanford type B dissection involving the aortic arch is still limited.

Automated plant, production management system

NASA Astrophysics Data System (ADS)

Aksenova, V. I.; Belov, V. I.

1984-12-01

The development of a complex of tasks for the operational management of production (OUP) within the framework of an automated system for production management (ASUP) shows that it is impossible to have effective computations without reliable initial information. The influence of many factors involving the production and economic activity of the entire enterprise upon the plan and course of production are considered. It is suggested that an adequate model should be available which covers all levels of the hierarchical system: workplace, section (bridgade), shop, enterprise, and the model should be incorporated into the technological sequence of performance and there should be provisions for an adequate man machine system.

Method for concurrent execution of primitive operations by dynamically assigning operations based upon computational marked graph and availability of data

NASA Technical Reports Server (NTRS)

Mielke, Roland V. (Inventor); Stoughton, John W. (Inventor)

1990-01-01

Computationally complex primitive operations of an algorithm are executed concurrently in a plurality of functional units under the control of an assignment manager. The algorithm is preferably defined as a computationally marked graph contianing data status edges (paths) corresponding to each of the data flow edges. The assignment manager assigns primitive operations to the functional units and monitors completion of the primitive operations to determine data availability using the computational marked graph of the algorithm. All data accessing of the primitive operations is performed by the functional units independently of the assignment manager.

Endodontic management of a fused mandibular third molar and distomolar: a case report.

PubMed

Zeylabi, Ali; Shirani, Farzaneh; Heidari, Fatemeh; Farhad, Ali Reza

2010-04-01

Careful management of fused teeth is essential as abnormal morphology can predispose a tooth to caries and periodontal disease. In this paper, a rare case of successful endodontic management of unilateral mandibular third molar fused to a distomolar is reported. Caries was removed from the tooth complex under local anaesthesia. The pulp chambers of the third molar and supernumerary tooth were accessed and the root canals were prepared using rotary instrumentation and copious irrigation with 2.5% sodium hypochlorite. Obturation using the lateral condensation technique with gutta-percha and AH26 sealer was subsequently performed. A 1-year recall showed a good treatment result.

Data Provenance Hybridization Supporting Extreme-Scale Scientific WorkflowApplications

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

Elsethagen, Todd O.; Stephan, Eric G.; Raju, Bibi

As high performance computing (HPC) infrastructures continue to grow in capability and complexity, so do the applications that they serve. HPC and distributed-area computing (DAC) (e.g. grid and cloud) users are looking increasingly toward workflow solutions to orchestrate their complex application coupling, pre- and post-processing needs To gain insight and a more quantitative understanding of a workflow’s performance our method includes not only the capture of traditional provenance information, but also the capture and integration of system environment metrics helping to give context and explanation for a workflow’s execution. In this paper, we describe IPPD’s provenance management solution (ProvEn) andmore » its hybrid data store combining both of these data provenance perspectives.« less

CoreTSAR: Core Task-Size Adapting Runtime

DOE PAGES

Scogland, Thomas R. W.; Feng, Wu-chun; Rountree, Barry; ...

2014-10-27

Heterogeneity continues to increase at all levels of computing, with the rise of accelerators such as GPUs, FPGAs, and other co-processors into everything from desktops to supercomputers. As a consequence, efficiently managing such disparate resources has become increasingly complex. CoreTSAR seeks to reduce this complexity by adaptively worksharing parallel-loop regions across compute resources without requiring any transformation of the code within the loop. Lastly, our results show performance improvements of up to three-fold over a current state-of-the-art heterogeneous task scheduler as well as linear performance scaling from a single GPU to four GPUs for many codes. In addition, CoreTSAR demonstratesmore » a robust ability to adapt to both a variety of workloads and underlying system configurations.« less

Object-oriented Approach to High-level Network Monitoring and Management

NASA Technical Reports Server (NTRS)

Mukkamala, Ravi

2000-01-01

An absolute prerequisite for the management of large investigating methods to build high-level monitoring computer networks is the ability to measure their systems that are built on top of existing monitoring performance. Unless we monitor a system, we cannot tools. Due to the heterogeneous nature of the hope to manage and control its performance. In this underlying systems at NASA Langley Research Center, paper, we describe a network monitoring system that we use an object-oriented approach for the design, we are currently designing and implementing. Keeping, first, we use UML (Unified Modeling Language) to in mind the complexity of the task and the required model users' requirements. Second, we identify the flexibility for future changes, we use an object-oriented existing capabilities of the underlying monitoring design methodology. The system is built using the system. Third, we try to map the former with the latter. APIs offered by the HP OpenView system.

A comparative study of two different uncinectomy techniques: swing-door and classical.

PubMed

Singhania, Ankit A; Bansal, Chetan; Chauhan, Nirali; Soni, Saurav

2012-01-01

The aim of this study was to determine which technique of uncinectomy, classical or swing door technique. Four hundred eighty Cases of sinusitis were selected and operated for Functional Endoscopic Sinus Surgery (FESS). Out of these, in 240 uncinectomies classical uncinectomy was done whereas in another 240 uncinectomies swing door technique was used. Initially patients were medically managed treated according to their symptoms and prior management. Patients who had received previous adequate medical management were evaluated with CT scan of the sinuses. If disease still persists than they were operated for FESS. The authors' experience indicates that Functional endoscopic sinus surgery can be performed under local or general anesthesia, as permitted or tolerated. In this review classical technique was used in 240 uncinectomies. Out of this, ethmoidal complex injury was noted in 4 cases, missed maxillary ostium syndrome (incomplete removal) was reported in 12 patients and orbital fat exposure was encountered in 5 patients. As compared to 240 uncinectomies done with swing door technique, incomplete removal was evident in 2 cases and lacrimal duct injury was reported in 3 cases. 'Evidence that underscores how this 'swing door technique' successfully combines 'the conservation goals of the anterior-to-posterior approach and anatomic virtues of the posterior-to-anterior approach to ethmoidectomy of the total 480 uncinectomies operated. Out of which 240 uncinectomies have been performed using the 'swing-door' technique. The 240 uncinectomies performed using classical technique were used as controls. The incidence of orbital penetration, incomplete removal, ethmoidal complex injury and ostium non-identification was significantly less with the new technique. Three lacrimal injuries occurred with the 'swing-door' technique compared to no injuries with classical technique. The authors recommend swing door technique as it is easy to learn, allows complete removal of the uncinate flush with the lateral nasal wall and allows easy identification of the natural ostium of the maxillary sinus without injuring the ethmoidal complex.

A design for a new catalog manager and associated file management for the Land Analysis System (LAS)

NASA Technical Reports Server (NTRS)

Greenhagen, Cheryl

1986-01-01

Due to the larger number of different types of files used in an image processing system, a mechanism for file management beyond the bounds of typical operating systems is necessary. The Transportable Applications Executive (TAE) Catalog Manager was written to meet this need. Land Analysis System (LAS) users at the EROS Data Center (EDC) encountered some problems in using the TAE catalog manager, including catalog corruption, networking difficulties, and lack of a reliable tape storage and retrieval capability. These problems, coupled with the complexity of the TAE catalog manager, led to the decision to design a new file management system for LAS, tailored to the needs of the EDC user community. This design effort, which addressed catalog management, label services, associated data management, and enhancements to LAS applications, is described. The new file management design will provide many benefits including improved system integration, increased flexibility, enhanced reliability, enhanced portability, improved performance, and improved maintainability.

Automated distribution system management for multichannel space power systems

NASA Technical Reports Server (NTRS)

Fleck, G. W.; Decker, D. K.; Graves, J.

1983-01-01

A NASA sponsored study of space power distribution system technology is in progress to develop an autonomously managed power system (AMPS) for large space power platforms. The multichannel, multikilowatt, utility-type power subsystem proposed presents new survivability requirements and increased subsystem complexity. The computer controls under development for the power management system must optimize the power subsystem performance and minimize the life cycle cost of the platform. A distribution system management philosophy has been formulated which incorporates these constraints. Its implementation using a TI9900 microprocessor and FORTH as the programming language is presented. The approach offers a novel solution to the perplexing problem of determining the optimal combination of loads which should be connected to each power channel for a versatile electrical distribution concept.

Understanding the Data Complexity continuum to reduce data management costs and increase data usability through partnerships with the National Centers for Environmental Information

NASA Astrophysics Data System (ADS)

Mesick, S.; Weathers, K. W.

2017-12-01

Data complexity can be seen as a continuum from complex to simple. The term data complexity refers to data collections that are disorganized, poorly documented, and generally do not follow best data management practices. Complex data collections are challenging and expensive to manage. Simplified collections readily support automated archival processes, enhanced discovery and data access, as well as production of services that make data easier to reuse. In this session, NOAA NCEI scientific data stewards will discuss the data complexity continuum. This talk will explore data simplification concepts, methods, and tools that data managers can employ which may offer more control over data management costs and processes, while achieving policy goals for open data access and ready reuse. Topics will include guidance for data managers on best allocation of limited data management resources; models for partnering with NCEI to accomplish shared data management goals; and will demonstrate through case studies the benefits of investing in documentation, accessibility, and services to increase data value and return on investment.

Drinking Water Management and Governance in Canada: An Innovative Plan-Do-Check-Act (PDCA) Framework for a Safe Drinking Water Supply

NASA Astrophysics Data System (ADS)

Bereskie, Ty; Rodriguez, Manuel J.; Sadiq, Rehan

2017-08-01

Drinking water management in Canada is complex, with a decentralized, three-tiered governance structure responsible for safe drinking water throughout the country. The current approach has been described as fragmented, leading to governance gaps, duplication of efforts, and an absence of accountability and enforcement. Although there have been no major waterborne disease outbreaks in Canada since 2001, a lack of performance improvement, especially in small drinking water systems, is evident. The World Health Organization water safety plan approach for drinking water management represents an alternative preventative management framework to the current conventional, reactive drinking water management strategies. This approach has seen successful implementation throughout the world and has the potential to address many of the issues with drinking water management in Canada. This paper presents a review and strengths-weaknesses-opportunities-threats analysis of drinking water management and governance in Canada at the federal, provincial/territorial, and municipal levels. Based on this analysis, a modified water safety plan (defined as the plan-do-check-act (PDCA)-WSP framework) is proposed, established from water safety plan recommendations and the principles of PDCA for continuous performance improvement. This proposed framework is designed to strengthen current drinking water management in Canada and is designed to fit within and incorporate the existing governance structure.

Drinking Water Management and Governance in Canada: An Innovative Plan-Do-Check-Act (PDCA) Framework for a Safe Drinking Water Supply.

PubMed

Bereskie, Ty; Rodriguez, Manuel J; Sadiq, Rehan

2017-08-01

Drinking water management in Canada is complex, with a decentralized, three-tiered governance structure responsible for safe drinking water throughout the country. The current approach has been described as fragmented, leading to governance gaps, duplication of efforts, and an absence of accountability and enforcement. Although there have been no major waterborne disease outbreaks in Canada since 2001, a lack of performance improvement, especially in small drinking water systems, is evident. The World Health Organization water safety plan approach for drinking water management represents an alternative preventative management framework to the current conventional, reactive drinking water management strategies. This approach has seen successful implementation throughout the world and has the potential to address many of the issues with drinking water management in Canada. This paper presents a review and strengths-weaknesses-opportunities-threats analysis of drinking water management and governance in Canada at the federal, provincial/territorial, and municipal levels. Based on this analysis, a modified water safety plan (defined as the plan-do-check-act (PDCA)-WSP framework) is proposed, established from water safety plan recommendations and the principles of PDCA for continuous performance improvement. This proposed framework is designed to strengthen current drinking water management in Canada and is designed to fit within and incorporate the existing governance structure.

RECALMIN: The association between management of Spanish National Health Service Internal Medical Units and health outcomes.

PubMed

Zapatero-Gaviria, Antonio; Javier Elola-Somoza, Francisco; Casariego-Vales, Emilio; Fernandez-Perez, Cristina; Gomez-Huelgas, Ricardo; Bernal, José Luis; Barba-Martín, Raquel

2017-08-01

To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Spanish National Health Service. One hundred and twenty-four acute general hospitals with available data of management and outcomes (401 424 discharges). IMU risk standardized mortality rates were calculated using a multilevel model adjusted by Charlson Index. Risk standardized myocardial infarction and heart failure mortality rates were calculated using specific multilevel models. Length of stay was adjusted by complexity. Greater hospital complexity was associated with longer average length of stays (r: 0.42; P < 0.001). Crude in-hospital mortality rates were higher at larger hospitals, but no significant differences were found when mortality was risk adjusted. There was an association between nurse workload with mortality rate for selected conditions (r: 0.25; P = 0.009). Safety committee and multidisciplinary ward rounds were also associated with outcomes. We have not found any association between complexity and intra-hospital mortality. There is an association between some management indicators with intra-hospital mortality and the length of stay. Better disease-specific outcomes adjustments and a larger number of IMUs in the sample may provide more insights about the association between management of IMUs with healthcare outcomes. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Trends in the use of of nephron-sparing surgery (NSS) at an Australian tertiary referral centre: an analysis of surgical decision-making using the R.E.N.A.L. nephrometry scoring system.

PubMed

Satasivam, Prassannah; Rajarubendra, Nieroshan; Chia, Ping Han; Munshey, Aasheen; Sengupta, Shomik; Bolton, Damien

2012-05-01

Study Type--Therapy (case series). Level of Evidence 4. What's known on the subject? And what does the study add? Nephron-sparing surgery (NSS) is increasingly recognised as a preferred form of management for the incidentally detected small renal mass (SRM). Within the context of equivalent oncological outcomes, patients treated by NSS may have a survival advantage over those treated by radical nephrectomy (RN) through a reduced risk of chronic kidney disease and its associated cardiac morbidity. Despite this, according to Medicare data from the USA, a disproportionate number of patients with SRMs continue to be treated with RN instead of NSS. Similar data from Australia are not yet available. The present study explores the evolving management of SRMs at an Australian tertiary centre over a 5-year period. It utilises the R.E.N.A.L. Nephrometry Score to assess how lesion complexity has influenced surgical decision-making and charts the increasing use of NSS in the management of low-complexity renal masses at our centre. • To examine recent trends in the use of nephron-sparing surgery (NSS) at our centre. Specifically, we sought to examine the process of surgical decision-making by applying the R.E.N.A.L. nephrometry scoring system to assess the complexity of lesions for which surgery was undertaken. • We performed a retrospective review of renal masses treated by surgery from January 2005 to December 2009, including 79 RN and 70 NSS. • CT images were available for analysis in 50 patients within each group. • Lesions were scored on the basis of their complexity using the R.E.N.A.L. nephrometry scoring system developed by Kutikov and Uzzo. • There was no difference in age between patients undergoing RN and NSS (median age 61 vs 60 years). • RN was performed for significantly larger lesions (mean [sd] 68 [9] vs 29 [2] mm, P < 0.05) of predominantly moderate and high complexity (12% low, 56% moderate, 32% high). • NSS was primarily used for low-complexity lesions, but included four (8%) moderate-complexity lesions in the final 2 years of the study. • The use of NSS increased from 28.6% of cases in 2005 to 60.0% of cases in 2009, which mirrored the increase in the proportion of operations performed for low-complexity lesions (22.2% low-complexity in 2005 to 70.6% in 2009, P < 0.01 for trend). • The increasing use of NSS at our institution mirrored the increasing treatment of low-complexity renal lesions. • This may reflect an increased detection and referral of such lesions, or a shift towards treatment of lesions that in the past would have been under surveillance. • Practice at our centre reflects a shifting paradigm towards preferential use of NSS for the treatment of suitable renal masses. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

The Stryker Mobile Gun System: A Case Study on Managing Complexity

DTIC Science & Technology

2009-06-01

In his article Managing Innovation in Complex Product Systems, Howard Rush (1997) identified three “hotspot” categories: 1) requirements... Managing innovation in complex product systems. The Institution for Electrical Engineers. Retrieved February 2, 2009, from http

Going beyond the hero in leadership development: the place of healthcare context, complexity and relationships: Comment on "Leadership and leadership development in healthcare settings - a simplistic solution to complex problems?".

PubMed

Ford, Jackie

2015-04-01

There remains a conviction that the torrent of publications and the financial outlay on leadership development will create managers with the skills and characters of perfect leaders, capable of guiding healthcare organisations through the challenges and crises of the 21st century. The focus of much attention continues to be the search for the (illusory) core set of heroic qualities, abilities or competencies that will enable the development of leaders to achieve levels of supreme leadership and organisational performance. This brief commentary adds support to McDonald's (1) call for recognition of the complexity of the undertaking.

Essential Concepts in Modern Health Services

PubMed Central

El Taguri, A

2008-01-01

Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints. PMID:21499457

Perceptions of disease risk: from social construction of subjective judgments to rational decision making.

PubMed

McRoberts, N; Hall, C; Madden, L V; Hughes, G

2011-06-01

Many factors influence how people form risk perceptions. Farmers' perceptions of risk and levels of risk aversion impact on decision-making about such things as technology adoption and disease management practices. Irrespective of the underlying factors that affect risk perceptions, those perceptions can be summarized by variables capturing impact and uncertainty components of risk. We discuss a new framework that has the subjective probability of disease and the cost of decision errors as its central features, which might allow a better integration of social science and epidemiology, to the benefit of plant disease management. By focusing on the probability and cost (or impact) dimensions of risk, the framework integrates research from the social sciences, economics, decision theory, and epidemiology. In particular, we review some useful properties of expected regret and skill value, two measures of expected cost that are particularly useful in the evaluation of decision tools. We highlight decision-theoretic constraints on the usefulness of decision tools that may partly explain cases of failure of adoption. We extend this analysis by considering information-theoretic criteria that link model complexity and relative performance and which might explain why users reject forecasters that impose even moderate increases in the complexity of decision making despite improvements in performance or accept very simple decision tools that have relatively poor performance.

[Treatment of enophthalmos after severe malar-maxillary complex fracture with titanium mesh and high density polyethylene (Medpor)].

PubMed

Zhao, Yan-feng; Lu, Ping; Zhou, Xiao-nan; Qu, Chang-feng

2010-03-01

To study the surgical management of enophthalmos after severe malar maxillary complex fracture. The X-ray and CT examination were performed before operation to diagnose the orbital fracture and intraorbital tissue displacement. The fractured orbital rim was repositioned intraoperatively, followed by implantation of shaped titanium mesh to rebuild the orbital floor. The Medpor was inserted above the titanium mesh to correct the enophthalmos. From Sept. 2007 to Jan. 2009, 6 cases of enophthalmos after severe malar-maxillary complex fracture were treated. The enophthalmos was corrected or improved obviously in all the patients. The enophthalmos after severe malar-maxillary complex fracture can be corrected or obviously improved. Shaped titanium mesh can be used to rebuild the orbital floor with the Medpor to reconstruct the intraorbital tissue volume.

Immediate and late management of iatrogenic ureteric injuries: 28 years of experience.

PubMed

El Abd, Ahmed S; El-Abd, Shawky A; El-Enen, Mohamed Abo; Tawfik, Ahmed M; Soliman, Mohamed G; Abo-Farha, Mohamed; Gamasy, Abd-El Naser El; El-Sharaby, Mahmoud; El-Gamal, Samir

2015-12-01

To evaluate the long-term results after managing intraoperative and late-diagnosed cases of iatrogenic ureteric injury (IUI), treated endoscopically or by open surgery. Patients immediately diagnosed with IUI were managed under the same anaesthetic, while those referred late had a radiological assessment of the site of injury, and endoscopic management. Open surgical procedures were used only for the failed cases with previous diversion. In all, 98 patients who were followed had IUI after gynaecological, abdominopelvic and ureteroscopic procedures in 60.2%, 14.3% and 25.5%, respectively. The 27 patients diagnosed during surgery were managed immediately, while in the late-referred 71 patients ureteroscopic ureteric realignment with stenting was successful in 26 (36.6%). Complex open reconstruction with re-implantation or ureteric substitution, using bladder-tube or intestinal-loop procedures, was used in 27 (60%), 16 (35.5%) and two (4.5%) patients of the late group, respectively. A long-term radiological follow-up with a mean (range) of 46.6 (24.5-144) months showed recurrent obstruction in 16 (16.3%) patients managed endoscopically and reflux in six (8.3%) patients. Three renal units only (3%) were lost in the late-presenting patients. Patients managed immediately had better long-term results. More than a third of the late-diagnosed patients were successfully managed endoscopically with minimal morbidity. Open reconstruction by an experienced urologist who can perform a complex substitutional procedure was mandatory to preserve renal units in the long-term.

Biodiversity conservation in agriculture requires a multi-scale approach.

PubMed

Gonthier, David J; Ennis, Katherine K; Farinas, Serge; Hsieh, Hsun-Yi; Iverson, Aaron L; Batáry, Péter; Rudolphi, Jörgen; Tscharntke, Teja; Cardinale, Bradley J; Perfecto, Ivette

2014-09-22

Biodiversity loss--one of the most prominent forms of modern environmental change--has been heavily driven by terrestrial habitat loss and, in particular, the spread and intensification of agriculture. Expanding agricultural land-use has led to the search for strong conservation strategies, with some suggesting that biodiversity conservation in agriculture is best maximized by reducing local management intensity, such as fertilizer and pesticide application. Others highlight the importance of landscape-level approaches that incorporate natural or semi-natural areas in landscapes surrounding farms. Here, we show that both of these practices are valuable to the conservation of biodiversity, and that either local or landscape factors can be most crucial to conservation planning depending on which types of organisms one wishes to save. We performed a quantitative review of 266 observations taken from 31 studies that compared the impacts of localized (within farm) management strategies and landscape complexity (around farms) on the richness and abundance of plant, invertebrate and vertebrate species in agro-ecosystems. While both factors significantly impacted species richness, the richness of sessile plants increased with less-intensive local management, but did not significantly respond to landscape complexity. By contrast, the richness of mobile vertebrates increased with landscape complexity, but did not significantly increase with less-intensive local management. Invertebrate richness and abundance responded to both factors. Our analyses point to clear differences in how various groups of organisms respond to differing scales of management, and suggest that preservation of multiple taxonomic groups will require multiple scales of conservation. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Reduced complexity of multi-track joint 2-D Viterbi detectors for bit-patterned media recording channel

NASA Astrophysics Data System (ADS)

Myint, L. M. M.; Warisarn, C.

2017-05-01

Two-dimensional (2-D) interference is one of the prominent challenges in ultra-high density recording system such as bit patterned media recording (BPMR). The multi-track joint 2-D detection technique with the help of the array-head reading can tackle this problem effectively by jointly processing the multiple readback signals from the adjacent tracks. Moreover, it can robustly alleviate the impairments due to track mis-registration (TMR) and media noise. However, the computational complexity of such detectors is normally too high and hard to implement in a reality, even for a few multiple tracks. Therefore, in this paper, we mainly focus on reducing the complexity of multi-track joint 2-D Viterbi detector without paying a large penalty in terms of the performance. We propose a simplified multi-track joint 2-D Viterbi detector with a manageable complexity level for the BPMR's multi-track multi-head (MTMH) system. In the proposed method, the complexity of detector's trellis is reduced with the help of the joint-track equalization method which employs 1-D equalizers and 2-D generalized partial response (GPR) target. Moreover, we also examine the performance of a full-fledged multi-track joint 2-D detector and the conventional 2-D detection. The results show that the simplified detector can perform close to the full-fledge detector, especially when the system faces high media noise, with the significant low complexity.

Automation technology for aerospace power management

NASA Technical Reports Server (NTRS)

Larsen, R. L.

1982-01-01

The growing size and complexity of spacecraft power systems coupled with limited space/ground communications necessitate increasingly automated onboard control systems. Research in computer science, particularly artificial intelligence has developed methods and techniques for constructing man-machine systems with problem-solving expertise in limited domains which may contribute to the automation of power systems. Since these systems perform tasks which are typically performed by human experts they have become known as Expert Systems. A review of the current state of the art in expert systems technology is presented, and potential applications in power systems management are considered. It is concluded that expert systems appear to have significant potential for improving the productivity of operations personnel in aerospace applications, and in automating the control of many aerospace systems.

Management of health care expenditure by soft computing methodology

NASA Astrophysics Data System (ADS)

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

2017-01-01

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

The complexity of managing COPD exacerbations: a grounded theory study of European general practice

PubMed Central

Risør, Mette Bech; Spigt, Mark; Iversen, R; Godycki-Cwirko, M; Francis, N; Altiner, A; Andreeva, E; Kung, K; Melbye, H

2013-01-01

Objectives To understand the concerns and challenges faced by general practitioners (GPs) and respiratory physicians about primary care management of acute exacerbations in patients with chronic obstructive pulmonary disease (COPD). Design 21 focus group discussions (FGDs) were performed in seven countries with a Grounded Theory approach. Each country performed three rounds of FGDs. Setting Primary and secondary care in Norway, Germany, Wales, Poland, Russia, The Netherlands, China (Hong Kong). Participants 142 GPs and respiratory physicians were chosen to include urban and rural GPs as well as hospital-based and out patient-clinic respiratory physicians. Results Management of acute COPD exacerbations is dealt with within a scope of concerns. These concerns range from ‘dealing with comorbidity’ through ‘having difficult patients’ to ‘confronting a hopeless disease’. The first concern displays medical uncertainty regarding diagnosis, medication and hospitalisation. These clinical processes become blurred by comorbidity and the social context of the patient. The second concern shows how patients receive the label ‘difficult’ exactly because they need complex attention, but even more because they are time consuming, do not take responsibility and are non-compliant. The third concern relates to the emotional reactions by the physicians when confronted with ‘a hopeless disease’ due to the fact that most of the patients do not improve and the treatment slows down the process at best. GPs and respiratory physicians balance these concerns with medical knowledge and practical, situational knowledge, trying to encompass the complexity of a medical condition. Conclusions Knowing the patient is essential when dealing with comorbidities as well as with difficult relations in the consultations on exacerbations. This study suggests that it is crucial to improve the collaboration between primary and secondary care, in terms of, for example, shared consultations and defined work tasks, which may enhance shared knowledge of patients, medical decision-making and improved management planning. PMID:24319274

Circadian Effects on Simple Components of Complex Task Performance

NASA Technical Reports Server (NTRS)

Clegg, Benjamin A.; Wickens, Christopher D.; Vieane, Alex Z.; Gutzwiller, Robert S.; Sebok, Angelia L.

2015-01-01

The goal of this study was to advance understanding and prediction of the impact of circadian rhythm on aspects of complex task performance during unexpected automation failures, and subsequent fault management. Participants trained on two tasks: a process control simulation, featuring automated support; and a multi-tasking platform. Participants then completed one task in a very early morning (circadian night) session, and the other during a late afternoon (circadian day) session. Small effects of time of day were seen on simple components of task performance, but impacts on more demanding components, such as those that occur following an automation failure, were muted relative to previous studies where circadian rhythm was compounded with sleep deprivation and fatigue. Circadian low participants engaged in compensatory strategies, rather than passively monitoring the automation. The findings and implications are discussed in the context of a model that includes the effects of sleep and fatigue factors.

Cross-modal links among vision, audition, and touch in complex environments.

PubMed

Ferris, Thomas K; Sarter, Nadine B

2008-02-01

This study sought to determine whether performance effects of cross-modal spatial links that were observed in earlier laboratory studies scale to more complex environments and need to be considered in multimodal interface design. It also revisits the unresolved issue of cross-modal cuing asymmetries. Previous laboratory studies employing simple cues, tasks, and/or targets have demonstrated that the efficiency of processing visual, auditory, and tactile stimuli is affected by the modality, lateralization, and timing of surrounding cues. Very few studies have investigated these cross-modal constraints in the context of more complex environments to determine whether they scale and how complexity affects the nature of cross-modal cuing asymmetries. Amicroworld simulation of battlefield operations with a complex task set and meaningful visual, auditory, and tactile stimuli was used to investigate cuing effects for all cross-modal pairings. Significant asymmetric performance effects of cross-modal spatial links were observed. Auditory cues shortened response latencies for collocated visual targets but visual cues did not do the same for collocated auditory targets. Responses to contralateral (rather than ipsilateral) targets were faster for tactually cued auditory targets and each visual-tactile cue-target combination, suggesting an inhibition-of-return effect. The spatial relationships between multimodal cues and targets significantly affect target response times in complex environments. The performance effects of cross-modal links and the observed cross-modal cuing asymmetries need to be examined in more detail and considered in future interface design. The findings from this study have implications for the design of multimodal and adaptive interfaces and for supporting attention management in complex, data-rich domains.

The effect of an electronic cognitive aid on the management of ST-elevation myocardial infarction during caesarean section: a prospective randomised simulation study.

PubMed

St Pierre, Michael; Luetcke, Bjoern; Strembski, Dieter; Schmitt, Christopher; Breuer, Georg

2017-03-20

Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g., cardiac arrest emergencies, management of the difficult airway). At present, there is limited information on the usefulness of cognitive aids in critical situations with moderate time pressure and complexity. Intraoperative myocardial infarction may be an emergency to which these limitations apply. Anaesthetic teams were allocated to control (no cognitive aid; n = 10) or intervention (cognitive aid provided; n = 10) groups. The primary aim of this study was to compare cognitive aid versus memory for intraoperative ST-elevation myocardial infarction (STEMI) management in a simulation of caesarean delivery under spinal anaesthesia. We identified nine evidence-based metrics of essential care from current guidelines and subdivided them into mandatory (high level of evidence; no interference with surgery) and optional (lower class of recommendation; possible impact on surgery) tasks. Six clinically relevant tasks were added by consensus. Implementation of these steps was measured by scoring task items in a binary fashion (yes/no). The interval between the diagnosis of STEMI and the first contact with the cardiac catheterisation lab was measured. To determine whether or not the cognitive aid had prompted an action, participants from the cognitive aid group were interviewed during debriefing on every single treatment step. At the end of the simulation, session participants were asked to complete a survey. The presence of the cognitive aid did not shorten the time interval until the cardiac catheterisation lab was contacted. The availability of the cognitive aid improved task performance in the tasks identified from the guidelines (93% vs. 69%; p < 0.001) as well as overall task performance (87.5% vs. 59%; p < 0.001). The observed difference in performance can be attributed to the use of the cognitive aid, as performance from memory alone would have been comparable across both groups. Trainees appeared to derive greater benefit from the cognitive aid than did consultants and nurses. The management of intraoperative ST-elevation myocardial infarction can be improved if teams use a cognitive aid. Trainees appeared to derive greater benefit from the cognitive aid than did consultants and nurses.

The disruptive effects of pain on multitasking in a virtual errands task.

PubMed

Moore, David J; Law, Anna S

2017-07-01

Pain is known to have a disruptive effect on cognitive performance, but prior studies have used highly constrained laboratory tasks that lack ecological validity. In everyday life people are required to complete more complex sets of tasks, prioritising task completion and recalling lists of tasks which need to be completed, and these tasks continue to be attempted during episodes or states of pain. The present study therefore examined the impact of thermal induced pain on a simulated errand task. Fifty-five healthy adults (36 female) performed the Edinburgh Virtual Errands Task (EVET) either during a painful thermal sensation or with no concurrent pain. Participants also completed the Experience of Cognitive Intrusion of Pain (ECIP) questionnaire to measure their self-reported cognitive impact of pain in general life. Participants who completed the EVET task in pain and who self-reported high intrusion of pain made significantly more errors than those who reported lower intrusion on the ECIP. Findings here support the growing literature that suggests that pain has a significant impact on cognitive performance. Furthermore, these findings support the developing literature suggesting that this relationship is complex when considering real world cognition, and that self-report on the ECIP relates well to performance on a task designed to reflect the complexities of everyday living. If extrapolated to chronic pain populations, these data suggest that pain during complex multitasking performance may have a significant impact on the number of errors made. For people highly vulnerable to cognitive intrusion by pain, this may result in errors such as selecting the wrong location or item to perform tasks, or forgetting to perform these tasks at the correct time. If these findings are shown to extend to chronic pain populations then occupational support to manage complex task performance, using for example diaries/electronic reminders, may help to improve everyday abilities. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

A decision-making framework for total ownership cost management of complex systems: A Delphi study

NASA Astrophysics Data System (ADS)

King, Russel J.

This qualitative study, using a modified Delphi method, was conducted to develop a decision-making framework for the total ownership cost management of complex systems in the aerospace industry. The primary focus of total ownership cost is to look beyond the purchase price when evaluating complex system life cycle alternatives. A thorough literature review and the opinions of a group of qualified experts resulted in a compilation of total ownership cost best practices, cost drivers, key performance factors, applicable assessment methods, practitioner credentials and potential barriers to effective implementation. The expert panel provided responses to the study questions using a 5-point Likert-type scale. Data were analyzed and provided to the panel members for review and discussion with the intent to achieve group consensus. As a result of the study, the experts agreed that a total ownership cost analysis should (a) be as simple as possible using historical data; (b) establish cost targets, metrics, and penalties early in the program; (c) monitor the targets throughout the product lifecycle and revise them as applicable historical data becomes available; and (d) directly link total ownership cost elements with other success factors during program development. The resultant study framework provides the business leader with incentives and methods to develop and implement strategies for controlling and reducing total ownership cost over the entire product life cycle when balancing cost, schedule, and performance decisions.

Planning factors for developing an enterprise-wide picture archiving and communication system maintenance program.

PubMed

Staley, S; Romlein, J; Chacko, A K; Wider, R

2000-05-01

Picture archiving and communication system (PACS) maintenance on an individual site basis has historically been a complex and costly challenge. With the advent of enterprise-wide PACS projects such as the Virtual Radiology Environment (VRE) project, the challenge of a maintenance program with even more complexities has presented itself. The approach of the project management team for the VRE project is not one of reactive maintenance, but one of highly proactive planning and negotiations, in hopes of capitalizing on the economies of scale of an enterprise-wide PACS maintenance program. A proactive maintenance program is one aspect of life-cycle management. As with any capital acquisition, life-cycle management may be used to manage the specific project aspects related to PACS. The purpose of an enterprise-wide warranty and maintenance life-cycle management approach is to maintain PACS at its maximum operational efficiency and utilization levels through a flexible, shared, yet symbiotic relationship between local, regional, and vendor resources. These goals include providing maximum operational performance levels on a local, regional, and enterprise basis, while maintaining acceptable costs and resource utilization levels. This goal must be achieved without negatively impacting point of care activities, regardless of changes to the clinical business environment.

Orion GN&C Fault Management System Verification: Scope And Methodology

NASA Technical Reports Server (NTRS)

Brown, Denise; Weiler, David; Flanary, Ronald

2016-01-01

In order to ensure long-term ability to meet mission goals and to provide for the safety of the public, ground personnel, and any crew members, nearly all spacecraft include a fault management (FM) system. For a manned vehicle such as Orion, the safety of the crew is of paramount importance. The goal of the Orion Guidance, Navigation and Control (GN&C) fault management system is to detect, isolate, and respond to faults before they can result in harm to the human crew or loss of the spacecraft. Verification of fault management/fault protection capability is challenging due to the large number of possible faults in a complex spacecraft, the inherent unpredictability of faults, the complexity of interactions among the various spacecraft components, and the inability to easily quantify human reactions to failure scenarios. The Orion GN&C Fault Detection, Isolation, and Recovery (FDIR) team has developed a methodology for bounding the scope of FM system verification while ensuring sufficient coverage of the failure space and providing high confidence that the fault management system meets all safety requirements. The methodology utilizes a swarm search algorithm to identify failure cases that can result in catastrophic loss of the crew or the vehicle and rare event sequential Monte Carlo to verify safety and FDIR performance requirements.

The problem of motivating teaching staff in a complex amalgamation.

PubMed

Kenrick, M A

1993-09-01

This paper addresses some of the problems brought about by the merger of a number of schools of nursing into a new complex amalgamation. A very real concern in the new colleges of nursing and midwifery in the United Kingdom is the effect of amalgamation on management systems and staff morale. The main focus of this paper is the motivation of staff during this time of change. There is currently a lack of security amongst staff and in many instances the personal job satisfaction of nurse teachers and managers of nurse education has been reduced, which has made the task of motivating staff difficult. Hence, two major theories of motivation and the implications of these theories for managers of nurse education are discussed. The criteria used for the selection of managers within the new colleges, leadership styles and organizational structures are reviewed. The amalgamations have brought about affiliation with higher-education institutions. Some problems associated with these mergers and the effects on the motivation of staff both within the higher-education institutions and the nursing colleges are outlined. Strategies for overcoming some of the problems are proposed including job enlargement, job enrichment, potential achievement rewards and the use of individual performance reviews which may be useful for assessing the ability of all staff, including managers, in the new amalgamations.

Complexity: A Frontier for Management Education

ERIC Educational Resources Information Center

Axley, Stephen R.; McMahon, Timothy R.

2006-01-01

This article critiques the mechanistic grounding of traditional management education and proposes complexity science as a fitting explanatory model for an age of complexity, contributing timely and important educational content and instructional processes to management education. It highlights some of those contributions and reviews instructional…

Modeling two-phase flow in three-dimensional complex flow-fields of proton exchange membrane fuel cells

NASA Astrophysics Data System (ADS)

Kim, Jinyong; Luo, Gang; Wang, Chao-Yang

2017-10-01

3D fine-mesh flow-fields recently developed by Toyota Mirai improved water management and mass transport in proton exchange membrane (PEM) fuel cell stacks, suggesting their potential value for robust and high-power PEM fuel cell stack performance. In such complex flow-fields, Forchheimer's inertial effect is dominant at high current density. In this work, a two-phase flow model of 3D complex flow-fields of PEMFCs is developed by accounting for Forchheimer's inertial effect, for the first time, to elucidate the underlying mechanism of liquid water behavior and mass transport inside 3D complex flow-fields and their adjacent gas diffusion layers (GDL). It is found that Forchheimer's inertial effect enhances liquid water removal from flow-fields and adds additional flow resistance around baffles, which improves interfacial liquid water and mass transport. As a result, substantial improvements in high current density cell performance and operational stability are expected in PEMFCs with 3D complex flow-fields, compared to PEMFCs with conventional flow-fields. Higher current density operation required to further reduce PEMFC stack cost per kW in the future will necessitate optimizing complex flow-field designs using the present model, in order to efficiently remove a large amount of product water and hence minimize the mass transport voltage loss.

Automation of checkout for the shuttle operations era

NASA Technical Reports Server (NTRS)

Anderson, J. A.; Hendrickson, K. O.

1985-01-01

The Space Shuttle checkout is different from its Apollo predecessor. The complexity of the hardware, the shortened turnaround time, and the software that performs ground checkout are outlined. Generating new techniques and standards for software development and the management structure to control it are implemented. The utilization of computer systems for vehicle testing is high lighted.

Teaching Coaches to Coach Holistically: Can Problem-Based Learning (PBL) Help?

ERIC Educational Resources Information Center

Jones, Robyn L.; Turner, Poppy

2006-01-01

Background: Coaching, as related to improving others' sporting experience and/or performance, at any level is unquestionably a complex business. General agreement exists that the dynamic and intricate nature of the work in teaching, guiding and managing others in this regard precludes any paint-by-number plans that practitioners can easily follow.…

The Relationship between Student Health and Academic Performance: Implications for School Psychologists

ERIC Educational Resources Information Center

Shaw, Steven R.; Gomes, Paul; Polotskaia, Anna; Jankowska, Anna M.

2015-01-01

Children who are unhealthy are at higher risk for school problems than students who are free from medical problems. Students with poor health have a higher probability of school failure, grade retention, and dropout. The relationship between student health and academic success is complex. Common manageable factors of student health are nutrition,…

Complex wound management in ventricular assist device (VAD) patients: the role of aggressive debridement and vascularized soft tissue coverage.

PubMed

Nelson, Jonas A; Shaked, Oren; Fischer, John P; Mirzabeigi, Michael N; Jandali, Shareef; Kovach, Stephen J; Low, David W; Acker, Michael A; Kanchwala, Suhail K

2014-12-01

Infections and complex wounds after ventricular assist device (VAD) placement can result in significant morbidity and mortality. The purpose of this study was to evaluate complex wound management in the VAD patient, and to describe a treatment protocol for these challenging and potentially mortal complications. A retrospective study was performed to examine all patients who underwent continuous flow, second-generation VAD placement at the Hospital of the University of Pennsylvania between March 2008 and April 2013. Overall, 150 VADs were placed, with 12 (8%) patients requiring 15 operative interventions by the plastic surgery services. The most common indication for operative intervention was a complicated wound with VAD exposure (5/12, 41.7%). All patients underwent aggressive operative debridement, and 11/12 (92%) underwent vascularized soft tissue coverage. Flaps commonly utilized included rectus abdominus myocutaneous (n = 4), rectus abdominus muscle (n = 4), pectoralis major (n = 3), and omentum (n = 3). Three patients experienced complications which required a return to the operating room, including 1 flap loss, 1 hematoma, and 1 wound dehiscence requiring further soft tissue coverage. Salvage was achieved, yet a 50% mortality rate in follow-up was noted. Complex wound management in VAD patients can be achieved with aggressive debridement and vascularized soft tissue coverage, most commonly utilizing well-vascularized rectus abdominus muscle or omental flaps. Plastic surgeons should be familiar with the armamentarium at their disposal when approaching these challenging cases as VAD wound complications stand to become an increasingly prevalent issue.

Using food-web theory to conserve ecosystems

PubMed Central

McDonald-Madden, E.; Sabbadin, R.; Game, E. T.; Baxter, P. W. J.; Chadès, I.; Possingham, H. P.

2016-01-01

Food-web theory can be a powerful guide to the management of complex ecosystems. However, we show that indices of species importance common in food-web and network theory can be a poor guide to ecosystem management, resulting in significantly more extinctions than necessary. We use Bayesian Networks and Constrained Combinatorial Optimization to find optimal management strategies for a wide range of real and hypothetical food webs. This Artificial Intelligence approach provides the ability to test the performance of any index for prioritizing species management in a network. While no single network theory index provides an appropriate guide to management for all food webs, a modified version of the Google PageRank algorithm reliably minimizes the chance and severity of negative outcomes. Our analysis shows that by prioritizing ecosystem management based on the network-wide impact of species protection rather than species loss, we can substantially improve conservation outcomes. PMID:26776253

Mission possible: Building an effective business continuity team in seven steps.

PubMed

Porter, David

2016-01-01

Several books and studies exist on the creation, development and benefits of high-performing teams; many others offer insights into the business continuity management (BCM) discipline, crisis response and planning. Very rarely, however, do they cover both. This paper will explore the seven main development areas that helped build the foundation for a successful and high-performing BCM team in the Australian Taxation Office. Practical, actionable advice will be provided, recognising that the task for those starting out can be quite daunting and complex.

Neurofibromatosis of the head and neck: classification and surgical management.

PubMed

Latham, Kerry; Buchanan, Edward P; Suver, Daniel; Gruss, Joseph S

2015-03-01

Neurofibromatosis is common and presents with variable penetrance and manifestations in one in 2500 to one in 3000 live births. The management of these patients is often multidisciplinary because of the complexity of the disease. Plastic surgeons are frequently involved in the surgical management of patients with head and neck involvement. A 20-year retrospective review of patients treated surgically for head and neck neurofibroma was performed. Patients were identified according to International Classification of Diseases, Ninth Revision codes for neurofibromatosis and from the senior author's database. A total of 59 patients with head and neck neurofibroma were identified. These patients were categorized into five distinct, but not exclusive, categories to assist with diagnosis and surgical management. These categories included plexiform, cranioorbital, facial, neck, and parotid/auricular neurofibromatosis. A surgical classification system and clinical characteristics of head and neck neurofibromatosis is presented to assist practitioners with diagnosis and surgical management of this complex disease. The surgical management of the cranioorbital type is discussed in detail in 24 patients. The importance and safety of facial nerve dissection and preservation using intraoperative nerve monitoring were validated in 16 dissections in 15 patients. Massive involvement of the neck extending from the skull base to the mediastinum, frequently considered inoperable, has been safely resected by the use of access osteotomies of the clavicle and sternum, muscle takedown, and brachial plexus dissection and preservation using intraoperative nerve monitoring. Therapeutic, IV.

Specific features of goal setting in road traffic safety

NASA Astrophysics Data System (ADS)

Kolesov, V. I.; Danilov, O. F.; Petrov, A. I.

2017-10-01

Road traffic safety (RTS) management is inherently a branch of cybernetics and therefore requires clear formalization of the task. The paper aims at identification of the specific features of goal setting in RTS management under the system approach. The paper presents the results of cybernetic modeling of the cause-to-effect mechanism of a road traffic accident (RTA); in here, the mechanism itself is viewed as a complex system. A designed management goal function is focused on minimizing the difficulty in achieving the target goal. Optimization of the target goal has been performed using the Lagrange principle. The created working algorithms have passed the soft testing. The key role of the obtained solution in the tactical and strategic RTS management is considered. The dynamics of the management effectiveness indicator has been analyzed based on the ten-year statistics for Russia.

Apollo Program Management, Kennedy Space Center, Florida. Volume 4

NASA Technical Reports Server (NTRS)

1968-01-01

The evolution of the Kennedy Space Center as the launch organization for Apollo/ Saturn V involved the concurrent solution of numerous complex problems. A significant increase in manpower was involved. Large and complex checkout and launch facilities were to be designed and constructed. Expansion of operational capabilities required the establishment and integration of a Government-Contractor operational team. From an initial cadre of approximately 200 civil service personnel of the Army Ballistic Missile Agency, transferred to NASA in 1960 following its establishment, expansion to the present civil service level of 2,900 occurred in the last seven years. Established within NASA as a directorate of the Marshall Space Flight Center, KSC achieved center status in 1962. With its designation as a Center, KSC accomplished the development and staffing of an organization that could perform procurement, resources, financial, and other management requirements formerly provided by the parent organization. In addition to continuing launch operations for established programs, KSC undertook the design and construction of large, new, and unique launch facilities for Apollo/Saturn V. With the expansion of the civil service work force, KSC integrated contractor organizations employing 23,000 personnel at the Center to perform specific operational and support missions under the technical supervision and observation of the Government team. The management techniques, organizational concepts, and continuing efforts utilized to meet the Apollo goals and challenges are discussed in this document.

Project management for complex ground-based instruments: MEGARA plan

NASA Astrophysics Data System (ADS)

García-Vargas, María. Luisa; Pérez-Calpena, Ana; Gil de Paz, Armando; Gallego, Jesús; Carrasco, Esperanza; Cedazo, Raquel; Iglesias, Jorge

2014-08-01

The project management of complex instruments for ground-based large telescopes is a challenge itself. A good management is a clue for project success in terms of performance, schedule and budget. Being on time has become a strict requirement for two reasons: to assure the arrival at the telescope due to the pressure on demanding new instrumentation for this first world-class telescopes and to not fall in over-costs. The budget and cash-flow is not always the expected one and has to be properly handled from different administrative departments at the funding centers worldwide distributed. The complexity of the organizations, the technological and scientific return to the Consortium partners and the participation in the project of all kind of professional centers working in astronomical instrumentation: universities, research centers, small and large private companies, workshops and providers, etc. make the project management strategy, and the tools and procedures tuned to the project needs, crucial for success. MEGARA (Multi-Espectrógrafo en GTC de Alta Resolución para Astronomía) is a facility instrument of the 10.4m GTC (La Palma, Spain) working at optical wavelengths that provides both Integral-Field Unit (IFU) and Multi-Object Spectrograph (MOS) capabilities at resolutions in the range R=6,000-20,000. The project is an initiative led by Universidad Complutense de Madrid (Spain) in collaboration with INAOE (Mexico), IAA-CSIC (Spain) and Universidad Politécnica de Madrid (Spain). MEGARA is being developed under contract with GRANTECAN.

Strategic planning for MyRA performance: A causal loop diagram approach

NASA Astrophysics Data System (ADS)

Abidin, Norhaslinda Zainal; Zaibidi, Nerda Zura; Karim, Khairah Nazurah

2017-10-01

The nexus of research and innovation in higher education are continually receiving worldwide priority attention. Hence, Malaysia has taken its move to enhance public universities as a center of excellence by introducing the status of Research University (RU). To inspire all universities towards becoming a research university, The Ministry of Higher Education (MoHE) had revised an assessment called Malaysian Research Assessment Instrument (MyRA) to evaluate the performance of existence RUs, and other potential higher education institutions. The available spreadsheet tool to access MyRA performance is inadequate to support strategic planning. Since, higher education management is a complex system, in which components and their interactions are ever changing over time, there is a need to for an efficient approach to investigate system behavior and devise research management policies for the benefit of the institution itself and the higher education system. In this paper, we proposed a system dynamics simulation model to evaluate the impact of policies for obtaining the highest performance in MyRA assessment. Causal loop diagram is developed to investigate the relationship of various elements in research management, their inter-relationship that link together and their evolution of behavior over time.

WATCHMAN: A Data Warehouse Intelligent Cache Manager

NASA Technical Reports Server (NTRS)

Scheuermann, Peter; Shim, Junho; Vingralek, Radek

1996-01-01

Data warehouses store large volumes of data which are used frequently by decision support applications. Such applications involve complex queries. Query performance in such an environment is critical because decision support applications often require interactive query response time. Because data warehouses are updated infrequently, it becomes possible to improve query performance by caching sets retrieved by queries in addition to query execution plans. In this paper we report on the design of an intelligent cache manager for sets retrieved by queries called WATCHMAN, which is particularly well suited for data warehousing environment. Our cache manager employs two novel, complementary algorithms for cache replacement and for cache admission. WATCHMAN aims at minimizing query response time and its cache replacement policy swaps out entire retrieved sets of queries instead of individual pages. The cache replacement and admission algorithms make use of a profit metric, which considers for each retrieved set its average rate of reference, its size, and execution cost of the associated query. We report on a performance evaluation based on the TPC-D and Set Query benchmarks. These experiments show that WATCHMAN achieves a substantial performance improvement in a decision support environment when compared to a traditional LRU replacement algorithm.

Nevada National Security Site Environmental Report 2016

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

Wills

This Nevada National Security Site Environmental Report (NNSSER) was prepared to satisfy DOE Order DOE O 231.1B, “Environment, Safety and Health Reporting.” Its purpose is to (1) report compliance status with environmental standards and requirements, (2) present results of environmental monitoring of radiological and nonradiological effluents, (3) report estimated radiological doses to the public from releases of radioactive material, (4) summarize environmental incidents of noncompliance and actions taken in response to them, (5) describe the National Nuclear Security Administration Nevada Field Office (NNSA/NFO) Environmental Management System and characterize its performance, and (6) highlight significant environmental programs and efforts. This NNSSERmore » summarizes data and compliance status for calendar year 2016 at the Nevada National Security Site (NNSS) and its two Nevada-based support facilities, the North Las Vegas Facility (NLVF) and the Remote Sensing Laboratory–Nellis (RSL-Nellis). It also addresses environmental restoration (ER) projects conducted at the Tonopah Test Range (TTR) and the Nevada Test and Training Range (NTTR). NNSA/NFO directs the management and operation of the NNSS and six sites across the nation. In addition to the NNSA itself, the six sites include two in Nevada (NLVF and RSL-Nellis) and four in other states (RSL-Andrews in Maryland, Livermore Operations in California, Los Alamos Operations in New Mexico, and Special Technologies Laboratory in California). Los Alamos, Lawrence Livermore, and Sandia National Laboratories are the principal organizations that sponsor and implement the nuclear weapons programs at the NNSS. National Security Technologies, LLC (NSTec), is the current Management and Operating contractor accountable for the successful execution of work and ensuring that work is performed in compliance with environmental regulations. The six sites all provide support to enhance the NNSS as a location for its multiple missions. The three major NNSS missions include National Security/Defense, Environmental Management, and Nondefense. The major programs that support these missions are Stockpile Stewardship and Management, Nonproliferation and Counterterrorism, Nuclear Emergency Response, Strategic Partnership Projects, Environmental Restoration, Waste Management, Conservation and Renewable Energy, Other Research and Development, and Infrastructure. The major facilities that support the programs include the U1a Facility, Big Explosives Experimental Facility (BEEF), Device Assembly Facility, Dense Plasma Focus Facility, Joint Actinide Shock Physics Experimental Research Facility, Radiological/Nuclear Countermeasures Test and Evaluation Complex, Nonproliferation Test and Evaluation Complex (NPTEC), Radiological/Nuclear Weapons of Mass Destruction Incident Exercise Site, the Area 5 Radioactive Waste Management Complex (RWMC), and the Area 3 Radioactive Waste Management Site (RWMS).« less

Using key performance indicators as knowledge-management tools at a regional health-care authority level.

PubMed

Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris

2005-06-01

The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.

Secure Large-Scale Airport Simulations Using Distributed Computational Resources

NASA Technical Reports Server (NTRS)

McDermott, William J.; Maluf, David A.; Gawdiak, Yuri; Tran, Peter; Clancy, Dan (Technical Monitor)

2001-01-01

To fully conduct research that will support the far-term concepts, technologies and methods required to improve the safety of Air Transportation a simulation environment of the requisite degree of fidelity must first be in place. The Virtual National Airspace Simulation (VNAS) will provide the underlying infrastructure necessary for such a simulation system. Aerospace-specific knowledge management services such as intelligent data-integration middleware will support the management of information associated with this complex and critically important operational environment. This simulation environment, in conjunction with a distributed network of supercomputers, and high-speed network connections to aircraft, and to Federal Aviation Administration (FAA), airline and other data-sources will provide the capability to continuously monitor and measure operational performance against expected performance. The VNAS will also provide the tools to use this performance baseline to obtain a perspective of what is happening today and of the potential impact of proposed changes before they are introduced into the system.

Overcoming learning barriers through knowledge management.

PubMed

Dror, Itiel E; Makany, Tamas; Kemp, Jonathan

2011-02-01

The ability to learn highly depends on how knowledge is managed. Specifically, different techniques for note-taking utilize different cognitive processes and strategies. In this paper, we compared dyslexic and control participants when using linear and non-linear note-taking. All our participants were professionals working in the banking and financial sector. We examined comprehension, accuracy, mental imagery & complexity, metacognition, and memory. We found that participants with dyslexia, when using a non-linear note-taking technique outperformed the control group using linear note-taking and matched the performance of the control group using non-linear note-taking. These findings emphasize how different knowledge management techniques can avoid some of the barriers to learners. Copyright © 2010 John Wiley & Sons, Ltd.

Ada and software management in NASA: Assessment and recommendations

NASA Technical Reports Server (NTRS)

1989-01-01

Recent NASA missions have required software systems that are larger, more complex, and more critical than NASA software systems of the past. The Ada programming language and the software methods and support environments associated with it are seen as potential breakthroughs in meeting NASA's software requirements. The findings of a study by the Ada and Software Management Assessment Working Group (ASMAWG) are presented. The study was chartered to perform three tasks: (1) assess the agency's ongoing and planned Ada activities; (2) assess the infrastructure (standards, policies, and internal organizations) supporting software management and the Ada activities; and (3) present an Ada implementation and use strategy appropriate for NASA over the next 5 years.

Nurse manager cognitive decision-making amidst stress and work complexity.

PubMed

Shirey, Maria R; Ebright, Patricia R; McDaniel, Anna M

2013-01-01

  The present study provides insight into nurse manager cognitive decision-making amidst stress and work complexity.   Little is known about nurse manager decision-making amidst stress and work complexity. Because nurse manager decisions have the potential to impact patient care quality and safety, understanding their decision-making processes is useful for designing supportive interventions.   This qualitative descriptive study interviewed 21 nurse managers from three hospitals to answer the research question: What decision-making processes do nurse managers utilize to address stressful situations in their nurse manager role? Face-to-face interviews incorporating components of the Critical Decision Method illuminated expert-novice practice differences. Content analysis identified one major theme and three sub-themes.   The present study produced a cognitive model that guides nurse manager decision-making related to stressful situations. Experience in the role, organizational context and situation factors influenced nurse manager cognitive decision-making processes.   Study findings suggest that chronic exposure to stress and work complexity negatively affects nurse manager health and their decision-making processes potentially threatening individual, patient and organizational outcomes.   Cognitive decision-making varies based on nurse manager experience and these differences have coaching and mentoring implications. This present study contributes a current understanding of nurse manager decision-making amidst stress and work complexity. © 2012 Blackwell Publishing Ltd.

Virtual Team Governance: Addressing the Governance Mechanisms and Virtual Team Performance

NASA Astrophysics Data System (ADS)

Zhan, Yihong; Bai, Yu; Liu, Ziheng

As technology has improved and collaborative software has been developed, virtual teams with geographically dispersed members spread across diverse physical locations have become increasingly prominent. Virtual team is supported by advancing communication technologies, which makes virtual teams able to largely transcend time and space. Virtual teams have changed the corporate landscape, which are more complex and dynamic than traditional teams since the members of virtual teams are spread on diverse geographical locations and their roles in the virtual team are different. Therefore, how to realize good governance of virtual team and arrive at good virtual team performance is becoming critical and challenging. Good virtual team governance is essential for a high-performance virtual team. This paper explores the performance and the governance mechanism of virtual team. It establishes a model to explain the relationship between the performance and the governance mechanisms in virtual teams. This paper is focusing on managing virtual teams. It aims to find the strategies to help business organizations to improve the performance of their virtual teams and arrive at the objectives of good virtual team management.

Efficacy of Noninvasive Stellate Ganglion Blockade Performed Using Physical Agent Modalities in Patients with Sympathetic Hyperactivity-Associated Disorders: A Systematic Review and Meta-Analysis.

PubMed

Liao, Chun-De; Tsauo, Jau-Yih; Liou, Tsan-Hon; Chen, Hung-Chou; Rau, Chi-Lun

2016-01-01

Stellate ganglion blockade (SGB) is mainly used to relieve symptoms of neuropathic pain in conditions such as complex regional pain syndrome and has several potential complications. Noninvasive SGB performed using physical agent modalities (PAMs), such as light irradiation and electrical stimulation, can be clinically used as an alternative to conventional invasive SGB. However, its application protocols vary and its clinical efficacy remains controversial. This study investigated the use of noninvasive SGB for managing neuropathic pain or other disorders associated with sympathetic hyperactivity. We performed a comprehensive search of the following online databases: Medline, PubMed, Excerpta Medica Database, Cochrane Library Database, Ovid MEDLINE, Europe PubMed Central, EBSCOhost Research Databases, CINAHL, ProQuest Research Library, Physiotherapy Evidence Database, WorldWideScience, BIOSIS, and Google Scholar. We identified and included quasi-randomized or randomized controlled trials reporting the efficacy of SGB performed using therapeutic ultrasound, transcutaneous electrical nerve stimulation, light irradiation using low-level laser therapy, or xenon light or linearly polarized near-infrared light irradiation near or over the stellate ganglion region in treating complex regional pain syndrome or disorders requiring sympatholytic management. The included articles were subjected to a meta-analysis and risk of bias assessment. Nine randomized and four quasi-randomized controlled trials were included. Eleven trials had good methodological quality with a Physiotherapy Evidence Database (PEDro) score of ≥6, whereas the remaining two trials had a PEDro score of <6. The meta-analysis results revealed that the efficacy of noninvasive SGB on 100-mm visual analog pain score is higher than that of a placebo or active control (weighted mean difference, -21.59 mm; 95% CI, -34.25, -8.94; p = 0.0008). Noninvasive SGB performed using PAMs effectively relieves pain of various etiologies, making it a valuable addition to the contemporary pain management armamentarium. However, this evidence is limited by the potential risk of bias.

Aligning population-based care management with chronic disease complexity.

PubMed

Hewner, Sharon; Seo, Jin Young; Gothard, Sandra E; Johnson, Barbara J

2014-01-01

Risk-stratified care management requires knowledge of the complexity of chronic disease and comorbidity, information that is often not readily available in the primary care setting. The purpose of this article was to describe a population-based approach to risk-stratified care management that could be applied in primary care. Three populations (Medicaid, Medicare, and privately insured) at a regional health plan were divided into risk-stratified cohorts based on chronic disease and complexity, and utilization was compared before and after the implementation of population-specific care management teams of nurses. Risk-stratified care management was associated with reductions in hospitalization rates in all three populations, but the opportunities to avoid admissions were different. Knowledge of population complexity is critical to the development of risk-stratified care management in primary care, and a complexity matrix can help nurses identify gaps in care and align interventions to cohort and population needs. Copyright © 2014 Elsevier Inc. All rights reserved.

Forming system of strategic innovation management at high-tech engineering enterprises

NASA Astrophysics Data System (ADS)

Ergunova, O. T.; Lizunkov, V. G.; Malushko, E. Yu; Marchuk, V. I.; Ignatenko, A. Yu

2017-02-01

The article considers the processes of forming the strategic system of innovative activity management at the enterprises of a high-tech mechanical engineering complex (MEC) that are traditionally decisive in shaping the economic base of Russia. The authors proposed a method of designing a strategic system of innovative activity management at the MEC’s enterprises of the region which is based on the consideration of means and opportunities of the enterprise to implement intellectual activity. The proposed methodology and the empirical results constituted a ground for developing a system of strategic innovation management when performing the state-guaranteed order at the hi-tech MEC enterprises. Its implementation will help to reduce the level of uncertainty throughout the entire life cycle of an innovative activity product.

Structuring a central business office to succeed in a managed care dominated environment.

PubMed

Lomicka, E W

2001-01-01

Integrated delivery systems have begun to consolidate the business office functions of their member facilities in response to a decline in managed care revenues and an increase in health care expenses. Many who have pursued this strategy have experienced cost reductions through staff restructuring, but have not experienced the revenue retention, cash acceleration, and other performance gains originally envisioned. This often occurs when the role of the central business office (CBO) has been limited to serving only the "back-office" functions of claims processing. In today's health care environment, the viability of a CBO depends on its responsiveness to the administrative complexities of managed care. Successful CBOs accommodate extensive cross-functional coordination, achieve operational efficiencies through the use of automation, and adopt best practices for implementing managed care contractual obligations.

Managing Programmatic Risk for Complex Space System Developments

NASA Technical Reports Server (NTRS)

Panetta, Peter V.; Hastings, Daniel; Brumfield, Mark (Technical Monitor)

2001-01-01

Risk management strategies have become a recent important research topic to many aerospace organizations as they prepare to develop the revolutionary complex space systems of the future. Future multi-disciplinary complex space systems will make it absolutely essential for organizations to practice a rigorous, comprehensive risk management process, emphasizing thorough systems engineering principles to succeed. Project managers must possess strong leadership skills to direct high quality, cross-disciplinary teams for successfully developing revolutionary space systems that are ever increasing in complexity. Proactive efforts to reduce or eliminate risk throughout a project's lifecycle ideally must be practiced by all technical members in the organization. This paper discusses some of the risk management perspectives that were collected from senior managers and project managers of aerospace and aeronautical organizations by the use of interviews and surveys. Some of the programmatic risks which drive the success or failure of projects are revealed. Key findings lead to a number of insights for organizations to consider for proactively approaching the risks which face current and future complex space systems projects.

Medicaid's Complex Goals: Challenges for Managed Care and Behavioral Health

PubMed Central

Gold, Marsha; Mittler, Jessica

2000-01-01

The Medicaid program has become increasingly complex as policymakers use it to address various policy objectives, leading to structural tensions that surface with Medicaid managed care. In this article, we illustrate this complexity by focusing on the experience of three States with behavioral health carveouts—Maryland, Oregon, and Tennessee. Converting to Medicaid managed care forces policymakers to confront Medicaid's competing policy objectives, multiplicity of stakeholders, and diverse patients, many with complex needs. Emerging Medicaid managed care systems typically represent compromises in which existing inequities and fragmentation are reconfigured rather than eliminated. PMID:12500322

A review of materials for spectral design coatings in signature management applications

NASA Astrophysics Data System (ADS)

Andersson, Kent E.; Škerlind, Christina

2014-10-01

The current focus in Swedish policy towards national security and high-end technical systems, together with a rapid development in multispectral sensor technology, adds to the utility of developing advanced materials for spectral design in signature management applications. A literature study was performed probing research databases for advancements. Qualitative text analysis was performed using a six-indicator instrument: spectrally selective reflectance; low gloss; low degree of polarization; low infrared emissivity; non-destructive properties in radar and in general controllability of optical properties. Trends are identified and the most interesting materials and coating designs are presented with relevant performance metrics. They are sorted into categories in the order of increasing complexity: pigments and paints, one-dimensional structures, multidimensional structures (including photonic crystals), and lastly biomimic and metamaterials. The military utility of the coatings is assessed qualitatively. The need for developing a framework for assessing the military utility of incrementally increasing the performance of spectrally selective coatings is identified.

Managing Schools as Complex Adaptive Systems: A Strategic Perspective

ERIC Educational Resources Information Center

Fidan, Tuncer; Balci, Ali

2017-01-01

This conceptual study examines the analogies between schools and complex adaptive systems and identifies strategies used to manage schools as complex adaptive systems. Complex adaptive systems approach, introduced by the complexity theory, requires school administrators to develop new skills and strategies to realize their agendas in an…

Organisational effectiveness within National Health Service (NHS) Trusts.

PubMed

Jackson, S

1998-01-01

In view of the dearth of information relating to organisational effectiveness of NHS Trusts in comparison with clinical effectiveness, a complex study was undertaken to determine whether overall effectiveness was a result of management processes, people, or a combination of both. The study incorporated two phases involving the distribution of a comprehensive questionnaire to identify the "whats" of organisational effectiveness, and a bench-marking exercise aimed at identifying the "hows". In the main, the better performing trusts were found to be subscribing to the concepts of "keeping it simple", innovation and attainment of highly efficient processes. A number of examples of better/best practices were observed which included visible leadership, a commitment towards stakeholder involvement and the practice of teamworking. Given the complexity of the study area, the findings were deemed valuable to managers practising within all areas of healthcare. However, a need for further research was identified in order to substantiate the results.

Convective Weather Avoidance with Uncertain Weather Forecasts

NASA Technical Reports Server (NTRS)

Karahan, Sinan; Windhorst, Robert D.

2009-01-01

Convective weather events have a disruptive impact on air traffic both in terminal area and in en-route airspaces. In order to make sure that the national air transportation system is safe and efficient, it is essential to respond to convective weather events effectively. Traffic flow control initiatives in response to convective weather include ground delay, airborne delay, miles-in-trail restrictions as well as tactical and strategic rerouting. The rerouting initiatives can potentially increase traffic density and complexity in regions neighboring the convective weather activity. There is a need to perform rerouting in an intelligent and efficient way such that the disruptive effects of rerouting are minimized. An important area of research is to study the interaction of in-flight rerouting with traffic congestion or complexity and developing methods that quantitatively measure this interaction. Furthermore, it is necessary to find rerouting solutions that account for uncertainties in weather forecasts. These are important steps toward managing complexity during rerouting operations, and the paper is motivated by these research questions. An automated system is developed for rerouting air traffic in order to avoid convective weather regions during the 20- minute - 2-hour time horizon. Such a system is envisioned to work in concert with separation assurance (0 - 20-minute time horizon), and longer term air traffic management (2-hours and beyond) to provide a more comprehensive solution to complexity and safety management. In this study, weather is dynamic and uncertain; it is represented as regions of airspace that pilots are likely to avoid. Algorithms are implemented in an air traffic simulation environment to support the research study. The algorithms used are deterministic but periodically revise reroutes to account for weather forecast updates. In contrast to previous studies, in this study convective weather is represented as regions of airspace that pilots are likely to avoid. The automated system periodically updates forecasts and reassesses rerouting decisions in order to account for changing weather predictions. The main objectives are to reroute flights to avoid convective weather regions and determine the resulting complexity due to rerouting. The eventual goal is to control and reduce complexity while rerouting flights during the 20 minute - 2 hour planning period. A three-hour simulation is conducted using 4800 flights in the national airspace. The study compares several metrics against a baseline scenario using the same traffic and weather but with rerouting disabled. The results show that rerouting can have a negative impact on congestion in some sectors, as expected. The rerouting system provides accurate measurements of the resulting complexity in the congested sectors. Furthermore, although rerouting is performed only in the 20-minute - 2-hour range, it results in a 30% reduction in encounters with nowcast weather polygons (100% being the ideal for perfectly predictable and accurate weather). In the simulations, rerouting was performed for the 20-minute - 2-hour flight time horizon, and for the en-route segment of air traffic. The implementation uses CWAM, a set of polygons that represent probabilities of pilot deviation around weather. The algorithms were implemented in a software-based air traffic simulation system. Initial results of the system's performance and effectiveness were encouraging. Simulation results showed that when flights were rerouted in the 20-minute - 2-hour flight time horizon of air traffic, there were fewer weather encounters in the first 20 minutes than for flights that were not rerouted. Some preliminary results were also obtained that showed that rerouting will also increase complexity. More simulations will be conducted in order to report conclusive results on the effects of rerouting on complexity. Thus, the use of the 20-minute - 2-hour flight time horizon weather avoidance teniques performed in the simulation is expected to provide benefits for short-term weather avoidance.

Managing inherent complexity for sustainable walleye fisheries in Lake Erie

USGS Publications Warehouse

Roseman, Edward F.; Drouin, Richard; Gaden, Marc; Knight, Roger; Tyson, Jeff; Zhao, Yingming; Taylor, William W.; Lynch, Abigail J.; Léonard, Nancy J.

2012-01-01

In Lake Erie, Walleye (Sander vitreus vitreus) is king. The naturally occurring species is the foundation of commercial fishing operations on the Canadian side of the lake and is a much-prized sport fish on the American side. Management of Lake Erie walleye fisheries is complex and takes place in an inter-jurisdictional setting composed of resource agencies from the states of Michigan (MDNR), Ohio (ODNR), Pennsylvania (PFBC), and New York (NYDEC) and the province of Ontario (OMNR). The complexity of walleye management is exacerbated by interactions among environmental and ecological changes in Lake Erie, complex life-history characteristics of the species, public demand for walleye, and cultural/governance differences among managing groups and their respective constituents. Success of future management strategies will largely hinge upon our ability to understand these inherent complexities and to employ tactics that successfully accommodate stock productivity and human demand in a highly dynamic environment. In this report, we review the history of Lake Erie walleye management, outline the multi-jurisdictional process for international management of walleye, and discuss strategies to address challenges facing managers.

Toolsets Maintain Health of Complex Systems

NASA Technical Reports Server (NTRS)

2010-01-01

First featured in Spinoff 2001, Qualtech Systems Inc. (QSI), of Wethersfield, Connecticut, adapted its Testability, Engineering, and Maintenance System (TEAMS) toolset under Small Business Innovation Research (SBIR) contracts from Ames Research Center to strengthen NASA's systems health management approach for its large, complex, and interconnected systems. Today, six NASA field centers utilize the TEAMS toolset, including TEAMS-Designer, TEAMS-RT, TEAMATE, and TEAMS-RDS. TEAMS is also being used on industrial systems that generate power, carry data, refine chemicals, perform medical functions, and produce semiconductor wafers. QSI finds TEAMS can lower costs by decreasing problems requiring service by 30 to 50 percent.

High throughput computing: a solution for scientific analysis

USGS Publications Warehouse

O'Donnell, M.

2011-01-01

handle job failures due to hardware, software, or network interruptions (obviating the need to manually resubmit the job after each stoppage); be affordable; and most importantly, allow us to complete very large, complex analyses that otherwise would not even be possible. In short, we envisioned a job-management system that would take advantage of unused FORT CPUs within a local area network (LAN) to effectively distribute and run highly complex analytical processes. What we found was a solution that uses High Throughput Computing (HTC) and High Performance Computing (HPC) systems to do exactly that (Figure 1).

Heuristics in Managing Complex Clinical Decision Tasks in Experts’ Decision Making

PubMed Central

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2016-01-01

Background Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. Objective The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. Method After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. Results We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Conclusion Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Application Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design. PMID:27275019

Heuristics in Managing Complex Clinical Decision Tasks in Experts' Decision Making.

PubMed

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2014-09-01

Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design.

Congenital heart surgery: surgical performance according to the Aristotle complexity score.

PubMed

Arenz, Claudia; Asfour, Boulos; Hraska, Viktor; Photiadis, Joachim; Haun, Christoph; Schindler, Ehrenfried; Sinzobahamvya, Nicodème

2011-04-01

Aristotle score methodology defines surgical performance as 'complexity score times hospital survival'. We analysed how this performance evolved over time and in correlation with case volume. Aristotle basic and comprehensive complexity scores and corresponding basic and comprehensive surgical performances were determined for primary (main) procedures carried out from 2006 to 2009. Surgical case volume performance described as unit performance was estimated as 'surgical performance times the number of primary procedures'. Basic and comprehensive complexity scores for the whole cohort of procedures (n=1828) were 7.74±2.66 and 9.89±3.91, respectively. With an early survival of 97.5% (1783/1828), mean basic and comprehensive surgical performances reached 7.54±2.54 and 9.64±3.81, respectively. Basic surgical performance varied little over the years: 7.46±2.48 in 2006, 7.43±2.58 in 2007, 7.50±2.76 in 2008 and 7.79±2.54 in 2009. Comprehensive surgical performance decreased from 9.56±3.91 (2006) to 9.22±3.94 (2007), and then to 9.13±3.77 (2008), thereafter increasing up to 10.62±3.67 (2009). No significant change of performance was observed for low comprehensive complexity levels 1-3. Variation concerned level 4 (p=0.048) which involved the majority of procedures (746, or 41% of cases) and level 6 (p<0.0001) which included a few cases (20, or 1%), whereas for level 5, statistical significance was almost attained: p=0.079. With a mean annual number of procedures of 457, mean basic and comprehensive unit performance was estimated at 3447±362 and 4405±577, respectively. Basic unit performance increased year to year from 3036 (2006, 100%) to 3254 (2007, 107.2%), then 3720 (2008, 122.5%), up to 3793 (2009, 124.9%). Comprehensive unit performance also increased: from 3891 (2006, 100%) to 4038 (2007, 103.8%), 4528 (2008, 116.4%) and 5172 (2009, 132.9%). Aristotle scoring of surgical performance allows quality assessment of surgical management of congenital heart disease over time. The newly defined unit performance appears to well reflect the trend of activity and efficiency of a congenital heart surgery department. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome (CRPS) Recurrence after Amputation for CRPS, and Failure of Conventional Spinal Cord Stimulation.

PubMed

Goebel, Andreas; Lewis, Sarah; Phillip, Rhodri; Sharma, Manohar

2018-01-01

Limb amputation is sometimes being performed in long-standing complex regional pain syndrome (CRPS), although little evidence is available guiding management decisions, including how CRPS recurrence should be managed. This report details the management of a young soldier with CRPS recurrence 2 years after midtibial amputation for CRPS. Conventional spinal cord stimulation did not achieve paraesthetic coverage, or pain relief in the stump, whereas L4 dorsal root ganglion stimulation achieved both coverage and initially modest pain relief, and over time, substantial pain relief. Current evidence does not support the use of amputation to improve either pain or function in CRPS. Before a decision is made, in exceptional cases, about referral for amputation, dorsal root ganglion stimulation should be considered as a potentially effective treatment, even where conventional spinal cord stimulator treatment has failed to achieve reliable paraesthetic cover. Furthermore, this treatment may provide pain relief in those patients with CRPS recurrence in the stump after amputation. © 2017 World Institute of Pain.

Strategies to manage activities in everyday life after a pain rehabilitation program.

PubMed

Kallhed, Cecilia; Mårtensson, Lena

2018-03-01

Owing to the complexity of the pain experience, it is important to understand how persons with chronic pain manage their condition, in order to provide an indication of how occupational therapists can enable participation in meaningful everyday activities during pain rehabilitation. The aim of this study was to explore how persons with chronic pain reason about their use and choice of strategies to manage activities of everyday life. A qualitative approach was used to capture experiences of strategies employed to manage activities while living with chronic pain. Eight persons agreed to participate. An overall theme, 'adjusting to life with chronic pain', encompasses the underlying meaning and the relations between the categories: finding new ways to perform activities, reaching for a reasonable balance of activities and using activities to achieve other purposes. Persons with chronic pain use various strategies as means to enable performance in activities of everyday life despite living with pain, which supports the conception that occupational therapists should focus on activities and strategies rather than the pain condition during pain rehabilitation.

Emergency in the clinic: a simulation curriculum to improve outpatient safety.

PubMed

Espey, Eve; Baty, Gillian; Rask, John; Chungtuyco, Michelle; Pereda, Brenda; Leeman, Lawrence

2017-12-01

Emergency response skills are essential when events such as seizure, anaphylaxis, or hemorrhage occur in the outpatient setting. As services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy. This pre- and postcurriculum study enrolled residents and fellows in Obstetrics and Gynecology and Family Medicine in a simulation-based, outpatient emergency management curriculum. Learners completed self-efficacy questionnaires and were videotaped managing 3 medical emergency scenarios (seizure, over-sedation/cardiopulmonary arrest, and hemorrhage) in the simulation laboratory both before and after completion of the curriculum. Evaluators who were blinded to training level scored the simulation performance videotapes using a graded rubric with critical action checklists. Scenario scores were assigned in 5 domains and globally. Paired t-tests were used to determine differences pre- and postcurriculum. Thirty residents completed the curriculum and pre- and postcurriculum testing. Subjects' objective performance scores improved in all 5 domains (P<.05) in all scenarios. When scores were stratified by level of training, all participants demonstrated global improvement. When scores were stratified by previous outpatient simulation experience, subjects with previous experience improved in all but management of excess sedation. Pre- and postcurriculum self-efficacy evaluations demonstrated improvement in all 7 measured areas: confidence, use of appropriate resources, communication skills, complex airway management, bag mask ventilation, resuscitation, and hemorrhage management. Self-efficacy assessment showed improvement in confidence managing outpatient emergencies (P=.001) and ability to communicate well in emergency situations (P<.001). A simulation-based curriculum improved both self-efficacy and objectively rated performance scores in management of outpatient medical emergencies. Simulation-based curricula should be incorporated into residency education. Copyright © 2017 Elsevier Inc. All rights reserved.

Solid waste management in primary healthcare centers: application of a facilitation tool 1

PubMed Central

Moreira, Ana Maria Maniero; Günther, Wanda Maria Risso

2016-01-01

Abstract Objectives: to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. Method: descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. Results: the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%), infectious-sharps (31-42%) and recyclable (5-17%). The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. Conclusion: the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services. PMID:27556874

Community Health Worker Performance in the Management of Multiple Childhood Illnesses: Siaya District, Kenya, 1997–2001

PubMed Central

Kelly, Jane M.; Osamba, Benta; Garg, Renu M.; Hamel, Mary J.; Lewis, Jennifer J.; Rowe, Samantha Y.; Rowe, Alexander K.; Deming, Michael S.

2001-01-01

Objectives. To characterize community health worker (CHW) performance using an algorithm for managing common childhood illnesses in Siaya District, Kenya, we conducted CHW evaluations in 1998, 1999, and 2001. Methods. Randomly selected CHWs were observed managing sick outpatient and inpatient children at a hospital, and their management was compared with that of an expert clinician who used the algorithm. Results. One hundred, 108, and 114 CHWs participated in the evaluations in 1998, 1999, and 2001, respectively. The proportions of children treated “adequately” (with an antibiotic, antimalarial, oral rehydration solution, or referral, depending on the child's disease classifications) were 57.8%, 35.5%, and 38.9%, respectively, for children with a severe classification and 27.7%, 77.3%, and 74.3%, respectively, for children with a moderate (but not severe) classification. CHWs adequately treated 90.5% of malaria cases (the most commonly encountered classification). CHWs often made mistakes assessing symptoms, classifying illnesses, and prescribing correct doses of medications. Conclusions. Deficiencies were found in the management of sick children by CHWs, although care was not consistently poor. Key reasons for the deficiencies appear to be guideline complexity and inadequate clinical supervision; other possible causes are discussed. PMID:11574324

Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction

PubMed Central

Pedraza, Rodrigo; Nieto, Javier; Ibarra, Sergio; Haas, Eric M.

2014-01-01

Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR) is a noninvasive modality involving cognitive reeducation, modification, and retraining of the pelvic floor and associated musculature. We describe our standardized PMR protocol for the management of pelvic floor dysfunction syndromes. Pelvic Muscle Rehabilitation Program. The diagnostic assessment includes electromyography and manometry analyzed in 4 phases: (1) initial baseline phase; (2) rapid contraction phase; (3) tonic contraction and endurance phase; and (4) late baseline phase. This evaluation is performed at the onset of every session. PMR management consists of 6 possible therapeutic modalities, employed depending on the diagnostic evaluation: (1) down-training; (2) accessory muscle isolation; (3) discrimination training; (4) muscle strengthening; (5) endurance training; and (6) electrical stimulation. Eight to ten sessions are performed at one-week intervals with integration of home exercises and lifestyle modifications. Conclusions. The PMR protocol offers a standardized approach to diagnose and manage pelvic floor dysfunction syndromes with potential advantages over traditional biofeedback, involving additional interventions and a continuous pelvic floor assessment with management modifications over the clinical course. PMID:25006337

Consensus guidelines for the investigation and management of encephalitis in adults and children in Australia and New Zealand.

PubMed

Britton, P N; Eastwood, K; Paterson, B; Durrheim, D N; Dale, R C; Cheng, A C; Kenedi, C; Brew, B J; Burrow, J; Nagree, Y; Leman, P; Smith, D W; Read, K; Booy, R; Jones, C A

2015-05-01

Encephalitis is a complex neurological syndrome caused by inflammation of the brain parenchyma. The management of encephalitis is challenging because: the differential diagnosis of encephalopathy is broad; there is often rapid disease progression; it often requires intensive supportive management; and there are many aetiologic agents for which there is no definitive treatment. Patients with possible meningoencephalitis are often encountered in the emergency care environment where clinicians must consider differential diagnoses, perform appropriate investigations and initiate empiric antimicrobials. For patients who require admission to hospital and in whom encephalitis is likely, a staged approach to investigation and management is preferred with the potential involvement of multiple medical specialties. Key considerations in the investigation and management of patients with encephalitis addressed in this guideline include: Which first-line investigations should be performed?; Which aetiologies should be considered possible based on clinical features, risk factors and radiological features?; What tests should be arranged in order to diagnose the common causes of encephalitis?; When to consider empiric antimicrobials and immune modulatory therapies?; and What is the role of brain biopsy? © 2015 Royal Australasian College of Physicians.

Effects of distance learning on clinical management of LUTS in primary care: a randomised trial.

PubMed

Wolters, René; Wensing, Michel; Klomp, Maarten; Lagro-Jansen, Toine; Weel, Chris van; Grol, Richard

2005-11-01

To determine the effect of a distance learning programme on general practice management of men with lower urinary tract symptoms (LUTS). A cluster randomised controlled trial was performed. General practitioners (GPs) were randomised to a distance learning programme accompanied with educational materials or to a control group only receiving mailed clinical guidelines on LUTS. Clinical management was considered as outcome. Sixty-three GPs registered care management of 187 patients older than 50 years attending the practice because of LUTS. The intervention group showed a lower referral rate to a urologist (OR: 0.08 (95% CI: 0.02-0.40)), but no effect on PSA testing or prescription of medication. PSA testing tended to be requested more frequently by intervention group GPs. Secondary analysis showed patients in the intervention group received more educational materials (OR: 75.6 (95% CI: 13.60-419.90)). The educational programme had impact on clinical management without changing PSA testing. Distance learning is an promising method for continuing education. Activating distance learning packages are a potentially effective method for improving professional performance. Emotional matters as PSA testing probably need a more complex approach.

Knowledge management performance methodology regarding manufacturing organizations

NASA Astrophysics Data System (ADS)

Istrate, C.; Herghiligiu, I. V.

2016-08-01

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

CAP/ACMG proficiency testing for biochemical genetics laboratories: a summary of performance.

PubMed

Oglesbee, Devin; Cowan, Tina M; Pasquali, Marzia; Wood, Timothy C; Weck, Karen E; Long, Thomas; Palomaki, Glenn E

2018-01-01

PurposeTesting for inborn errors of metabolism is performed by clinical laboratories worldwide, each utilizing laboratory-developed procedures. We sought to summarize performance in the College of American Pathologists' (CAP) proficiency testing (PT) program and identify opportunities for improving laboratory quality. When evaluating PT data, we focused on a subset of laboratories that have participated in at least one survey since 2010.MethodsAn analysis of laboratory performance (2004 to 2014) on the Biochemical Genetics PT Surveys, a program administered by CAP and the American College of Medical Genetics and Genomics. Analytical and interpretive performance was evaluated for four tests: amino acids, organic acids, acylcarnitines, and mucopolysaccharides.ResultsSince 2010, 150 laboratories have participated in at least one of four PT surveys. Analytic sensitivities ranged from 88.2 to 93.4%, while clinical sensitivities ranged from 82.4 to 91.0%. Performance was higher for US participants and for more recent challenges. Performance was lower for challenges with subtle findings or complex analytical patterns.ConclusionUS clinical biochemical genetics laboratory proficiency is satisfactory, with a minority of laboratories accounting for the majority of errors. Our findings underscore the complex nature of clinical biochemical genetics testing and highlight the necessity of continuous quality management.

When weight management lasts. Lower perceived rule complexity increases adherence.

PubMed

Mata, Jutta; Todd, Peter M; Lippke, Sonia

2010-02-01

Maintaining behavior change is one of the major challenges in weight management and long-term weight loss. We investigated the impact of the cognitive complexity of eating rules on adherence to weight management programs. We studied whether popular weight management programs can fail if participants find the rules too complicated from a cognitive perspective, meaning that individuals are not able to recall or process all required information for deciding what to eat. The impact on program adherence of participants' perceptions of eating rule complexity and other behavioral factors known to influence adherence (including previous weight management, self-efficacy, and planning) was assessed via a longitudinal online questionnaire given to 390 participants on two different popular weight management regimens. As we show, the regimens, Weight Watchers and a popular German recipe diet (Brigitte), strongly differ in objective rule complexity and thus their cognitive demands on the dieter. Perceived rule complexity was the strongest factor associated with increased risk of quitting the cognitively demanding weight management program (Weight Watchers); it was not related to adherence length for the low cognitive demand program (Brigitte). Higher self-efficacy generally helped in maintaining a program. The results emphasize the importance of considering rule complexity to promote long-term weight management. 2009 Elsevier Ltd. All rights reserved.

Factors influencing use of an e-health website in a community sample of older adults.

PubMed

Czaja, Sara J; Sharit, Joseph; Lee, Chin Chin; Nair, Sankaran N; Hernández, Mario A; Arana, Neysarí; Fu, Shih Hua

2013-01-01

The use of the internet as a source of health information and link to healthcare services has raised concerns about the ability of consumers, especially vulnerable populations such as older adults, to access these applications. This study examined the influence of training on the ability of adults (aged 45+ years) to use the Medicare.gov website to solve problems related to health management. The influence of computer experience and cognitive abilities on performance was also examined. Seventy-one participants, aged 47-92, were randomized into a Multimedia training, Unimodal training, or Cold Start condition and completed three healthcare management problems. MEASUREMENT AND ANALYSES: Computer/internet experience was measured via questionnaire, and cognitive abilities were assessed using standard neuropsychological tests. Performance metrics included measures of navigation, accuracy and efficiency. Data were analyzed using analysis of variance, χ(2) and regression techniques. The data indicate that there was no difference among the three conditions on measures of accuracy, efficiency, or navigation. However, results of the regression analyses showed that, overall, people who received training performed better on the tasks, as evidenced by greater accuracy and efficiency. Performance was also significantly influenced by prior computer experience and cognitive abilities. Participants with more computer experience and higher cognitive abilities performed better. The findings indicate that training, experience, and abilities are important when using complex health websites. However, training alone is not sufficient. The complexity of web content needs to be considered to ensure successful use of these websites by those with lower abilities.

Factors influencing use of an e-health website in a community sample of older adults

PubMed Central

Sharit, Joseph; Lee, Chin Chin; Nair, Sankaran N; Hernández, Mario A; Arana, Neysarí; Fu, Shih Hua

2013-01-01

Objective The use of the internet as a source of health information and link to healthcare services has raised concerns about the ability of consumers, especially vulnerable populations such as older adults, to access these applications. This study examined the influence of training on the ability of adults (aged 45+ years) to use the Medicare.gov website to solve problems related to health management. The influence of computer experience and cognitive abilities on performance was also examined. Design Seventy-one participants, aged 47–92, were randomized into a Multimedia training, Unimodal training, or Cold Start condition and completed three healthcare management problems. Measurement and analyses Computer/internet experience was measured via questionnaire, and cognitive abilities were assessed using standard neuropsychological tests. Performance metrics included measures of navigation, accuracy and efficiency. Data were analyzed using analysis of variance, χ2 and regression techniques. Results The data indicate that there was no difference among the three conditions on measures of accuracy, efficiency, or navigation. However, results of the regression analyses showed that, overall, people who received training performed better on the tasks, as evidenced by greater accuracy and efficiency. Performance was also significantly influenced by prior computer experience and cognitive abilities. Participants with more computer experience and higher cognitive abilities performed better. Conclusions The findings indicate that training, experience, and abilities are important when using complex health websites. However, training alone is not sufficient. The complexity of web content needs to be considered to ensure successful use of these websites by those with lower abilities. PMID:22802269

Forested Wetlands: Functions, Benefits and the Use of Best Management Practices

Treesearch

David J. Welsch; David L. Smart; James N. Boyer; Paul Minken; Howard C. Smith; Tamara L. McCandless

1995-01-01

Wetlands are complex and fascinating ecosystems that perform a variety of functions of vital importance to the environment and to the society whose very existence depends on the quality of the environment. Wetlands regulate water flow by detaining storm flows for short periods thus reducing Wetlands protect lake shore and coastal areas by buffering the erosive action...

An Exploration of the Impact of an Open Governance Approach on Strategic Decision Making, Collaboration, Organizational Change, and Sustainability

ERIC Educational Resources Information Center

Hensley, Kendra

2011-01-01

Total quality management based governance models tend to focus on incremental improvements within the boundaries of a single organization. This may limit the benefits of information technology because they are not complex enough to address business or performance problems that extend beyond the boundaries of a single organization. The research…

Making Semantic Information Work Effectively for Degraded Environments

DTIC Science & Technology

2013-06-01

Control Research & Technology Symposium (ICCRTS) held 19-21 June, 2013 in Alexandria, VA. 14. ABSTRACT The challenges of effectively managing semantic...technologies over disadvantaged or degraded environments are numerous and complex. One of the greatest challenges is the size of raw data. Large...approach mitigates this challenge by performing data reduction through the adoption of format recognition technologies, semantic data extractions, and the

Unlocking the Secrets of High-Performing Charters: Tight Management and "No Excuses"

ERIC Educational Resources Information Center

Peyser, James A.

2011-01-01

Charter schools are approaching the ripe old age of 20. Although more work remains if one is to fully understand this complex education reform "movement," a growing body of data and research is being compiled about its strengths, weaknesses, and impact. An important subset of the charter school sector is just now receiving a similar level of…

Everyday Expertise in Self-Management of Diabetes in the Dominican Republic: Implications for Learning and Performance Support Systems Design

ERIC Educational Resources Information Center

Reyes Paulino, Lisette G.

2012-01-01

An epidemic such as diabetes is an extremely complex public health, economic and social problem that is difficult to solve through medical expertise alone. Evidence-based models for improving healthcare delivery systems advocate educating patients to become more active participants in their own care. This shift demands preparing chronically ill…

Impact of Cognitive Abilities and Prior Knowledge on Complex Problem Solving Performance – Empirical Results and a Plea for Ecologically Valid Microworlds

PubMed Central

Süß, Heinz-Martin; Kretzschmar, André

2018-01-01

The original aim of complex problem solving (CPS) research was to bring the cognitive demands of complex real-life problems into the lab in order to investigate problem solving behavior and performance under controlled conditions. Up until now, the validity of psychometric intelligence constructs has been scrutinized with regard to its importance for CPS performance. At the same time, different CPS measurement approaches competing for the title of the best way to assess CPS have been developed. In the first part of the paper, we investigate the predictability of CPS performance on the basis of the Berlin Intelligence Structure Model and Cattell’s investment theory as well as an elaborated knowledge taxonomy. In the first study, 137 students managed a simulated shirt factory (Tailorshop; i.e., a complex real life-oriented system) twice, while in the second study, 152 students completed a forestry scenario (FSYS; i.e., a complex artificial world system). The results indicate that reasoning – specifically numerical reasoning (Studies 1 and 2) and figural reasoning (Study 2) – are the only relevant predictors among the intelligence constructs. We discuss the results with reference to the Brunswik symmetry principle. Path models suggest that reasoning and prior knowledge influence problem solving performance in the Tailorshop scenario mainly indirectly. In addition, different types of system-specific knowledge independently contribute to predicting CPS performance. The results of Study 2 indicate that working memory capacity, assessed as an additional predictor, has no incremental validity beyond reasoning. We conclude that (1) cognitive abilities and prior knowledge are substantial predictors of CPS performance, and (2) in contrast to former and recent interpretations, there is insufficient evidence to consider CPS a unique ability construct. In the second part of the paper, we discuss our results in light of recent CPS research, which predominantly utilizes the minimally complex systems (MCS) measurement approach. We suggest ecologically valid microworlds as an indispensable tool for future CPS research and applications. PMID:29867627

New technologies for supporting real-time on-board software development

NASA Astrophysics Data System (ADS)

Kerridge, D.

1995-03-01

The next generation of on-board data management systems will be significantly more complex than current designs, and will be required to perform more complex and demanding tasks in software. Improved hardware technology, in the form of the MA31750 radiation hard processor, is one key component in addressing the needs of future embedded systems. However, to complement these hardware advances, improved support for the design and implementation of real-time data management software is now needed. This will help to control the cost and risk assoicated with developing data management software development as it becomes an increasingly significant element within embedded systems. One particular problem with developing embedded software is managing the non-functional requirements in a systematic way. This paper identifies how Logica has exploited recent developments in hard real-time theory to address this problem through the use of new hard real-time analysis and design methods which can be supported by specialized tools. The first stage in transferring this technology from the research domain to industrial application has already been completed. The MA37150 Hard Real-Time Embedded Software Support Environment (HESSE) is a loosely integrated set of hardware and software tools which directly support the process of hard real-time analysis for software targeting the MA31750 processor. With further development, this HESSE promises to provide embedded system developers with software tools which can reduce the risks associated with developing complex hard real-time software. Supported in this way by more sophisticated software methods and tools, it is foreseen that MA31750 based embedded systems can meet the processing needs for the next generation of on-board data management systems.

The Evolution of CERN EDMS

NASA Astrophysics Data System (ADS)

Wardzinska, Aleksandra; Petit, Stephan; Bray, Rachel; Delamare, Christophe; Garcia Arza, Griselda; Krastev, Tsvetelin; Pater, Krzysztof; Suwalska, Anna; Widegren, David

2015-12-01

Large-scale long-term projects such as the LHC require the ability to store, manage, organize and distribute large amounts of engineering information, covering a wide spectrum of fields. This information is a living material, evolving in time, following specific lifecycles. It has to reach the next generations of engineers so they understand how their predecessors designed, crafted, operated and maintained the most complex machines ever built. This is the role of CERN EDMS. The Engineering and Equipment Data Management Service has served the High Energy Physics Community for over 15 years. It is CERN's official PLM (Product Lifecycle Management), supporting engineering communities in their collaborations inside and outside the laboratory. EDMS is integrated with the CAD (Computer-aided Design) and CMMS (Computerized Maintenance Management) systems used at CERN providing tools for engineers who work in different domains and who are not PLM specialists. Over the years, human collaborations and machines grew in size and complexity. So did EDMS: it is currently home to more than 2 million files and documents, and has over 6 thousand active users. In April 2014 we released a new major version of EDMS, featuring a complete makeover of the web interface, improved responsiveness and enhanced functionality. Following the results of user surveys and building upon feedback received from key users group, we brought what we think is a system that is more attractive and makes it easy to perform complex tasks. In this paper we will describe the main functions and the architecture of EDMS. We will discuss the available integration options, which enable further evolution and automation of engineering data management. We will also present our plans for the future development of EDMS.

Operating room data management: improving efficiency and safety in a surgical block.

PubMed

Agnoletti, Vanni; Buccioli, Matteo; Padovani, Emanuele; Corso, Ruggero M; Perger, Peter; Piraccini, Emanuele; Orelli, Rebecca Levy; Maitan, Stefano; Dell'amore, Davide; Garcea, Domenico; Vicini, Claudio; Montella, Teresa Maria; Gambale, Giorgio

2013-03-11

European Healthcare Systems are facing a difficult period characterized by increasing costs and spending cuts due to economic problems. There is the urgent need for new tools which sustain Hospitals decision makers work. This project aimed to develop a data recording system of the surgical process of every patient within the operating theatre. The primary goal was to create a practical and easy data processing tool to give hospital managers, anesthesiologists and surgeons the information basis to increase operating theaters efficiency and patient safety. The developed data analysis tool is embedded in an Oracle Business Intelligence Environment, which processes data to simple and understandable performance tachometers and tables. The underlying data analysis is based on scientific literature and the projects teams experience with tracked data. The system login is layered and different users have access to different data outputs depending on their professional needs. The system is divided in the tree profile types Manager, Anesthesiologist and Surgeon. Every profile includes subcategories where operators can access more detailed data analyses. The first data output screen shows general information and guides the user towards more detailed data analysis. The data recording system enabled the registration of 14.675 surgical operations performed from 2009 to 2011. Raw utilization increased from 44% in 2009 to 52% in 2011. The number of high complexity surgical procedures (≥120 minutes) has increased in certain units while decreased in others. The number of unscheduled procedures performed has been reduced (from 25% in 2009 to 14% in 2011) while maintaining the same percentage of surgical procedures. The number of overtime events decreased in 2010 (23%) and in 2011 (21%) compared to 2009 (28%) and the delays expressed in minutes are almost the same (mean 78 min). The direct link found between the complexity of surgical procedures, the number of unscheduled procedures and overtime show a positive impact of the project on OR management. Despite a consistency in the complexity of procedures (19% in 2009 and 21% in 2011), surgical groups have been successful in reducing the number of unscheduled procedures (from 25% in 2009 to 14% in 2011) and overtime (from 28% in 2009 to 21% in 2011). The developed project gives healthcare managers, anesthesiologists and surgeons useful information to increase surgical theaters efficiency and patient safety. In difficult economic times is possible to develop something that is of some value to the patient and healthcare system too.

Operating room data management: improving efficiency and safety in a surgical block

PubMed Central

2013-01-01

Background European Healthcare Systems are facing a difficult period characterized by increasing costs and spending cuts due to economic problems. There is the urgent need for new tools which sustain Hospitals decision makers work. This project aimed to develop a data recording system of the surgical process of every patient within the operating theatre. The primary goal was to create a practical and easy data processing tool to give hospital managers, anesthesiologists and surgeons the information basis to increase operating theaters efficiency and patient safety. Methods The developed data analysis tool is embedded in an Oracle Business Intelligence Environment, which processes data to simple and understandable performance tachometers and tables. The underlying data analysis is based on scientific literature and the projects teams experience with tracked data. The system login is layered and different users have access to different data outputs depending on their professional needs. The system is divided in the tree profile types Manager, Anesthesiologist and Surgeon. Every profile includes subcategories where operators can access more detailed data analyses. The first data output screen shows general information and guides the user towards more detailed data analysis. The data recording system enabled the registration of 14.675 surgical operations performed from 2009 to 2011. Results Raw utilization increased from 44% in 2009 to 52% in 2011. The number of high complexity surgical procedures (≥120 minutes) has increased in certain units while decreased in others. The number of unscheduled procedures performed has been reduced (from 25% in 2009 to 14% in 2011) while maintaining the same percentage of surgical procedures. The number of overtime events decreased in 2010 (23%) and in 2011 (21%) compared to 2009 (28%) and the delays expressed in minutes are almost the same (mean 78 min). The direct link found between the complexity of surgical procedures, the number of unscheduled procedures and overtime show a positive impact of the project on OR management. Despite a consistency in the complexity of procedures (19% in 2009 and 21% in 2011), surgical groups have been successful in reducing the number of unscheduled procedures (from 25% in 2009 to 14% in 2011) and overtime (from 28% in 2009 to 21% in 2011). Conclusions The developed project gives healthcare managers, anesthesiologists and surgeons useful information to increase surgical theaters efficiency and patient safety. In difficult economic times is possible to develop something that is of some value to the patient and healthcare system too. PMID:23496977

A performance improvement case study in aircraft maintenance and its implications for hazard identification.

PubMed

Ward, Marie; McDonald, Nick; Morrison, Rabea; Gaynor, Des; Nugent, Tony

2010-02-01

Aircraft maintenance is a highly regulated, safety critical, complex and competitive industry. There is a need to develop innovative solutions to address process efficiency without compromising safety and quality. This paper presents the case that in order to improve a highly complex system such as aircraft maintenance, it is necessary to develop a comprehensive and ecologically valid model of the operational system, which represents not just what is meant to happen, but what normally happens. This model then provides the backdrop against which to change or improve the system. A performance report, the Blocker Report, specific to aircraft maintenance and related to the model was developed gathering data on anything that 'blocks' task or check performance. A Blocker Resolution Process was designed to resolve blockers and improve the current check system. Significant results were obtained for the company in the first trial and implications for safety management systems and hazard identification are discussed. Statement of Relevance: Aircraft maintenance is a safety critical, complex, competitive industry with a need to develop innovative solutions to address process and safety efficiency. This research addresses this through the development of a comprehensive and ecologically valid model of the system linked with a performance reporting and resolution system.

Effects of training on short- and long-term skill retention in a complex multiple-task environment.

PubMed

Sauer, J; Hockey, G R; Wastell, D G

2000-12-01

The paper reports the results of an experiment on the performance and retention of a complex task. This was a computer-based simulation of the essential elements of a spacecraft's life support system. It allowed the authors to take a range of measures, including primary and secondary task performance, system intervention and information sampling strategies, mental model structure, and subjective operator state. The study compared the effectiveness of two methods of training, based on low level (procedure-based) and high level (system-based) understanding. Twenty-five participants were trained extensively on the task, then given a 1-h testing session. A second testing session was carried out 8 months after the first (with no intervening practice) with 17 of the original participants. While training had little effect on control performance, there were considerable effects on system management strategies, as well as in structure of operator's mental model. In the second testing session, the anticipated general performance decrement did not occur, though for complex faults there was an increase in selectivity towards the primary control task. The relevance of the findings for training and skill retention in real work environments is discussed in the context of a model of compensatory control.

Design of operating rules in complex water resources systems using historical records, expert criteria and fuzzy logic

NASA Astrophysics Data System (ADS)

Pulido-Velazquez, Manuel; Macian-Sorribes, Hector; María Benlliure-Moreno, Jose; Fullana-Montoro, Juan

2015-04-01

Water resources systems in areas with a strong tradition in water use are complex to manage by the high amount of constraints that overlap in time and space, creating a complicated framework in which past, present and future collide between them. In addition, it is usual to find "hidden constraints" in system operations, which condition operation decisions being unnoticed by anyone but the river managers and users. Being aware of those hidden constraints requires usually years of experience and a degree of involvement in that system's management operations normally beyond the possibilities of technicians. However, their impact in the management decisions is strongly imprinted in the historical data records available. The purpose of this contribution is to present a methodology capable of assessing operating rules in complex water resources systems combining historical records and expert criteria. Both sources are coupled using fuzzy logic. The procedure stages are: 1) organize expert-technicians preliminary meetings to let the first explain how they manage the system; 2) set up a fuzzy rule-based system (FRB) structure according to the way the system is managed; 3) use the historical records available to estimate the inputs' fuzzy numbers, to assign preliminary output values to the FRB rules and to train and validate these rules; 4) organize expert-technician meetings to discuss the rule structure and the input's quantification, returning if required to the second stage; 5) once the FRB structure is accepted, its output values must be refined and completed with the aid of the experts by using meetings, workshops or surveys; 6) combine the FRB with a Decision Support System (DSS) to simulate the effect of those management decisions; 7) compare its results with the ones offered by the historical records and/or simulation or optimization models; and 8) discuss with the stakeholders the model performance returning, if it's required, to the fifth or the second stage. The methodology proposed has been applied to the Jucar River Basin (Spain). This basin has 3 reservoirs, 4 headwaters, 11 demands and 5 environmental flows; which form together a complex constraint set. After the preliminary meetings, one 81-rule FRB was created, using as inputs the system state variables at the start of the hydrologic year, and as outputs the target reservoir release schedule. The inputs' fuzzy numbers were estimated jointly using surveys. Fifteen years of historical records were used to train the system's outputs. The obtained FRB was then refined during additional expert-technician meetings. After that, the resulting FRB was introduced into a DSS simulating the effect of those management rules for different hydrological conditions. Three additional FRB's were created using: 1) exclusively the historical records; 2) a stochastic optimization model; and 3) a deterministic optimization model. The results proved to be consistent with the expectations, with the stakeholder's FRB performance located between the data-driven simulation and the stochastic optimization FRB's; and reflect the stakeholders' major goals and concerns about the river management. ACKNOWLEDGEMENT: This study has been partially supported by the IMPADAPT project (CGL2013-48424-C2-1-R) with Spanish MINECO (Ministerio de Economía y Competitividad) funds.

Complex anal fistulas: plug or flap?

PubMed

Muhlmann, Mark D; Hayes, Julian L; Merrie, Arend E H; Parry, Bryan R; Bissett, Ian P

2011-10-01

Rectal mucosal advancement flaps (RMAF) and fistula plugs (FP) are techniques used to manage complex anal fistulas. The purpose of this study was to review and compare the results of these methods of repair. A retrospective review of all complex anal fistulas treated by either a RMAF or a FP at Auckland City Hospital from 2004 to 2008. Comparisons were made in terms of successful healing rates, time to failure and the use of magnetic resonance imaging. Overall, 70 operations were performed on 55 patients (55.7% male). The mean age was 44.9 years. Twenty-one patients (30%) had had at least one previous unsuccessful repair. Indications for repair included 57 high cryptoglandular anal (81%), 4 Crohn's anal (6%), 7 rectovaginal (10%), 1 rectourethral (1%) and 1 pouch-vaginal fistula (1%). All patients were followed up with a mean of 4.5 months. Forty-eight RMAFs (69% of total) were performed with 16 successful repairs (33%). Twenty-two FPs (31% of total) were performed with 7 successful repairs (32%, P = 0.9). In failed repairs, there was no difference in terms of mean time to failure (RMAF 4.8 months versus FP 4.1 months, P = 0.62). Magnetic resonance imaging was performed in 21 patients (37%) before the repair. The success rate in these patients was 20%. The results of treatment of complex anal fistulas are disappointing. The choice of operation of either a RMAF or a FP did not alter the poor healing rates of about one third of patients in each group.

Building the chronic kidney disease management team.

PubMed

Spry, Leslie

2008-01-01

The need to be efficient and the demands for performance-based service are changing how nephrologists deliver care. Chronic kidney disease (CKD) occurs in patients with complex medical and social problems. CKD management requires that multidisciplinary professionals provide patient education, disease management, and psychosocial support. To remain cost-efficient, many physicians are training and supervising midlevel practitioners in the delivery of specialized health care. Specialized care that meets present CKD patient needs is best delivered in a CKD clinic. Three models of CKD clinic are identified: (1) anemia management CKD clinic, (2) the basic CKD clinic, and (3) the comprehensive CKD clinic. Each clinic model is based on critical elements of staffing, billable services, and patient-focused health care. Billable services are anemia-management services, physician services that may be provided by midlevel practitioners, and medical nutrition therapy. In some cases, social worker services may be billable. Building a patient-focused clinic that offers CKD management requires planning, familiarity with federal regulations and statutes, and skillful practitioners. Making services cost-efficient and outcome oriented requires careful physician leadership, talented midlevel practitioners, and billing professionals who understand the goals of the CKD clinic. As Medicare payment reforms evolve, a well-organized CKD program can be well poised to meet the requirements of payers and congressional mandates for performance-based purchasing.

10 CFR 830 Major Modification Determination for the Advanced Test Reactor Remote Monitoring and Management Capability

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

Bohachek, Randolph Charles

2015-09-01

The Advanced Test Reactor (ATR; TRA-670), which is located in the ATR Complex at Idaho National Laboratory, was constructed in the 1960s for the purpose of irradiating reactor fuels and materials. Other irradiation services, such as radioisotope production, are also performed at ATR. While ATR is safely fulfilling current mission requirements, assessments are continuing. These assessments intend to identify areas to provide defense–in-depth and improve safety for ATR. One of the assessments performed by an independent group of nuclear industry experts recommended that a remote accident management capability be provided. The report stated that: “contemporary practice in commercial power reactorsmore » is to provide a remote shutdown station or stations to allow shutdown of the reactor and management of long-term cooling of the reactor (i.e., management of reactivity, inventory, and cooling) should the main control room be disabled (e.g., due to a fire in the control room or affecting the control room).” This project will install remote reactor monitoring and management capabilities for ATR. Remote capabilities will allow for post scram reactor management and monitoring in the event the main Reactor Control Room (RCR) must be evacuated.« less

Land Treatment Digital Library

USGS Publications Warehouse

Pilliod, David S.; Welty, Justin L.

2013-01-01

The Land Treatment Digital Library (LTDL) was created by the U.S. Geological Survey to catalog legacy land treatment information on Bureau of Land Management lands in the western United States. The LTDL can be used by federal managers and scientists for compiling information for data-calls, producing maps, generating reports, and conducting analyses at varying spatial and temporal scales. The LTDL currently houses thousands of treatments from BLM lands across 10 states. Users can browse a map to find information on individual treatments, perform more complex queries to identify a set of treatments, and view graphs of treatment summary statistics.

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

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

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

1995-06-01

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

Managing Analysis Models in the Design Process

NASA Technical Reports Server (NTRS)

Briggs, Clark

2006-01-01

Design of large, complex space systems depends on significant model-based support for exploration of the design space. Integrated models predict system performance in mission-relevant terms given design descriptions and multiple physics-based numerical models. Both the design activities and the modeling activities warrant explicit process definitions and active process management to protect the project from excessive risk. Software and systems engineering processes have been formalized and similar formal process activities are under development for design engineering and integrated modeling. JPL is establishing a modeling process to define development and application of such system-level models.

Management accounting for advanced technological environments.

PubMed

Kaplan, R S

1989-08-25

Management accounting systems designed decades ago no longer provide timely, relevant information for companies in today's highly competitive environment. New operational control and performance measurement systems are recognizing the importance of direct measurement of quality, manufacturing lead times, flexibility, and customer responsiveness, as well as more accurate measures of the actual costs of consumed resources. Activity-based cost systems can assign the costs of indirect and support resources to the specific products and activities that benefit from these resources. Both operational control and activity-based systems represent new opportunities for improved managerial information in complex, technologically advanced environments.

Developing an instrument to measure heart failure disease management program intensity and complexity.

PubMed

Riegel, Barbara; Lee, Christopher S; Sochalski, Julie

2010-05-01

Comparing disease management programs and their effects is difficult because of wide variability in program intensity and complexity. The purpose of this effort was to develop an instrument that can be used to describe the intensity and complexity of heart failure (HF) disease management programs. Specific composition criteria were taken from the American Heart Association (AHA) taxonomy of disease management and hierarchically scored to allow users to describe the intensity and complexity of the domains and subdomains of HF disease management programs. The HF Disease Management Scoring Instrument (HF-DMSI) incorporates 6 of the 8 domains from the taxonomy: recipient, intervention content, delivery personnel, method of communication, intensity/complexity, and environment. The 3 intervention content subdomains (education/counseling, medication management, and peer support) are described separately. In this first test of the HF-DMSI, overall intensity (measured as duration) and complexity were rated using an ordinal scoring system. Possible scores reflect a clinical rationale and differ by category, with zero given only if the element could potentially be missing (eg, surveillance by remote monitoring). Content validity was evident as the instrument matches the existing AHA taxonomy. After revision and refinement, 2 authors obtained an inter-rater reliability intraclass correlation coefficient score of 0.918 (confidence interval, 0.880 to 0.944, P<0.001) in their rating of 12 studies. The areas with most variability among programs were delivery personnel and method of communication. The HF-DMSI is useful for describing the intensity and complexity of HF disease management programs.

Tracheal stenosis: our experience at a tertiary care centre in India with special regard to cause and management.

PubMed

Nair, Satish; Mohan, Sharad; Mandal, Ghanashyam; Nilakantan, Ajith

2014-01-01

Tracheal stenosis (TS), a challenging problem, is a known complication of prolonged intubation and tracheostomy. The management involves a multidisciplinary approach with multiple complex procedures. In this study we discuss our experience with severe TS with regards to patient characteristics, cause and management. A retrospective analysis of 20 patients of severe TS treated at a tertiary care centre was evaluated. Inclusion criteria were all patients with severe TS who required surgical intervention. Exclusion criteria were patients with associated laryngeal stenosis and TS due to cancer. Demographic data was recorded and findings relating to aetiology, characteristics of stenosis and the various aspects of therapeutic procedures performed are discussed with review of literature. Descriptive analysis of data were performed SPSS 18. Results of the 20 patients, 17 patients (85 %) developed TS post tracheostomy, or post intubation and subsequent tracheostomy. 13 Patients (65 %) had true stenosis of which 7 patients (35 %) had simple web or circumferential fibrosis and 6 patients (30 %) had complex stenosis. Seven patients (35 %) had granulations causing severe TS which were mostly suprastomal (5 patients), stomal (5 patients) and combined stomal and suprastomal (3 patients). The average length of stenosis was 3.57 cm (0.5-8 cm). Montgomery t tube insertion was a common procedure in 18 patients (90 %) pre or post intervention. Each patient underwent an average of 3.4 procedures during their course of treatment which included rigid bronchoscopy and mechanical debulking, Nd YAG laser, KTP laser, balloon dilatation and use of stents. Among the 7 patients with granulations 100 % successful decanulation was noted with endoscopic management whereas in 13 patients with true stenosis, 10 patients (76.9 %) required open surgical management (8 tracheal resection and anastomosis and 2 tracheoplasty) with 80 % successful decanulation, 2 patients (15.4 %) were treated with endoscopy with 100 % successful decanulation and 1 patient (7.7 %) was a non surgical candidate on stent. Of the total 20 patients with severe TS in this series, 17 (85 %) of patients who were decanulated, asymptomatic on routine daily activities with normal FFB were considered cured. TS is a challenging condition requiring a highly skilled multidisciplinary team for adequate management. Prolonged intubation and tracheostomy are the common causes leading to tracheal stenosis. Simple tracheal stenosis is easier to manage than a complex stenosis which usually requires an open surgical procedure for successful management. Presence of conditions like tracheoesophageal fistula and long segment tracheomalacia are poor factors for successful management. In our cases successful decanulation was possible in 85 % of the patients following a systematic multidisciplinary approach.

Self-organization versus self-management: two sides of the same coin?

PubMed

Clancy, Thomas R

2009-03-01

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the eighth in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, the author explores self-organization as it relates to self-management in complex social organizations.

Innovation in user-centered skills and performance improvement for sustainable complex service systems.

PubMed

Karwowski, Waldemar; Ahram, Tareq Z

2012-01-01

In order to leverage individual and organizational learning and to remain competitive in current turbulent markets it is important for employees, managers, planners and leaders to perform at high levels over time. Employee competence and skills are extremely important matters in view of the general shortage of talent and the mobility of employees with talent. Two factors emerged to have the greatest impact on the competitiveness of complex service systems: improving managerial and employee's knowledge attainment for skills, and improving the training and development of the workforce. This paper introduces the knowledge-based user-centered service design approach for sustainable skill and performance improvement in education, design and modeling of the next generation of complex service systems. The rest of the paper cover topics in human factors and sustainable business process modeling for the service industry, and illustrates the user-centered service system development cycle with the integration of systems engineering concepts in service systems. A roadmap for designing service systems of the future is discussed. The framework introduced in this paper is based on key user-centered design principles and systems engineering applications to support service competitiveness.

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

Unat, Didem; Dubey, Anshu; Hoefler, Torsten

The cost of data movement has always been an important concern in high performance computing (HPC) systems. It has now become the dominant factor in terms of both energy consumption and performance. Support for expression of data locality has been explored in the past, but those efforts have had only modest success in being adopted in HPC applications for various reasons. However, with the increasing complexity of the memory hierarchy and higher parallelism in emerging HPC systems, locality management has acquired a new urgency. Developers can no longer limit themselves to low-level solutions and ignore the potential for productivity andmore » performance portability obtained by using locality abstractions. Fortunately, the trend emerging in recent literature on the topic alleviates many of the concerns that got in the way of their adoption by application developers. Data locality abstractions are available in the forms of libraries, data structures, languages and runtime systems; a common theme is increasing productivity without sacrificing performance. Furthermore, this paper examines these trends and identifies commonalities that can combine various locality concepts to develop a comprehensive approach to expressing and managing data locality on future large-scale high-performance computing systems.« less

Applying systems ergonomics methods in sport: A systematic review.

PubMed

Hulme, Adam; Thompson, Jason; Plant, Katherine L; Read, Gemma J M; Mclean, Scott; Clacy, Amanda; Salmon, Paul M

2018-04-16

As sports systems become increasingly more complex, competitive, and technology-centric, there is a greater need for systems ergonomics methods to consider the performance, health, and safety of athletes in context with the wider settings in which they operate. Therefore, the purpose of this systematic review was to identify and critically evaluate studies which have applied a systems ergonomics research approach in the context of sports performance and injury management. Five databases (PubMed, Scopus, ScienceDirect, Web of Science, and SPORTDiscus) were searched for the dates 01 January 1990 to 01 August 2017, inclusive, for original peer-reviewed journal articles and conference papers. Reported analyses were underpinned by a recognised systems ergonomics method, and study aims were related to the optimisation of sports performance (e.g. communication, playing style, technique, tactics, or equipment), and/or the management of sports injury (i.e. identification, prevention, or treatment). A total of seven articles were identified. Two articles were focussed on understanding and optimising sports performance, whereas five examined sports injury management. The methods used were the Event Analysis of Systemic Teamwork, Cognitive Work Analysis (the Work Domain Analysis Abstraction Hierarchy), Rasmussen's Risk Management Framework, and the Systems Theoretic Accident Model and Processes method. The individual sport application was distance running, whereas the team sports contexts examined were cycling, football, Australian Football League, and rugby union. The included systems ergonomics applications were highly flexible, covering both amateur and elite sports contexts. The studies were rated as valuable, providing descriptions of injury controls and causation, the factors influencing injury management, the allocation of responsibilities for injury prevention, as well as the factors and their interactions underpinning sports performance. Implications and future directions for research are described. Copyright © 2018 Elsevier Ltd. All rights reserved.

Command Center Training Tool (C2T2)

NASA Technical Reports Server (NTRS)

Jones, Phillip; Drucker, Nich; Mathews, Reejo; Stanton, Laura; Merkle, Ed

2012-01-01

This abstract presents the training approach taken to create a management-centered, experiential learning solution for the Virginia Port Authority's Port Command Center. The resultant tool, called the Command Center Training Tool (C2T2), follows a holistic approach integrated across the training management cycle and within a single environment. The approach allows a single training manager to progress from training design through execution and AAR. The approach starts with modeling the training organization, identifying the organizational elements and their individual and collective performance requirements, including organizational-specific performance scoring ontologies. Next, the developer specifies conditions, the problems, and constructs that compose exercises and drive experiential learning. These conditions are defined by incidents, which denote a single, multi-media datum, and scenarios, which are stories told by incidents. To these layered, modular components, previously developed meta-data is attached, including associated performance requirements. The components are then stored in a searchable library An event developer can create a training event by searching the library based on metadata and then selecting and loading the resultant modular pieces. This loading process brings into the training event all the previously associated task and teamwork material as well as AAR preparation materials. The approach includes tools within an integrated management environment that places these materials at the fingertips of the event facilitator such that, in real time, the facilitator can track training audience performance and resultantly modify the training event. The approach also supports the concentrated knowledge management requirements for rapid preparation of an extensive AAR. This approach supports the integrated training cycle and allows a management-based perspective and advanced tools, through which a complex, thorough training event can be developed.

The effects of using screencasting as a multimedia pre-training tool to manage the intrinsic cognitive load of chemical equilibrium instruction for advanced high school chemistry students

NASA Astrophysics Data System (ADS)

Musallam, Ramsey

Chemistry is a complex knowledge domain. Specifically, research notes that Chemical Equilibrium presents greater cognitive challenges than other topics in chemistry. Cognitive Load Theory describes the impact a subject, and the learning environment, have on working memory. Intrinsic load is the facet of Cognitive Load Theory that explains the complexity innate to complex subjects. The purpose of this study was to build on the limited research into intrinsic cognitive load, by examining the effects of using multimedia screencasts as a pre-training technique to manage the intrinsic cognitive load of chemical equilibrium instruction for advanced high school chemistry students. A convenience sample of 62 fourth-year high school students enrolled in an advanced chemistry course from a co-ed high school in urban San Francisco were given a chemical equilibrium concept pre-test. Upon conclusion of the pre-test, students were randomly assigned to two groups: pre-training and no pre-training. The pre-training group received a 10 minute and 52 second pre-training screencast that provided definitions, concepts and an overview of chemical equilibrium. After pre-training both group received the same 50-minute instructional lecture. After instruction, all students were given a chemical equilibrium concept post-test. Independent sample t-tests were conducted to examine differences in performance and intrinsic load. No significant differences in performance or intrinsic load, as measured by ratings of mental effort, were observed on the pre-test. Significant differences in performance, t(60)=3.70, p=.0005, and intrinsic load, t(60)=5.34, p=.0001, were observed on the post-test. A significant correlation between total performance scores and total mental effort ratings was also observed, r(60)=-0.44, p=.0003. Because no significant differences in prior knowledge were observed, it can be concluded that pre-training was successful at reducing intrinsic load. Moreover, a significant correlation between performance and mental effort strengthens the argument that performance measures can be used to approximate intrinsic cognitive load.

Amanzi: An Open-Source Multi-process Simulator for Environmental Applications

NASA Astrophysics Data System (ADS)

Moulton, J. D.; Molins, S.; Johnson, J. N.; Coon, E.; Lipnikov, K.; Day, M.; Barker, E.

2014-12-01

The Advanced Simulation Capabililty for Environmental Management (ASCEM) program is developing an approach and open-source tool suite for standardized risk and performance assessments at legacy nuclear waste sites. These assessments begin with simplified models, and add geometric and geologic complexity as understanding is gained. The Platform toolsets (Akuna) generates these conceptual models and Amanzi provides the computational engine to perform the simulations, returning the results for analysis and visualization. In this presentation we highlight key elements of the design, algorithms and implementations used in Amanzi. In particular, the hierarchical and modular design is aligned with the coupled processes being sumulated, and naturally supports a wide range of model complexity. This design leverages a dynamic data manager and the synergy of two graphs (one from the high-level perspective of the models the other from the dependencies of the variables in the model) to enable this flexible model configuration at run time. Moreover, to model sites with complex hydrostratigraphy, as well as engineered systems, we are developing a dual unstructured/structured capability. Recently, these capabilities have been collected in a framework named Arcos, and efforts have begun to improve interoperability between the unstructured and structured AMR approaches in Amanzi. To leverage a range of biogeochemistry capability from the community (e.g., CrunchFlow, PFLOTRAN, etc.), a biogeochemistry interface library was developed called Alquimia. To ensure that Amanzi is truly an open-source community code we require a completely open-source tool chain for our development. We will comment on elements of this tool chain, including the testing and documentation development tools such as docutils, and Sphinx. Finally, we will show simulation results from our phased demonstrations, including the geochemically complex Savannah River F-Area seepage basins.

Smart rules: six ways to get people to solve problems without you.

PubMed

Morieux, Yves

2011-09-01

As the world has become more complex, companies have steadily increased their performance requirements: Now they strive to offer low prices and high quality; to customize products for local markets and standardize them for greater returns; to innovate and be efficient. The typical corporate response to such conflicting goals complicates things further: Firms restructure and try to align their organizations with extra coordinating functions, processes, and incentives. This approach does more harm than good. Managers' time gets sucked up by reports and meetings, leaving little time to work with employees. But there is a better way, says BCG senior partner Yves Morieux: Instead of strangling employees with new rules and procedures, create an environment in which they're compelled to work with one another to develop solutions to complex challenges. Managers can create this environment by applying six "smart rules": (1) improve understanding of what coworkers do and the real constraints they face, (2) determine which people are the firm's natural integrators and strengthen their roles, (3) expand the amount of power available to everyone, (4) increase the need for reciprocity in the system, (5) make employees feel the "shadow of the future," and (6) hold uncooperative people accountable. By tapping employees' ingenuity through the use of smart rules, firms can manage complexity quickly and creatively-and streamline their organizations.

The "Performance of Rotavirus and Oral Polio Vaccines in Developing Countries" (PROVIDE) study: description of methods of an interventional study designed to explore complex biologic problems.

PubMed

Kirkpatrick, Beth D; Colgate, E Ross; Mychaleckyj, Josyf C; Haque, Rashidul; Dickson, Dorothy M; Carmolli, Marya P; Nayak, Uma; Taniuchi, Mami; Naylor, Caitlin; Qadri, Firdausi; Ma, Jennie Z; Alam, Masud; Walsh, Mary Claire; Diehl, Sean A; Petri, William A

2015-04-01

Oral vaccines appear less effective in children in the developing world. Proposed biologic reasons include concurrent enteric infections, malnutrition, breast milk interference, and environmental enteropathy (EE). Rigorous study design and careful data management are essential to begin to understand this complex problem while assuring research subject safety. Herein, we describe the methodology and lessons learned in the PROVIDE study (Dhaka, Bangladesh). A randomized clinical trial platform evaluated the efficacy of delayed-dose oral rotavirus vaccine as well as the benefit of an injectable polio vaccine replacing one dose of oral polio vaccine. This rigorous infrastructure supported the additional examination of hypotheses of vaccine underperformance. Primary and secondary efficacy and immunogenicity measures for rotavirus and polio vaccines were measured, as well as the impact of EE and additional exploratory variables. Methods for the enrollment and 2-year follow-up of a 700 child birth cohort are described, including core laboratory, safety, regulatory, and data management practices. Intense efforts to standardize clinical, laboratory, and data management procedures in a developing world setting provide clinical trials rigor to all outcomes. Although this study infrastructure requires extensive time and effort, it allows optimized safety and confidence in the validity of data gathered in complex, developing country settings. © The American Society of Tropical Medicine and Hygiene.

Appreciating the Complexity of Project Management Execution: Using Simulation in the Classroom

ERIC Educational Resources Information Center

Hartman, Nathan S.; Watts, Charles A.; Treleven, Mark D.

2013-01-01

As the popularity and importance of project management increase, so does the need for well-prepared project managers. This article discusses our experiences using a project management simulation in undergraduate and MBA classes to help students better grasp the complexity of project management. This approach gives students hands-on experience with…

Complex Adaptive Systems as Metaphors for Organizational Management

ERIC Educational Resources Information Center

Palmberg, Klara

2009-01-01

Purpose: The purpose of this paper is to explore the concept of complex adaptive systems (CAS) from the perspective of managing organizations, to describe and explore the management principles in a case study of an organization with unconventional ways of management and to present a tentative model for managing organizations as CAS--system…

Learning to manage complexity through simulation: students' challenges and possible strategies.

PubMed

Gormley, Gerard J; Fenwick, Tara

2016-06-01

Many have called for medical students to learn how to manage complexity in healthcare. This study examines the nuances of students' challenges in coping with a complex simulation learning activity, using concepts from complexity theory, and suggests strategies to help them better understand and manage complexity.Wearing video glasses, participants took part in a simulation ward-based exercise that incorporated characteristics of complexity. Video footage was used to elicit interviews, which were transcribed. Using complexity theory as a theoretical lens, an iterative approach was taken to identify the challenges that participants faced and possible coping strategies using both interview transcripts and video footage.Students' challenges in coping with clinical complexity included being: a) unprepared for 'diving in', b) caught in an escalating system, c) captured by the patient, and d) unable to assert boundaries of acceptable practice.Many characteristics of complexity can be recreated in a ward-based simulation learning activity, affording learners an embodied and immersive experience of these complexity challenges. Possible strategies for managing complexity themes include: a) taking time to size up the system, b) attuning to what emerges, c) reducing complexity, d) boundary practices, and e) working with uncertainty. This study signals pedagogical opportunities for recognizing and dealing with complexity.

Resolving future fire management conflicts using multicriteria decision making.

PubMed

Driscoll, Don A; Bode, Michael; Bradstock, Ross A; Keith, David A; Penman, Trent D; Price, Owen F

2016-02-01

Management strategies to reduce the risks to human life and property from wildfire commonly involve burning native vegetation. However, planned burning can conflict with other societal objectives such as human health and biodiversity conservation. These conflicts are likely to intensify as fire regimes change under future climates and as growing human populations encroach farther into fire-prone ecosystems. Decisions about managing fire risks are therefore complex and warrant more sophisticated approaches than are typically used. We applied a multicriteria decision making approach (MCDA) with the potential to improve fire management outcomes to the case of a highly populated, biodiverse, and flammable wildland-urban interface. We considered the effects of 22 planned burning options on 8 objectives: house protection, maximizing water quality, minimizing carbon emissions and impacts on human health, and minimizing declines of 5 distinct species types. The MCDA identified a small number of management options (burning forest adjacent to houses) that performed well for most objectives, but not for one species type (arboreal mammal) or for water quality. Although MCDA made the conflict between objectives explicit, resolution of the problem depended on the weighting assigned to each objective. Additive weighting of criteria traded off the arboreal mammal and water quality objectives for other objectives. Multiplicative weighting identified scenarios that avoided poor outcomes for any objective, which is important for avoiding potentially irreversible biodiversity losses. To distinguish reliably among management options, future work should focus on reducing uncertainty in outcomes across a range of objectives. Considering management actions that have more predictable outcomes than landscape fuel management will be important. We found that, where data were adequate, an MCDA can support decision making in the complex and often conflicted area of fire management. © 2015 Society for Conservation Biology.

Management of pain in autosomal dominant polycystic kidney disease and anatomy of renal innervation.

PubMed

Tellman, Matthew W; Bahler, Clinton D; Shumate, Ashley M; Bacallao, Robert L; Sundaram, Chandru P

2015-05-01

Chronic pain is a prominent feature of autosomal dominant polycystic kidney disease that is difficult to treat and manage, often resulting in a decrease in quality of life. Understanding the underlying anatomy of renal innervation and the various etiologies of pain that occur in autosomal dominant polycystic kidney disease can help guide proper treatments to manage pain. Reviewing previously studied treatments for pain in autosomal dominant polycystic kidney disease can help characterize treatment in a stepwise fashion. We performed a literature search of the etiology and management of pain in autosomal dominant polycystic kidney disease and the anatomy of renal innervation using PubMed® and Embase® from January 1985 to April 2014 with limitations to human studies and English language. Pain occurs in the majority of patients with autosomal dominant polycystic kidney disease due to renal, hepatic and mechanical origins. Patients may experience different types of pain which can make it difficult to clinically confirm its etiology. An anatomical and histological evaluation of the complex renal innervation helps in understanding the mechanisms that can lead to renal pain. Understanding the complex nature of renal innervation is essential for surgeons to perform renal denervation. The management of pain in autosomal dominant polycystic kidney disease should be approached in a stepwise fashion. Acute causes of renal pain must first be ruled out due to the high incidence in autosomal dominant polycystic kidney disease. For chronic pain, nonopioid analgesics and conservative interventions can be used first, before opioid analgesics are considered. If pain continues there are surgical interventions such as renal cyst decortication, renal denervation and nephrectomy that can target pain produced by renal or hepatic cysts. Chronic pain in patients with autosomal dominant polycystic kidney disease is often refractory to conservative, medical and other noninvasive treatments. There are effective surgical procedures that can be performed when more conservative treatments fail. Laparoscopic cyst decortication has been well studied and results in the relief of chronic renal pain in the majority of patients. In addition, renal denervation has been used successfully and could be performed concurrently with cyst decortication. Nephrectomy should be reserved for patients with intractable pain and renal failure when other modalities have failed. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Balanced performance measurement in research hospitals: the participative case study of a haematology department.

PubMed

Catuogno, Simona; Arena, Claudia; Saggese, Sara; Sarto, Fabrizia

2017-08-03

The paper aims to review, design and implement a multidimensional performance measurement system for a public research hospital in order to address the complexity of its multifaceted stakeholder requirements and its double institutional aim of care and research. The methodology relies on a participative case study performed by external researchers in close collaboration with the staff of an Italian research hospital. The paper develops and applies a customized version of balanced scorecard based on a new set of performance measures. Our findings suggest that it can be considered an effective framework for measuring the research hospital performance, thanks to a combination of generalizable and context-specific factors. By showing how the balanced scorecard framework can be customized to research hospitals, the paper is especially of interest for complex healthcare organizations that are implementing management accounting practices. The paper contributes to the body of literature on the application of the balanced scorecard in healthcare through an examination of the challenges in designing and implementing this multidimensional performance tool. This is one of the first papers that show how the balanced scorecard model can be adapted to fit the specific requirements of public research hospitals.

Concept of a Cloud Service for Data Preparation and Computational Control on Custom HPC Systems in Application to Molecular Dynamics

NASA Astrophysics Data System (ADS)

Puzyrkov, Dmitry; Polyakov, Sergey; Podryga, Viktoriia; Markizov, Sergey

2018-02-01

At the present stage of computer technology development it is possible to study the properties and processes in complex systems at molecular and even atomic levels, for example, by means of molecular dynamics methods. The most interesting are problems related with the study of complex processes under real physical conditions. Solving such problems requires the use of high performance computing systems of various types, for example, GRID systems and HPC clusters. Considering the time consuming computational tasks, the need arises of software for automatic and unified monitoring of such computations. A complex computational task can be performed over different HPC systems. It requires output data synchronization between the storage chosen by a scientist and the HPC system used for computations. The design of the computational domain is also quite a problem. It requires complex software tools and algorithms for proper atomistic data generation on HPC systems. The paper describes the prototype of a cloud service, intended for design of atomistic systems of large volume for further detailed molecular dynamic calculations and computational management for this calculations, and presents the part of its concept aimed at initial data generation on the HPC systems.

DEC Ada interface to Screen Management Guidelines (SMG)

NASA Technical Reports Server (NTRS)

Laomanachareon, Somsak; Lekkos, Anthony A.

1986-01-01

DEC's Screen Management Guidelines are the Run-Time Library procedures that perform terminal-independent screen management functions on a VT100-class terminal. These procedures assist users in designing, composing, and keeping track of complex images on a video screen. There are three fundamental elements in the screen management model: the pasteboard, the virtual display, and the virtual keyboard. The pasteboard is like a two-dimensional area on which a user places and manipulates screen displays. The virtual display is a rectangular part of the terminal screen to which a program writes data with procedure calls. The virtual keyboard is a logical structure for input operation associated with a physical keyboard. SMG can be called by all major VAX languages. Through Ada, predefined language Pragmas are used to interface with SMG. These features and elements of SMG are briefly discussed.

Context Switching with Multiple Register Windows: A RISC Performance Study

NASA Technical Reports Server (NTRS)

Konsek, Marion B.; Reed, Daniel A.; Watcharawittayakul, Wittaya

1987-01-01

Although previous studies have shown that a large file of overlapping register windows can greatly reduce procedure call/return overhead, the effects of register windows in a multiprogramming environment are poorly understood. This paper investigates the performance of multiprogrammed, reduced instruction set computers (RISCs) as a function of window management strategy. Using an analytic model that reflects context switch and procedure call overheads, we analyze the performance of simple, linearly self-recursive programs. For more complex programs, we present the results of a simulation study. These studies show that a simple strategy that saves all windows prior to a context switch, but restores only a single window following a context switch, performs near optimally.

Occupations that people with late effects of polio perceive difficult to perform.

PubMed

Appelin, Katja; Lexell, Jan; Månsson Lexell, Eva

2014-09-01

The aims of this study were to describe which occupations that people with late effects of polio perceive difficult to perform, which occupational area the occupations were related to and their level of complexity. The aims were also to describe their own perception of the importance, performance and satisfaction with these occupations. Sixty-two participants (mean age 61 years) were assessed with the Canadian Occupational Performance Measure. A total of 431 occupations were reported (43% self-care, 32% productivity and 25% leisure). Two subcategories, household management (27 %) and functional mobility (23 %), represented half of all the reported occupations. Ratings for prioritized occupations (N = 300) were high for importance and generally low for performance and satisfaction. A wide variety of occupations were reported, related to both occupational areas and different levels of complexity within an occupational area. The results underscore the importance of using assessment tools that can capture both the variety and complexity of occupations. By obtaining more detailed information about occupations that people with late effects of polio perceive difficult to perform, this will enable occupational therapists to offer targeted interventions that can facilitate engagement in meaningful and purposeful occupations. A larger and more heterogeneous sample may enable the results to be generalized to more people with late effects of polio. Future studies should focus on methods that can facilitate engagement in meaningful and purposeful occupations for people with late effects of polio. Copyright © 2014 John Wiley & Sons, Ltd.

Exploring the state of health and safety management system performance measurement in mining organizations.

PubMed

Haas, Emily Joy; Yorio, Patrick

2016-03-01

Complex arguments continue to be articulated regarding the theoretical foundation of health and safety management system (HSMS) performance measurement. The culmination of these efforts has begun to enhance a collective understanding. Despite this enhanced theoretical understanding, however, there are still continuing debates and little consensus. The goal of the current research effort was to empirically explore common methods to HSMS performance measurement in mining organizations. The purpose was to determine if value and insight could be added into the ongoing approaches of the best ways to engage in health and safety performance measurement. Nine site-level health and safety management professionals were provided with 133 practices corresponding to 20 HSMS elements, each fitting into the plan, do, check, act phases common to most HSMS. Participants were asked to supply detailed information as to how they (1) assess the performance of each practice in their organization, or (2) would assess each practice if it were an identified strategic imperative. Qualitative content analysis indicated that the approximately 1200 responses provided could be described and categorized into interventions , organizational performance , and worker performance . A discussion of how these categories relate to existing indicator frameworks is provided. The analysis also revealed divergence in two important measurement issues; (1) quantitative vs qualitative measurement and reporting; and (2) the primary use of objective or subjective metrics. In lieu of these findings we ultimately recommend a balanced measurement and reporting approach within the three metric categories and conclude with suggestions for future research.

Exploring the state of health and safety management system performance measurement in mining organizations

PubMed Central

Haas, Emily Joy; Yorio, Patrick

2016-01-01

Complex arguments continue to be articulated regarding the theoretical foundation of health and safety management system (HSMS) performance measurement. The culmination of these efforts has begun to enhance a collective understanding. Despite this enhanced theoretical understanding, however, there are still continuing debates and little consensus. The goal of the current research effort was to empirically explore common methods to HSMS performance measurement in mining organizations. The purpose was to determine if value and insight could be added into the ongoing approaches of the best ways to engage in health and safety performance measurement. Nine site-level health and safety management professionals were provided with 133 practices corresponding to 20 HSMS elements, each fitting into the plan, do, check, act phases common to most HSMS. Participants were asked to supply detailed information as to how they (1) assess the performance of each practice in their organization, or (2) would assess each practice if it were an identified strategic imperative. Qualitative content analysis indicated that the approximately 1200 responses provided could be described and categorized into interventions, organizational performance, and worker performance. A discussion of how these categories relate to existing indicator frameworks is provided. The analysis also revealed divergence in two important measurement issues; (1) quantitative vs qualitative measurement and reporting; and (2) the primary use of objective or subjective metrics. In lieu of these findings we ultimately recommend a balanced measurement and reporting approach within the three metric categories and conclude with suggestions for future research. PMID:26823642

Marshall Space Flight Center Technology Capabilities for Use in Space Situational Awareness Activities

NASA Technical Reports Server (NTRS)

Gagliano, Larry; McLeod, Todd; Hovater, Mary A.

2017-01-01

Marshall performs research, integrates information, matures technologies, and enhances science to bring together a diverse portfolio of products and services of interest for Space Situational Awareness (SSA) and Space Asset Management (SAM), all of which can be accessed through partnerships with Marshall. Integrated Space Situational Awareness and Asset Management (ISSAAM) is an initiative of NASA's Marshall Space Flight Center to improve space situational awareness and space asset management through technical innovation, collaboration, and cooperation with U.S. Government agencies and the global space community. Marshall Space Flight Center provides solutions for complex issues with in-depth capabilities, a broad range of experience, and expertise unique in the world, and all available in one convenient location. NASA has longstanding guidelines that are used to assess space objects. Specifically, Marshall Space Flight Center has the capabilities, facilities and expertise to address the challenges that space objects, such as near-Earth objects (NEO) or Orbital Debris pose. ISSAAM's three pronged approach brings together vital information and in-depth tools working simultaneously toward examining the complex problems encountered in space situational awareness. Marshall's role in managing, understanding and planning includes many projects grouped under each prong area: Database/Analyses/Visualization; Detection/Tracking/ Mitigation/Removal. These are not limited to those listed below.

Modeling Complex Cross-Systems Software Interfaces Using SysML

NASA Technical Reports Server (NTRS)

Mandutianu, Sanda; Morillo, Ron; Simpson, Kim; Liepack, Otfrid; Bonanne, Kevin

2013-01-01

The complex flight and ground systems for NASA human space exploration are designed, built, operated and managed as separate programs and projects. However, each system relies on one or more of the other systems in order to accomplish specific mission objectives, creating a complex, tightly coupled architecture. Thus, there is a fundamental need to understand how each system interacts with the other. To determine if a model-based system engineering approach could be utilized to assist with understanding the complex system interactions, the NASA Engineering and Safety Center (NESC) sponsored a task to develop an approach for performing cross-system behavior modeling. This paper presents the results of applying Model Based Systems Engineering (MBSE) principles using the System Modeling Language (SysML) to define cross-system behaviors and how they map to crosssystem software interfaces documented in system-level Interface Control Documents (ICDs).

Psychological safety: The key to high performance in high stress, potentially traumatic environments

Treesearch

James Saveland

2011-01-01

Safety is typically talked about in a context of the absence of injury. The field of resilience engineering has been advocating that we think about safety differently, by taking a systems view and begin to see how people create safety in unsafe systems by managing risk. There is growing recognition that safety is an emergent behavior of our complex system of human...

Spacecraft software training needs assessment research

NASA Technical Reports Server (NTRS)

Ratcliff, Shirley; Golas, Katharine

1990-01-01

The problems were identified, along with their causes and potential solutions, that the management analysts were encountering in performing their jobs. It was concluded that sophisticated training applications would provide the most effective solution to a substantial portion of the analysts' problems. The remainder could be alleviated through the introduction of tools that could help make retrieval of the needed information from the vast and complex information resources feasible.

Strategic Performance Management: Organizing People and Their Work in the SEA of the Future

ERIC Educational Resources Information Center

Redding, Sam; Layland, Allison

2015-01-01

A State Education Agency (SEA), whether in a large state or small, is responsible for a complex education system, responsive to a host of stakeholders, and charged with advocating for a multitude of students of all ages attending schools of every description. Much of what an SEA is tasked with accomplishing is set by external entities, from the…

Orthodontic Management with Traction and Asymmetric Extraction for Multiple Impacted Permanent Maxillary Teeth - A Case Report.

PubMed

Niu, Qiannan; Zhang, Liang; Dai, Juan; Li, Feifei; Feng, Xue

2016-01-01

Multiple impacted teeth are a rare eruption disturbance that increases the case complexity. In this article, we described a 13-year-old boy whose 5 permanent maxillary teeth were not erupted although their root formation was complete. The orthodontic treatment with traction and asymmetric extraction was performed to achieve a significantly improved functional and esthetic result.

Operator strategies under varying conditions of workload

NASA Technical Reports Server (NTRS)

Arnegard, Ruth J.

1991-01-01

An attempt was made to operationally define and measure strategic behavior in a complex multiple task environment. The Multi-Attribute Task battery was developed to simulate various aspects of flight and consisted of an auditory communication task, monitoring tasks, a tracking tasks, a resource management task which allowed a wide range of responding patterns, and a scheduling window which allowed operators to predict changes in workload. This battery was validated for its sensitivity to strategic behavior, and baseline measures for each individual task were collected. Twenty-four undergraduate and graduate students then performed the battery for four 64 minute sessions which took place over a period of 2 days. Each subject performed the task battery under four levels of workload, which were presented for equal lengths of time during all four sessions. Results indicated that in general, performance improves as a function of experience with the battery, but that performance decreased as workload level increased. The data also showed that subjects developed strategies for responding to the resource management task which allowed them to manage the high workload levels more efficiently. This particular strategy developed over time but was also associated with errors of complacency. These results are presented along with implications for the aviation field and areas of future research.

Application of NASA management approach to solve complex problems on earth

NASA Technical Reports Server (NTRS)

Potate, J. S.

1972-01-01

The application of NASA management approach to solving complex problems on earth is discussed. The management of the Apollo program is presented as an example of effective management techniques. Four key elements of effective management are analyzed. Photographs of the Cape Kennedy launch sites and supporting equipment are included to support the discussions.

Nurse managers describe their practice environments.

PubMed

Warshawsky, Nora E; Lake, Sharon W; Brandford, Arica

2013-01-01

Hospital work environments that support the professional practice of nurses are critical to patient safety. Nurse managers are responsible for creating these professional practice environments for staff nurses, yet little is known about the environments needed to support nurse managers. Domains of nurse managers' practice environment have recently been defined. This is a secondary analysis of 2 cross-sectional studies of organizational characteristics that influence nurse manager practice. Content analysis of the free text comments from 127 nurse managers was used to illustrate the 8 domains of nurse managers' practice environments. Nurse managers valued time spent with their staff; therefore, workloads must permit meaningful interaction. Directors demonstrated trust when they empowered nurse managers to make decisions. Administrative leaders should build patient safety cultures on the basis of shared accountability and mutual respect among the health care team. The expectations of nurse managers have greatly expanded in the volume and complexity of direct reports, patient care areas, and job functions. The nurse managers in this analysis reported characteristics of their practice environments that limit their role effectiveness and may negatively impact organizational performance. Further research is needed to understand the effects of nurse managers' practice environments on staff and patient outcomes.

Matrix management in hospitals: testing theories of matrix structure and development.

PubMed

Burns, L R

1989-09-01

A study of 315 hospitals with matrix management programs was used to test several hypotheses concerning matrix management advanced by earlier theorists. The study verifies that matrix management involves several distinctive elements that can be scaled to form increasingly complex types of lateral coordinative devices. The scalability of these elements is evident only cross-sectionally. The results show that matrix complexity is not an outcome of program age, nor does matrix complexity at the time of implementation appear to influence program survival. Matrix complexity, finally, is not determined by the organization's task diversity and uncertainty. The results suggest several modifications in prevailing theories of matrix organization.

Performance evaluation of automated manufacturing systems using generalized stochastic Petri Nets. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Al-Jaar, Robert Y.; Desrochers, Alan A.

1989-01-01

The main objective of this research is to develop a generic modeling methodology with a flexible and modular framework to aid in the design and performance evaluation of integrated manufacturing systems using a unified model. After a thorough examination of the available modeling methods, the Petri Net approach was adopted. The concurrent and asynchronous nature of manufacturing systems are easily captured by Petri Net models. Three basic modules were developed: machine, buffer, and Decision Making Unit. The machine and buffer modules are used for modeling transfer lines and production networks. The Decision Making Unit models the functions of a computer node in a complex Decision Making Unit Architecture. The underlying model is a Generalized Stochastic Petri Net (GSPN) that can be used for performance evaluation and structural analysis. GSPN's were chosen because they help manage the complexity of modeling large manufacturing systems. There is no need to enumerate all the possible states of the Markov Chain since they are automatically generated from the GSPN model.

An Integrated Web-based Decision Support System in Disaster Risk Management

NASA Astrophysics Data System (ADS)

Aye, Z. C.; Jaboyedoff, M.; Derron, M. H.

2012-04-01

Nowadays, web based decision support systems (DSS) play an essential role in disaster risk management because of their supporting abilities which help the decision makers to improve their performances and make better decisions without needing to solve complex problems while reducing human resources and time. Since the decision making process is one of the main factors which highly influence the damages and losses of society, it is extremely important to make right decisions at right time by combining available risk information with advanced web technology of Geographic Information System (GIS) and Decision Support System (DSS). This paper presents an integrated web-based decision support system (DSS) of how to use risk information in risk management efficiently and effectively while highlighting the importance of a decision support system in the field of risk reduction. Beyond the conventional systems, it provides the users to define their own strategies starting from risk identification to the risk reduction, which leads to an integrated approach in risk management. In addition, it also considers the complexity of changing environment from different perspectives and sectors with diverse stakeholders' involvement in the development process. The aim of this platform is to contribute a part towards the natural hazards and geosciences society by developing an open-source web platform where the users can analyze risk profiles and make decisions by performing cost benefit analysis, Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) with the support of others tools and resources provided. There are different access rights to the system depending on the user profiles and their responsibilities. The system is still under development and the current version provides maps viewing, basic GIS functionality, assessment of important infrastructures (e.g. bridge, hospital, etc.) affected by landslides and visualization of the impact-probability matrix in terms of socio-economic dimension.

Battling Arrow's Paradox to Discover Robust Water Management Alternatives

NASA Astrophysics Data System (ADS)

Kasprzyk, J. R.; Reed, P. M.; Hadka, D.

2013-12-01

This study explores whether or not Arrow's Impossibility Theorem, a theory of social choice, affects the formulation of water resources systems planning problems. The theorem discusses creating an aggregation function for voters choosing from more than three alternatives for society. The Impossibility Theorem is also called Arrow's Paradox, because when trying to add more voters, a single individual's preference will dictate the optimal group decision. In the context of water resources planning, our study is motivated by recent theoretical work that has generalized the insights for Arrow's Paradox to the design of complex engineered systems. In this framing of the paradox, states of society are equivalent to water planning or design alternatives, and the voters are equivalent to multiple planning objectives (e.g. minimizing cost or maximizing performance). Seen from this point of view, multi-objective water planning problems are functionally equivalent to the social choice problem described above. Traditional solutions to such multi-objective problems aggregate multiple performance measures into a single mathematical objective. The Theorem implies that a subset of performance concerns will inadvertently dictate the overall design evaluations in unpredictable ways using such an aggregation. We suggest that instead of aggregation, an explicit many-objective approach to water planning can help overcome the challenges posed by Arrow's Paradox. Many-objective planning explicitly disaggregates measures of performance while supporting the discovery of the planning tradeoffs, employing multiobjective evolutionary algorithms (MOEAs) to find solutions. Using MOEA-based search to address Arrow's Paradox requires that the MOEAs perform robustly with increasing problem complexity, such as adding additional objectives and/or decisions. This study uses comprehensive diagnostic evaluation of MOEA search performance across multiple problem formulations (both aggregated and many-objective) to show whether or not aggregating performance measures biases decision making. In this study, we explore this hypothesis using an urban water portfolio management case study in the Lower Rio Grande Valley. The diagnostic analysis shows that modern self-adaptive MOEA search is efficient, effective, and reliable for the more complex many-objective LRGV planning formulations. Results indicate that although many classical water systems planning frameworks seek to account for multiple objectives, the common practice of reducing the problem into one or more highly aggregated performance measures can severely and negatively bias planning decisions.

Centralized Fabric Management Using Puppet, Git, and GLPI

NASA Astrophysics Data System (ADS)

Smith, Jason A.; De Stefano, John S., Jr.; Fetzko, John; Hollowell, Christopher; Ito, Hironori; Karasawa, Mizuki; Pryor, James; Rao, Tejas; Strecker-Kellogg, William

2012-12-01

Managing the infrastructure of a large and complex data center can be extremely difficult without taking advantage of recent technological advances in administrative automation. Puppet is a seasoned open-source tool that is designed for enterprise class centralized configuration management. At the RHIC and ATLAS Computing Facility (RACF) at Brookhaven National Laboratory, we use Puppet along with Git, GLPI, and some custom scripts as part of our centralized configuration management system. In this paper, we discuss how we use these tools for centralized configuration management of our servers and services, change management requiring authorized approval of production changes, a complete version controlled history of all changes made, separation of production, testing and development systems using puppet environments, semi-automated server inventory using GLPI, and configuration change monitoring and reporting using the Puppet dashboard. We will also discuss scalability and performance results from using these tools on a 2,000+ node cluster and 400+ infrastructure servers with an administrative staff of approximately 25 full-time employees (FTEs).

Experience of two trauma-centers with pancreatic injuries requiring immediate surgery.

PubMed

Ouaïssi, Mehdi; Sielezneff, Igor; Chaix, Jean Baptiste; Mardion, Remi Bon; Pirrò, Nicolas; Berdah, Stéphane; Emungania, Olivier; Consentino, Bernard; Cresti, Silvia; Dahan, Laetitia; Orsoni, Pierre; Moutardier, Vincent; Brunet, C; Sastre, Bernard

2008-01-01

Pancreatic injury from blunt trauma is infrequent. The aim of the present study was to evaluate a simplified approach of management of pancreatic trauma injuries requiring immediate surgery consisting of either drainage in complex situation or pancreatectomy in the other cases. From January 1986 to December 2006, 40 pancreatic traumas requiring immediate surgery were performed. Mechanism of trauma, clinical and laboratories findings were noted upon admission, classification of pancreatic injury according to Lucas' classification were considered. Fifteen (100%) drainages were performed for stage I (n=15), 60% splenopancreatectomies and 40% drainage was achieved for stage II (n=18), 3 Pancreaticoduonectomies and 2 exclusion of duodenum with drainage and 2 packing were performed for stage IV (n=7). There were 30 men and 10 women with mean age of 29+/-13 years (15-65). Thirty-eight patients had multiple trauma. Overall, mortality and global morbidity rate were 17% and 65% respectively, and the rates increased with Lucas' pancreatic trauma stage. Distal pancreatectomy is indicated for distal injuries with duct involvement, and complex procedures such as pancreaticoduodenectomy should be performed in hemodynamically stable patients.

Performance Measures for Evaluating Public Participation Activities in the Office of Environmental Management (DOE)

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

Carnes, S.A.

2001-02-15

Public participation in Office of Environmental Management (EM) activities throughout the DOE complex is a critical component of the overall success of remediation and waste management efforts. The challenges facing EM and its stakeholders over the next decade or more are daunting (Nuclear Waste News 1996). Achieving a mission composed of such challenges will require innovation, dedication, and a significant degree of good will among all stakeholders. EM's efforts to date, including obtaining and using inputs offered by EM stakeholders, have been notable. Public participation specialists have accepted and met challenges and have consistently tried to improve their performance. Theymore » have reported their experiences both formally and informally (e.g., at professional conferences and EM Public Participation Network Workshops, other internal meetings of DOE and contractor public participation specialists, and one-on-one consultations) in order to advance the state of their practice. Our research, and our field research in particular (including our interactions with many representatives of numerous stakeholder groups at nine DOE sites with diverse EM problems), have shown that it, is possible to develop coherent results even in a problem domain as complex as that of EM. We conclude that performance-based evaluations of public participation appear possible, and we have recommended an approach, based on combined and integrated multi-stakeholder views on the attributes of successful public participation and associated performance indicators, that seems workable and should be acceptable to diverse stakeholders. Of course, as an untested recommendation, our approach needs the validation that can only be achieved by application (perhaps at a few DOE sites with ongoing EM activities). Such an application would serve to refine the proposed approach in terms of its clarity, its workability, and its potential for full-scale use by EM and, potentially, other government agencies and private sector concerns.« less

Integrated Building Management System (IBMS)

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

Anita Lewis

This project provides a combination of software and services that more easily and cost-effectively help to achieve optimized building performance and energy efficiency. Featuring an open-platform, cloud- hosted application suite and an intuitive user experience, this solution simplifies a traditionally very complex process by collecting data from disparate building systems and creating a single, integrated view of building and system performance. The Fault Detection and Diagnostics algorithms developed within the IBMS have been designed and tested as an integrated component of the control algorithms running the equipment being monitored. The algorithms identify the normal control behaviors of the equipment withoutmore » interfering with the equipment control sequences. The algorithms also work without interfering with any cooperative control sequences operating between different pieces of equipment or building systems. In this manner the FDD algorithms create an integrated building management system.« less

Operational modes, health, and status monitoring

NASA Astrophysics Data System (ADS)

Taljaard, Corrie

2016-08-01

System Engineers must fully understand the system, its support system and operational environment to optimise the design. Operations and Support Managers must also identify the correct metrics to measure the performance and to manage the operations and support organisation. Reliability Engineering and Support Analysis provide methods to design a Support System and to optimise the Availability of a complex system. Availability modelling and Failure Analysis during the design is intended to influence the design and to develop an optimum maintenance plan for a system. The remote site locations of the SKA Telescopes place emphasis on availability, failure identification and fault isolation. This paper discusses the use of Failure Analysis and a Support Database to design a Support and Maintenance plan for the SKA Telescopes. It also describes the use of modelling to develop an availability dashboard and performance metrics.

Arthroscopic Management of Triangular Fibrocartilage Complex Peripheral Injury.

PubMed

Haugstvedt, Jan Ragnar; Søreide, Endre

2017-11-01

Patients suffering from ulnar-sided wrist pain after trauma may develop tenderness, clicking, a positive fovea sign, or instability of the distal radioulnar joint. If the pain is persistent, conservative treatment does not help, and the patient agrees to surgery, arthroscopy may reveal a triangular fibrocartilage complex (TFCC) injury with capsular detachment, foveal avulsion, or a combination thereof. Capsular reattachment is possible using an arthroscopic assisted technique. The reattachment can be performed with an inside-out, outside-in, or all-inside technique, providing good to excellent results, which tend to persist over time, in 60% to 90% of cases. Copyright © 2017 Elsevier Inc. All rights reserved.

Going beyond the hero in leadership development: the place of healthcare context, complexity and relationships

PubMed Central

Ford, Jackie

2015-01-01

There remains a conviction that the torrent of publications and the financial outlay on leadership development will create managers with the skills and characters of perfect leaders, capable of guiding healthcare organisations through the challenges and crises of the 21st century. The focus of much attention continues to be the search for the (illusory) core set of heroic qualities, abilities or competencies that will enable the development of leaders to achieve levels of supreme leadership and organisational performance. This brief commentary adds support to McDonald’s (1) call for recognition of the complexity of the undertaking. PMID:25844391

Subxiphoid complex uniportal video-assisted major pulmonary resections.

PubMed

Gonzalez-Rivas, Diego; Lirio, Francisco; Sesma, Julio; Abu Akar, Firas

2017-01-01

In recent years, the search for a less invasive and thus, less painful approach has driven technical innovation in modern thoracic surgery. In this context, subxiphoid uniportal approach has emerged as an alternative to avoid intercostal space manipulation and decrease postoperative pain and intercostal nerve chronic impairment. Subxiphoid uniportal major lung resections have been safe and effective procedures when performed by experienced surgeons even in complex cases or unexpected intraoperative situations. We present six of these surgical scenarios such as big tumors, incomplete or absent fissures, hilar calcified lymph nodes, active bleeding and massive adhesions to show the feasibility of subxiphoid approach to manage even these conditions.

Subxiphoid complex uniportal video-assisted major pulmonary resections

PubMed Central

Lirio, Francisco; Sesma, Julio; Abu Akar, Firas

2017-01-01

In recent years, the search for a less invasive and thus, less painful approach has driven technical innovation in modern thoracic surgery. In this context, subxiphoid uniportal approach has emerged as an alternative to avoid intercostal space manipulation and decrease postoperative pain and intercostal nerve chronic impairment. Subxiphoid uniportal major lung resections have been safe and effective procedures when performed by experienced surgeons even in complex cases or unexpected intraoperative situations. We present six of these surgical scenarios such as big tumors, incomplete or absent fissures, hilar calcified lymph nodes, active bleeding and massive adhesions to show the feasibility of subxiphoid approach to manage even these conditions. PMID:29078655

Resolution-independent surface rendering using programmable graphics hardware

DOEpatents

Loop, Charles T.; Blinn, James Frederick

2008-12-16

Surfaces defined by a Bezier tetrahedron, and in particular quadric surfaces, are rendered on programmable graphics hardware. Pixels are rendered through triangular sides of the tetrahedra and locations on the shapes, as well as surface normals for lighting evaluations, are computed using pixel shader computations. Additionally, vertex shaders are used to aid interpolation over a small number of values as input to the pixel shaders. Through this, rendering of the surfaces is performed independently of viewing resolution, allowing for advanced level-of-detail management. By individually rendering tetrahedrally-defined surfaces which together form complex shapes, the complex shapes can be rendered in their entirety.

Applications of Metal Additive Manufacturing in Veterinary Orthopedic Surgery

NASA Astrophysics Data System (ADS)

Harrysson, Ola L. A.; Marcellin-Little, Denis J.; Horn, Timothy J.

2015-03-01

Veterinary medicine has undergone a rapid increase in specialization over the last three decades. Veterinarians now routinely perform joint replacement, neurosurgery, limb-sparing surgery, interventional radiology, radiation therapy, and other complex medical procedures. Many procedures involve advanced imaging and surgical planning. Evidence-based medicine has also become part of the modus operandi of veterinary clinicians. Modeling and additive manufacturing can provide individualized or customized therapeutic solutions to support the management of companion animals with complex medical problems. The use of metal additive manufacturing is increasing in veterinary orthopedic surgery. This review describes and discusses current and potential applications of metal additive manufacturing in veterinary orthopedic surgery.

Magnetospheric MultiScale (MMS) System Manager

NASA Technical Reports Server (NTRS)

Schiff, Conrad; Maher, Francis Alfred; Henely, Sean Philip; Rand, David

2014-01-01

The Magnetospheric MultiScale (MMS) mission is an ambitious NASA space science mission in which 4 spacecraft are flown in tight formation about a highly elliptical orbit. Each spacecraft has multiple instruments that measure particle and field compositions in the Earths magnetosphere. By controlling the members relative motion, MMS can distinguish temporal and spatial fluctuations in a way that a single spacecraft cannot.To achieve this control, 2 sets of four maneuvers, distributed evenly across the spacecraft must be performed approximately every 14 days. Performing a single maneuver on an individual spacecraft is usually labor intensive and the complexity becomes clearly increases with four. As a result, the MMS flight dynamics team turned to the System Manager to put the routine or error-prone under machine control freeing the analysts for activities that require human judgment.The System Manager is an expert system that is capable of handling operations activities associated with performing MMS maneuvers. As an expert system, it can work off a known schedule, launching jobs based on a one-time occurrence or on a set reoccurring schedule. It is also able to detect situational changes and use event-driven programming to change schedules, adapt activities, or call for help.

GBA manager: an online tool for querying low-complexity regions in proteins.

PubMed

Bandyopadhyay, Nirmalya; Kahveci, Tamer

2010-01-01

Abstract We developed GBA Manager, an online software that facilitates the Graph-Based Algorithm (GBA) we proposed in our earlier work. GBA identifies the low-complexity regions (LCR) of protein sequences. GBA exploits a similarity matrix, such as BLOSUM62, to compute the complexity of the subsequences of the input protein sequence. It uses a graph-based algorithm to accurately compute the regions that have low complexities. GBA Manager is a user friendly web-service that enables online querying of protein sequences using GBA. In addition to querying capabilities of the existing GBA algorithm, GBA Manager computes the p-values of the LCR identified. The p-value gives an estimate of the possibility that the region appears by chance. GBA Manager presents the output in three different understandable formats. GBA Manager is freely accessible at http://bioinformatics.cise.ufl.edu/GBA/GBA.htm .

Ethical guidance in the era of managed care: an analysis of the American College of Healthcare Executives' Code of Ethics.

PubMed

Higgins, W

2000-01-01

Market competition and the rise of managed care are transforming the healthcare system from a physician-dominated cottage industry into a manager-dominated corporate enterprise. The managed care revolution is also undermining the safe-guards offered by medical ethics and raising serious public concerns. These trends highlight the growing importance of ethical standards for managers. The most comprehensive ethical guidance for health service managers is contained in the American College of Healthcare Executives' (ACHE) Code of Ethics. An analysis of the ACHE Code suggests that it does not adequately address several ethical concerns associated with managed care. The ACHE may wish to develop a supplemental statement regarding ethical issues in managed care. A supplemental statement that provides more specific guidance in the areas of financial incentives to reduce utilization, social mission, consumer/patient information, and the health service manager's responsibility to patients could be extremely valuable in today's complex and rapidly changing environment. More specific ethical guidelines would not ensure individual or organizational compliance. However, they would provide professional standards that could guide decision making and help managers evaluate performance in managed care settings.

Trajectory-Based Complexity (TBX): A Modified Aircraft Count to Predict Sector Complexity During Trajectory-Based Operations

NASA Technical Reports Server (NTRS)

Prevot, Thomas; Lee, Paul U.

2011-01-01

In this paper we introduce a new complexity metric to predict -in real-time- sector complexity for trajectory-based operations (TBO). TBO will be implemented in the Next Generation Air Transportation System (NextGen). Trajectory-Based Complexity (TBX) is a modified aircraft count that can easily be computed and communicated in a TBO environment based upon predictions of aircraft and weather trajectories. TBX is scaled to aircraft count and represents an alternate and additional means to manage air traffic demand and capacity with more consideration of dynamic factors such as weather, aircraft equipage or predicted separation violations, as well as static factors such as sector size. We have developed and evaluated TBX in the Airspace Operations Laboratory (AOL) at the NASA Ames Research Center during human-in-the-loop studies of trajectory-based concepts since 2009. In this paper we will describe the TBX computation in detail and present the underlying algorithm. Next, we will describe the specific TBX used in an experiment at NASA's AOL. We will evaluate the performance of this metric using data collected during a controller-inthe- loop study on trajectory-based operations at different equipage levels. In this study controllers were prompted at regular intervals to rate their current workload on a numeric scale. When comparing this real-time workload rating to the TBX values predicted for these time periods we demonstrate that TBX is a better predictor of workload than aircraft count. Furthermore we demonstrate that TBX is well suited to be used for complexity management in TBO and can easily be adjusted to future operational concepts.

Operable Data Management for Ocean Observing Systems

NASA Astrophysics Data System (ADS)

Chavez, F. P.; Graybeal, J. B.; Godin, M. A.

2004-12-01

As oceanographic observing systems become more numerous and complex, data management solutions must follow. Most existing oceanographic data management systems fall into one of three categories: they have been developed as dedicated solutions, with limited application to other observing systems; they expect that data will be pre-processed into well-defined formats, such as netCDF; or they are conceived as robust, generic data management solutions, with complexity (high) and maturity and adoption rates (low) to match. Each approach has strengths and weaknesses; no approach yet fully addresses, nor takes advantage of, the sophistication of ocean observing systems as they are now conceived. In this presentation we describe critical data management requirements for advanced ocean observing systems, of the type envisioned by ORION and IOOS. By defining common requirements -- functional, qualitative, and programmatic -- for all such ocean observing systems, the performance and nature of the general data management solution can be characterized. Issues such as scalability, maintaining metadata relationships, data access security, visualization, and operational flexibility suggest baseline architectural characteristics, which may in turn lead to reusable components and approaches. Interoperability with other data management systems, with standards-based solutions in metadata specification and data transport protocols, and with the data management infrastructure envisioned by IOOS and ORION, can also be used to define necessary capabilities. Finally, some requirements for the software infrastructure of ocean observing systems can be inferred. Early operational results and lessons learned, from development and operations of MBARI ocean observing systems, are used to illustrate key requirements, choices, and challenges. Reference systems include the Monterey Ocean Observing System (MOOS), its component software systems (Software Infrastructure and Applications for MOOS, and the Shore Side Data System), and the Autonomous Ocean Sampling Network (AOSN).

Effects of prescribed fire in the coastal prairies of Texas

USGS Publications Warehouse

Grace, James B.; Allain, Larry K.; Baldwin, Heather Q.; Billock, Arlene G.; Eddleman, William R.; Given, Aaron M.; Jeske, Clint W.; Moss, Rebecca

2005-01-01

Prescribed fire is widely applied for habitat management in coastal ecosystems. Fire management plans typically list a variety of objectives for prescribed burning, including succession management, promotion of native flora and fauna, providing habitat for species of importance, wildfire risk reduction (fuels management), as well as reduction and/or prevention of invasive species. In most cases, the information needed to determine the degree to which management objectives are met is not available. This study sought to provide an assessment of key objectives of fire management at the U.S. Fish and Wildlife Service (USFWS) Texas Mid-coast National Wildlife Refuge Complex. The main purpose of this work was to provide information and recommendations that will support Region 2 of the USFWS in the conduct of their fire and habitat management activities in the Western Gulf coast region. There were four main components of this project: (1) a historical analysis of the role of fire in this ecosystem, (2) the development of standard methodology for assessing and monitoring fire effects in this system, (3) an evaluation of the effects of prescribed burning on the habitat being managed, and (4) an evaluation of the effects of burning on select fauna of special concern. A team of researchers, including some from the U.S. Geological Survey (USGS), Southeast Missouri State University, and Louisiana State University were involved in the various components of this project. Extensive support by USFWS personnel, both at the Texas Mid-coast National Wildlife Refuge Complex and in the Regional Office (Region 2, USFWS), was a key component in this work. Data from the three years of this study were combined with the results of previous USGS studies performed at the site to strengthen our conclusions.

Evaluation and management of gunshot wounds of the penis: 20-year experience at an urban trauma center.

PubMed

Kunkle, David A; Lebed, Brett D; Mydlo, Jack H; Pontari, Michel A

2008-04-01

Although gunshot injuries to the penis occur relatively infrequently in patients with penetrating trauma, they often present dilemmas of subsequent evaluation and management. We review our extensive experience with gunshot wounds to the penis at a high volume urban trauma center. The urologic trauma database was retrospectively reviewed to extract and compile information from the records of 63 patients treated for gunshot wounds to the penis. Data were accumulated for a 20-year period from 1985 to 2004 with regard to findings on physical examination, diagnostic evaluation, associated injuries, management, and outcome. We detail our technique of penile exploration and artificial erection in the management of these injuries. Penile gunshot wounds were associated with additional injuries in 53 of 63 (84%) patients. A total of 48 (76%) patients were taken to the operating room and 44 (70%) penile explorations were performed. Evaluation included retrograde urethrogram in 50 of 63 (79%) patients and was diagnostic for urethral injury in 11 of 12 (92%) cases. Primary urethral repair was performed in 8 of 12 (67%) patients with urethral injury versus 4 of 12 (33%) who underwent urinary diversion by means of suprapubic cystotomy. Evaluation and management of gunshot wounds to the penis may potentially be complex. Retrograde urethrogram should be performed in all cases except the most insignificant and superficial wounds. We describe our technique of penile exploration and artificial erection, noting excellent results in patients for whom follow-up is available. Additional studies are needed to prospectively evaluate techniques for management of gunshot urethral injuries.

Enhanced Systemic Understanding of the Information Environment in Complex Crisis Management - Analytical Concept, Version 1.0

DTIC Science & Technology

2010-10-22

4. TITLE AND SUBTITLE Enhanced Systemic Understanding of the Information Environment in Complex Crisis Management Analytical Concept, Version 1.0...Email: schmidtb@iabg.de UNCLASSIFIED FOR PUBLIC RELEASE – Enhanced Systemic Understanding of the Information Environment in Complex Crisis ...multinational crisis management and the security sector about the significance and characteristics of the information environment. The framework is

If you take stand, how can you manage an ecosystem? The complex art of raising a forest.

Treesearch

Sally Duncan

2000-01-01

Managing whole ecosystem is a concept gaining considerable acceptance among forest managers throughout the Northwest, but it does not have a clear or simple definition. Terminology and definitions can be confusing. Forests are complex places, formed by complex processes, and the moment we try to simplify, we are likely to damage the healthy functioning of...

PROGRAM-ORIENTED INFORMATION--A MANAGEMENT SYSTEMS COMPLEX FOR STATE EDUCATION AGENCIES. PART II, MANUAL OF ACCOUNTING AND RELATED FINANCIAL PROCEDURES.

ERIC Educational Resources Information Center

FRIEDMAN, BURTON DEAN; AND OTHERS

THIS DOCUMENT IS THE SECOND PART OF A REPORT, PROGRAM-ORIENTED INFORMATION--A MANAGEMENT SYSTEMS COMPLEX FOR STATE EDUCATION AGENCIES. PART 1, EA 001 170, SUBTITLED "ANALYSIS AND PROPOSALS," CONTAINS AN OUTLINE OF THE NEED FOR A MANAGEMENT SYSTEMS COMPLEX WITHIN EACH STATE EDUCATION AGENCY. THIS DOCUMENT IS A MANUAL PRESENTING THE…

A general framework for a collaborative water quality knowledge and information network.

PubMed

Dalcanale, Fernanda; Fontane, Darrell; Csapo, Jorge

2011-03-01

Increasing knowledge about the environment has brought about a better understanding of the complexity of the issues, and more information publicly available has resulted into a steady shift from centralized decision making to increasing levels of participatory processes. The management of that information, in turn, is becoming more complex. One of the ways to deal with the complexity is the development of tools that would allow all players, including managers, researchers, educators, stakeholders and the civil society, to be able to contribute to the information system, in any level they are inclined to do so. In this project, a search for the available technology for collaboration, methods of community filtering, and community-based review was performed and the possible implementation of these tools to create a general framework for a collaborative "Water Quality Knowledge and Information Network" was evaluated. The main goals of the network are to advance water quality education and knowledge; encourage distribution and access to data; provide networking opportunities; allow public perceptions and concerns to be collected; promote exchange of ideas; and, give general, open, and free access to information. A reference implementation was made available online and received positive feedback from the community, which also suggested some possible improvements.

A General Framework for a Collaborative Water Quality Knowledge and Information Network

NASA Astrophysics Data System (ADS)

Dalcanale, Fernanda; Fontane, Darrell; Csapo, Jorge

2011-03-01

Increasing knowledge about the environment has brought about a better understanding of the complexity of the issues, and more information publicly available has resulted into a steady shift from centralized decision making to increasing levels of participatory processes. The management of that information, in turn, is becoming more complex. One of the ways to deal with the complexity is the development of tools that would allow all players, including managers, researchers, educators, stakeholders and the civil society, to be able to contribute to the information system, in any level they are inclined to do so. In this project, a search for the available technology for collaboration, methods of community filtering, and community-based review was performed and the possible implementation of these tools to create a general framework for a collaborative "Water Quality Knowledge and Information Network" was evaluated. The main goals of the network are to advance water quality education and knowledge; encourage distribution and access to data; provide networking opportunities; allow public perceptions and concerns to be collected; promote exchange of ideas; and, give general, open, and free access to information. A reference implementation was made available online and received positive feedback from the community, which also suggested some possible improvements.

@neurIST: infrastructure for advanced disease management through integration of heterogeneous data, computing, and complex processing services.

PubMed

Benkner, Siegfried; Arbona, Antonio; Berti, Guntram; Chiarini, Alessandro; Dunlop, Robert; Engelbrecht, Gerhard; Frangi, Alejandro F; Friedrich, Christoph M; Hanser, Susanne; Hasselmeyer, Peer; Hose, Rod D; Iavindrasana, Jimison; Köhler, Martin; Iacono, Luigi Lo; Lonsdale, Guy; Meyer, Rodolphe; Moore, Bob; Rajasekaran, Hariharan; Summers, Paul E; Wöhrer, Alexander; Wood, Steven

2010-11-01

The increasing volume of data describing human disease processes and the growing complexity of understanding, managing, and sharing such data presents a huge challenge for clinicians and medical researchers. This paper presents the @neurIST system, which provides an infrastructure for biomedical research while aiding clinical care, by bringing together heterogeneous data and complex processing and computing services. Although @neurIST targets the investigation and treatment of cerebral aneurysms, the system's architecture is generic enough that it could be adapted to the treatment of other diseases. Innovations in @neurIST include confining the patient data pertaining to aneurysms inside a single environment that offers clinicians the tools to analyze and interpret patient data and make use of knowledge-based guidance in planning their treatment. Medical researchers gain access to a critical mass of aneurysm related data due to the system's ability to federate distributed information sources. A semantically mediated grid infrastructure ensures that both clinicians and researchers are able to seamlessly access and work on data that is distributed across multiple sites in a secure way in addition to providing computing resources on demand for performing computationally intensive simulations for treatment planning and research.

How Project Managers Really Manage: An Indepth Look at Some Managers of Large, Complex NASA Projects

NASA Technical Reports Server (NTRS)

Mulenburg, Gerald M.; Impaeilla, Cliff (Technical Monitor)

2000-01-01

This paper reports on a research study by the author that examined ten contemporary National Aeronautics and Space Administration (NASA) complex projects. In-depth interviews with the project managers of these projects provided qualitative data about the inner workings of the project and the methodologies used in establishing and managing the projects. The inclusion of a variety of space, aeronautics, and ground based projects from several different NASA research centers helped to reduce potential bias in the findings toward any one type of project, or technical discipline. The findings address the participants and their individual approaches. The discussion includes possible implications for project managers of other large, complex, projects.

Multiple system modelling of waste management

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

Eriksson, Ola, E-mail: ola.eriksson@hig.se; Department of Building, Energy and Environmental Engineering, University of Gaevle, SE 801 76 Gaevle; Bisaillon, Mattias, E-mail: mattias.bisaillon@profu.se

2011-12-15

Highlights: > Linking of models will provide a more complete, correct and credible picture of the systems. > The linking procedure is easy to perform and also leads to activation of project partners. > The simulation procedure is a bit more complicated and calls for the ability to run both models. - Abstract: Due to increased environmental awareness, planning and performance of waste management has become more and more complex. Therefore waste management has early been subject to different types of modelling. Another field with long experience of modelling and systems perspective is energy systems. The two modelling traditions havemore » developed side by side, but so far there are very few attempts to combine them. Waste management systems can be linked together with energy systems through incineration plants. The models for waste management can be modelled on a quite detailed level whereas surrounding systems are modelled in a more simplistic way. This is a problem, as previous studies have shown that assumptions on the surrounding system often tend to be important for the conclusions. In this paper it is shown how two models, one for the district heating system (MARTES) and another one for the waste management system (ORWARE), can be linked together. The strengths and weaknesses with model linking are discussed when compared to simplistic assumptions on effects in the energy and waste management systems. It is concluded that the linking of models will provide a more complete, correct and credible picture of the consequences of different simultaneous changes in the systems. The linking procedure is easy to perform and also leads to activation of project partners. However, the simulation procedure is a bit more complicated and calls for the ability to run both models.« less

Project Assessment Framework through Design (PAFTD) - A Project Assessment Framework in Support of Strategic Decision Making

NASA Technical Reports Server (NTRS)

Depenbrock, Brett T.; Balint, Tibor S.; Sheehy, Jeffrey A.

2014-01-01

Research and development organizations that push the innovation edge of technology frequently encounter challenges when attempting to identify an investment strategy and to accurately forecast the cost and schedule performance of selected projects. Fast moving and complex environments require managers to quickly analyze and diagnose the value of returns on investment versus allocated resources. Our Project Assessment Framework through Design (PAFTD) tool facilitates decision making for NASA senior leadership to enable more strategic and consistent technology development investment analysis, beginning at implementation and continuing through the project life cycle. The framework takes an integrated approach by leveraging design principles of useability, feasibility, and viability and aligns them with methods employed by NASA's Independent Program Assessment Office for project performance assessment. The need exists to periodically revisit the justification and prioritization of technology development investments as changes occur over project life cycles. The framework informs management rapidly and comprehensively about diagnosed internal and external root causes of project performance.

Trajectory-Oriented Approach to Managing Traffic Complexity: Trajectory Flexibility Metrics and Algorithms and Preliminary Complexity Impact Assessment

NASA Technical Reports Server (NTRS)

Idris, Husni; Vivona, Robert A.; Al-Wakil, Tarek

2009-01-01

This document describes exploratory research on a distributed, trajectory oriented approach for traffic complexity management. The approach is to manage traffic complexity based on preserving trajectory flexibility and minimizing constraints. In particular, the document presents metrics for trajectory flexibility; a method for estimating these metrics based on discrete time and degree of freedom assumptions; a planning algorithm using these metrics to preserve flexibility; and preliminary experiments testing the impact of preserving trajectory flexibility on traffic complexity. The document also describes an early demonstration capability of the trajectory flexibility preservation function in the NASA Autonomous Operations Planner (AOP) platform.

Exploring the Complexity of Classroom Management: 8 Components of Managing a Highly Productive, Safe, and Respectful Urban Environment

ERIC Educational Resources Information Center

Jones, Karrie A.; Jones, Jennifer L.; Vermette, Paul J.

2013-01-01

Creating a learning environment where all students can thrive academically requires an understanding of the complexities of classroom management. The notions of "discipline," "conformity" and "obedience" that have littered discussions of classroom management in the past are no longer sufficient to describe the diverse…

Developing high-performance cross-functional teams: Understanding motivations, functional loyalties, and teaming fundamentals

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

Miller, M.A.

1996-08-01

Teamwork is the key to the future of effective technology management. Today`s technologies and markets have become too complex for individuals to work alone. Global competition, limited resources, cost consciousness, and time pressures have forced organizations and project managers to encourage teamwork. Many of these teams will be cross-functional teams that can draw on a multitude of talents and knowledge. To develop high-performing cross-functional teams, managers must understand motivations, functional loyalties, and the different backgrounds of the individual team members. To develop a better understanding of these issues, managers can learn from experience and from literature on teams and teamingmore » concepts. When studying the literature to learn about cross-functional teaming, managers will find many good theoretical concepts, but when put into practice, these concepts have varying effects. This issue of varying effectiveness is what drives the research for this paper. The teaming concepts were studied to confirm or modify current understanding. The literature was compared with a {open_quotes}ground truth{close_quotes}, a survey of the reality of teaming practices, to examine the teaming concepts that the literature finds to be critical to the success of teams. These results are compared to existing teams to determine if such techniques apply in real-world cases.« less

Applying the Balanced Scorecard approach in teaching hospitals: a literature review and conceptual framework.

PubMed

Trotta, Annarita; Cardamone, Emma; Cavallaro, Giusy; Mauro, Marianna

2013-01-01

Teaching hospitals (THs) simultaneously serve three different roles: offering medical treatment, teaching future doctors and promoting research. The international literature recognises such organisations as 'peaks of excellence' and highlights their economic function in the health system. In addition, the literature describes the urgent need to manage the complex dynamics and inefficiency issues that threaten the survival of teaching hospitals worldwide. In this context, traditional performance measurement systems that focus only on accounting and financial measures appear to be inadequate. Given that THs are highly specific and complex, a multidimensional system of performance measurement, such as the Balanced Scorecard (BSC), may be more appropriate because of the multitude of stakeholders, each of whom seek a specific type of accountability. The aim of the paper was twofold: (i) to review the literature on the BSC and its applications in teaching hospitals and (ii) to propose a scorecard framework that is suitable for assessing the performance of THs and serving as a guide for scholars and practitioners. In addition, this research will contribute to the ongoing debate on performance evaluation systems by suggesting a revised BSC framework and proposing specific performance indicators for THs. Copyright © 2012 John Wiley & Sons, Ltd.

Eco-efficiency analysis of an agricultural research complex.

PubMed

Reith, Charles C; Guidry, Michael J

2003-07-01

The Model Sustainable Agricultural Complex (MSAC) is a 600-acre experimental farm in south-central Louisiana, in the very southern reaches of the United States, approximately 40 km north of the Gulf of Mexico. The MSAC consists of many land uses and facilities, including a dairy, crawfish center, beef herd, sugarcane crop, and equestrian center, as well as numerous features and programs for research, education, and residence. The mission of the MSAC, which is operated by the Department of Renewable Resources at the University of Louisiana at Lafayette, has been to accommodate research and education in production agriculture, while generating revenues through the delivery of food products into the local economy. In recent years, environmental conservation has been increasingly important at the MSAC. Best management practices (BMPs) were implemented to reduce soil loss and mitigate nonpoint source pollution. Research was initiated to quantify the effectiveness of these BMPs, and workshops were conducted to explain preliminary results to local farmers. However, environmental improvements at the MSAC had until 2000 been piecemeal, which may be said as well for agriculture overall. What is needed is a comprehensive integrated approach to analyzing and improving environmental performance, as is possible when implementing an environmental management system (EMS). This manuscript describes our efforts to integrate piecemeal environmental improvements into a farm-wide program of systematic improvement. This process began with a qualitative ranking of the MSAC's inputs and outputs, followed by a quantification of certain key parameters related to the consumption of resources and provision of services at the Complex. Certain measures related to the Complex's eco-efficiency were combined into a ratio that provides a useful target for management and continuous improvement. Eco-efficiency, which is defined as 'the efficiency with which receivables are converted into deliverables', is a good way to apply the lessons of industry to the agricultural sector, for instance, by monitoring and managing resource efficiency as an aspect in an EMS such as prescribed by ISO 14000. This will require disciplined recordkeeping and managed conservation, and will promote long-term environmental improvement.

Determining the causal relationships among balanced scorecard perspectives on school safety performance: case of Saudi Arabia.

PubMed

Alolah, Turki; Stewart, Rodney A; Panuwatwanich, Kriengsak; Mohamed, Sherif

2014-07-01

In the public schools of many developing countries, numerous accidents and incidents occur because of poor safety regulations and management systems. To improve the educational environment in Saudi Arabia, the Ministry of Education seeks novel approaches to measure school safety performance in order to decrease incidents and accidents. The main objective of this research was to develop a systematic approach for measuring Saudi school safety performance using the balanced scorecard framework philosophy. The evolved third generation balanced scorecard framework is considered to be a suitable and robust framework that captures the system-wide leading and lagging indicators of business performance. The balanced scorecard architecture is ideal for adaptation to complex areas such as safety management where a holistic system evaluation is more effective than traditional compartmentalised approaches. In developing the safety performance balanced scorecard for Saudi schools, the conceptual framework was first developed and peer-reviewed by eighteen Saudi education experts. Next, 200 participants, including teachers, school executives, and Ministry of Education officers, were recruited to rate both the importance and the performance of 79 measurement items used in the framework. Exploratory factor analysis, followed by the confirmatory partial least squares method, was then conducted in order to operationalise the safety performance balanced scorecard, which encapsulates the following five salient perspectives: safety management and leadership; safety learning and training; safety policy, procedures and processes; workforce safety culture; and safety performance. Partial least squares based structural equation modelling was then conducted to reveal five significant relationships between perspectives, namely, safety management and leadership had a significant effect on safety learning and training and safety policy, procedures and processes, both safety learning and training and safety policy, procedures and processes had significant effects on workforce safety culture, and workforce safety culture had a significant effect on safety performance. Copyright © 2014 Elsevier Ltd. All rights reserved.

Methods Used to Support a Life Cycle of Complex Engineering Products

NASA Astrophysics Data System (ADS)

Zakharova, Alexandra A.; Kolegova, Olga A.; Nekrasova, Maria E.; Eremenko, Andrey O.

2016-08-01

Management of companies involved in the design, development and operation of complex engineering products recognize the relevance of creating systems for product lifecycle management. A system of methods is proposed to support life cycles of complex engineering products, based on fuzzy set theory and hierarchical analysis. The system of methods serves to demonstrate the grounds for making strategic decisions in an environment of uncertainty, allows the use of expert knowledge, and provides interconnection of decisions at all phases of strategic management and all stages of a complex engineering product lifecycle.

SOI technology for power management in automotive and industrial applications

NASA Astrophysics Data System (ADS)

Stork, Johannes M. C.; Hosey, George P.

2017-02-01

Semiconductor on Insulator (SOI) technology offers an assortment of opportunities for chip manufacturers in the Power Management market. Recent advances in the automotive and industrial markets, along with emerging features, the increasing use of sensors, and the ever-expanding "Internet of Things" (IoT) are providing for continued growth in these markets while also driving more complex solutions. The potential benefits of SOI include the ability to place both high-voltage and low-voltage devices on a single chip, saving space and cost, simplifying designs and models, and improving performance, thereby cutting development costs and improving time to market. SOI also offers novel new approaches to long-standing technologies.

Anesthesia information management systems: a review of functionality and installation considerations.

PubMed

Ehrenfeld, Jesse M; Rehman, Mohamed A

2011-02-01

The functionality and rate of implementation of Anesthesia Information Management Systems (AIMS) has markedly risen over the past decade. These systems have now become much more than the generic automated record keepers, originally proposed and developed in the 1980s. AIMS have now become complex integrated systems, which have been shown to improve patient care and, in some cases, the financial performance of a department. Although the underlying technology has improved greatly over the past 5 years, the process of selecting and completing an AIMS installation still presents a number of challenges, and must be approached carefully in order to maximize the benefits provided by these systems.

Surgical Management of Neurogenic Lower Urinary Tract Dysfunction.

PubMed

Gor, Ronak A; Elliott, Sean P

2017-08-01

Surgery for patients with neurogenic urinary tract dysfunction (nLUTD) is indicated when medical therapy fails, to correct conditions affecting patient safety, or when surgery can enhance the quality of life better than nonoperative management. Examples include failure of maximal medical therapy, inability to perform or aversion to clean intermittent catheterization, refractory incontinence, and complications from chronic, indwelling catheters. Adults with nLUTD have competing risk factors, including previous operations, obesity, poor nutritional status, complex living arrangements, impaired dexterity/paralysis, and impaired executive and cognitive function. Complications are common in this subgroup of patients requiring enduring commitments from surgeons, patients, and their caretakers. Copyright © 2017 Elsevier Inc. All rights reserved.

Automation of multi-agent control for complex dynamic systems in heterogeneous computational network

NASA Astrophysics Data System (ADS)

Oparin, Gennady; Feoktistov, Alexander; Bogdanova, Vera; Sidorov, Ivan

2017-01-01

The rapid progress of high-performance computing entails new challenges related to solving large scientific problems for various subject domains in a heterogeneous distributed computing environment (e.g., a network, Grid system, or Cloud infrastructure). The specialists in the field of parallel and distributed computing give the special attention to a scalability of applications for problem solving. An effective management of the scalable application in the heterogeneous distributed computing environment is still a non-trivial issue. Control systems that operate in networks, especially relate to this issue. We propose a new approach to the multi-agent management for the scalable applications in the heterogeneous computational network. The fundamentals of our approach are the integrated use of conceptual programming, simulation modeling, network monitoring, multi-agent management, and service-oriented programming. We developed a special framework for an automation of the problem solving. Advantages of the proposed approach are demonstrated on the parametric synthesis example of the static linear regulator for complex dynamic systems. Benefits of the scalable application for solving this problem include automation of the multi-agent control for the systems in a parallel mode with various degrees of its detailed elaboration.

History of shoulder instability surgery.

PubMed

Randelli, Pietro; Cucchi, Davide; Butt, Usman

2016-02-01

The surgical management of shoulder instability is an expanding and increasingly complex area of study within orthopaedics. This article describes the history and evolution of shoulder instability surgery, examining the development of its key principles, the currently accepted concepts and available surgical interventions. A comprehensive review of the available literature was performed using PubMed. The reference lists of reviewed articles were also scrutinised to ensure relevant information was included. The various types of shoulder instability including anterior, posterior and multidirectional instability are discussed, focussing on the history of surgical management of these topics, the current concepts and the results of available surgical interventions. The last century has seen important advancements in the understanding and treatment of shoulder instability. The transition from open to arthroscopic surgery has allowed the discovery of previously unrecognised pathologic entities and facilitated techniques to treat these. Nevertheless, open surgery still produces comparable results in the treatment of many instability-related conditions and is often required in complex or revision cases, particularly in the presence of bone loss. More high-quality research is required to better understand and characterise this spectrum of conditions so that successful evidence-based management algorithms can be developed. IV.

[What is the impact of education and training on flexible nursing management? Experiences from a tertiary care hospital].

PubMed

Lux, V

2013-08-01

Healthcare reforms and new legislations have a significant impact on patient care. New and more complex treatment designs and technologies are a great challenge for allied healthcare professionals. There is a growing demand for qualified allied healthcare professionals to increase productivity and to perform complex therapeutic regimens. Since recruitment of specialized healthcare workers is difficult, the University Hospital of Cologne arranges various training programs for allied healthcare staff. We provide more than 500 apprenticeship positions, 225 for nurses. Currently, 216 nursing students have been enrolled; thus, we have reached a 96 % capacity and could again improve last year's results. Some of our graduates continue their career in an academic course of study at university or a university of applied science. In this way nursing management loses qualified and dedicated employees at the bedside. In order to offer attractive alternatives to an academic course, it is important to complement basic education with advanced training and specialization. Traditional in-house education, basic as well as advanced training, is still the primary means to recruit qualified healthcare workers. Nursing management, therefore, still relies on this important strategic instrument for the recruitment and retention of staff.

Contemporary occurrence of hydrocephalus and Chiari I malformation in sagittal craniosynostosis. Case report and review of the literature.

PubMed

Sgulò, Francesco Giovanni; Spennato, Pietro; Aliberti, Ferdinando; Di Martino, Giuliana; Cascone, Daniele; Cinalli, Giuseppe

2017-01-01

Chiari malformation type I (CM-I) and hydrocephalus are often associated with complex craniosynostosis. On the contrary, their simultaneous occurrence in monosutural synostosis is extremely rare. The pathophysiological hypothesis is that they may alter posterior fossa growth and lead to cerebellar tonsil herniation also without skull base primary involvement. Hydrocephalus is multifactorial and may be secondary to fourth ventricle outlet obstruction. The management of these cases is quite complex and not well defined. Cranial vault remodeling should be the only treatment when CM-I is asymptomatic and not related to syringomyelia. Suboccipital decompression should be reserved only in complicated CM-I, usually as a second surgical step following the correction of the supratentorial deformity. In our opinion, the associated hydrocephalus should be treated first in order to normalize intracranial hypertension before opening the cranial sutures. We report the case of a 26-month-old child that presented with sagittal craniosynostosis, hydrocephalus, and CM-I. He was managed by performing endoscopic third ventriculostomy (ETV) first and cranial vault remodeling thereafter. Clinico-radiological outcome was very satisfying. Concerning literature is reviewed; physiopathology and surgical management are discussed.

Cryogenic Fluid Technologies for Long Duration In-Space Operations

NASA Technical Reports Server (NTRS)

Motil, Susan M.; Tramel, Terri L.

2008-01-01

Reliable knowledge of low-gravity cryogenic fluid management behavior is lacking and yet is critical in the areas of storage, distribution, and low-gravity propellant management. The Vision for Space Exploration mission objectives will require the use of high performance cryogenic propellants (hydrogen, oxygen, and methane). Additionally, lunar missions will require success in storing and transferring liquid and gas commodities on the surface. The fundamental challenges associated with the in-space use of cryogens are their susceptibility to environmental heat, their complex thermodynamic and fluid dynamic behavior in low gravity and the uncertainty of the position of the liquid-vapor interface if the propellants are not settled. The Cryogenic Fluid Management (CFM) project is addressing these issues through ground testing and analytical model development, and has crosscutting applications and benefits to virtually all missions requiring in-space operations with cryogens. Such knowledge can significantly reduce or even eliminate tank fluid boil-off losses for long term missions, reduce propellant launch mass and on-orbit margins, and simplify vehicle operations. The Cryogenic Fluid Management (CFM) Project is conducting testing and performing analytical evaluation of several areas to enable NASA s Exploration Vision. This paper discusses the content and progress of the technology focus areas within CFM.

Implementing a Lean Management System in Primary Care: Facilitators and Barriers From the Front Lines.

PubMed

Hung, Dorothy; Martinez, Meghan; Yakir, Maayan; Gray, Caroline

2015-01-01

Although Lean management techniques are increasingly used in health care to improve quality and reduce costs, lessons about how to successfully implement this approach on the front lines of care delivery are not well documented. In this study, we highlight key facilitators and barriers to implementing Lean among frontline primary care providers. This case study took place at a large, ambulatory care delivery system serving nearly 1 million patients. In-depth interviews were conducted with primary care physicians, staff, and administrators to identify key factors impacting Lean redesigns in primary care. Overall, staff engagement and performance management, sensitivity to the professional values and culture of medicine, and perceived adequacy of organizational resources were critical when introducing Lean changes. Specific drivers of change included empowerment of staff at all levels, visual display of performance metrics, and a culture of innovation and collaboration. Barriers included physician resistance to standardized work, difficulty transferring management responsibilities to non-physician staff, and time and staffing required for participating in improvement efforts. Although Lean offers a new approach to delivering care, the implementation process itself is both complex and crucial to success. Understanding early facilitators and barriers can maximize Lean's, potential to improve health care delivery.

Examination of the relationship between project management critical success factors and project success of oil and gas drilling projects

NASA Astrophysics Data System (ADS)

Alagba, Tonye J.

Oil and gas drilling projects are the primary means by which oil companies recover large volumes of commercially available hydrocarbons from deep reservoirs. These types of projects are complex in nature, involving management of multiple stakeholder interfaces, multidisciplinary personnel, complex contractor relationships, and turbulent environmental and market conditions, necessitating the application of proven project management best practices and critical success factors (CSFs) to achieve success. Although there is some practitioner oriented literature on project management CSFs for drilling projects, none of these is based on empirical evidence, from research. In addition, the literature has reported alarming rates of oil and gas drilling project failure, which is attributable not to technical factors, but to failure of project management. The aim of this quantitative correlational study therefore, was to discover an empirically verified list of project management CSFs, which consistent application leads to successful implementation of oil and gas drilling projects. The study collected survey data online, from a random sample of 127 oil and gas drilling personnel who were members of LinkedIn's online community "Drilling Supervisors, Managers, and Engineers". The results of the study indicated that 10 project management factors are individually related to project success of oil and gas drilling projects. These 10 CSFs are namely; Project mission, Top management support, Project schedule/plan, Client consultation, Personnel, Technical tasks, Client acceptance, Monitoring and feedback, Communication, and Troubleshooting. In addition, the study found that the relationships between the 10 CSFs and drilling project success is unaffected by participant and project demographics---role of project personnel, and project location. The significance of these findings are both practical, and theoretical. Practically, application of an empirically verified CSFs list to oil and gas drilling projects could help oil companies improve the performance of future drilling projects. Theoretically, the study's findings may help to bridge a gap in the project management CSFs literature, and add to the general project management body of knowledge.

Failure of Synthetic Implants: Strategies and Management.

PubMed

Jang, Yong Ju; Kim, Shin Ae; Alharethy, Sami

2018-06-01

Dorsal augmentation with synthetic implants is the most commonly performed rhinoplasty procedure, especially in the East-Asian region. However, as in all other surgical procedures, complications are inevitable. Complications that need to be managed surgically include displacement, deviation, suboptimal aesthetic outcome, extrusion, inflammation, infection, and changes in skin quality. Most complications can be easily managed with revision surgery. After the removal of the synthetic implant from the nasal dorsum, different dorsal implant materials such as dermofat, alloderm, or fascia-wrapped diced cartilage, conchal cartilage with perichondrial attachment, and costal cartilage are preferred. An irreversible change in the skin/soft tissue envelope poses a challenge that usually requires reconstructive surgery with a local flap. Therefore, early detection and prompt management of the complication are essential for minimizing the severity of the deformity and the complexity of the surgical procedures. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A mobile system for the improvement of heart failure management: Evaluation of a prototype.

PubMed

Haynes, Sarah C; Kim, Katherine K

2017-01-01

Management of heart failure is complex, often involving interaction with multiple providers, monitoring of symptoms, and numerous medications. Employing principles of user-centered design, we developed a high- fidelity prototype of a mobile system for heart failure self-management and care coordination. Participants, including both heart failure patients and health care providers, tested the mobile system during a one-hour one-on-one session with a facilitator. The facilitator interviewed participants about the strengths and weaknesses of the prototype, necessary features, and willingness to use the technology. We performed a qualitative content analysis using the transcripts of these interviews. Fourteen distinct themes were identified in the analysis. Of these themes, integration, technology literacy, memory, and organization were the most common. Privacy was the least common theme. Our study suggests that this integration is essential for adoption of a mobile system for chronic disease management and care coordination.

Hanford Site Environmental Safety and Health Fiscal Year 2001 Budget-Risk management summary

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

REEP, I.E.

1999-05-12

The Hanford Site Environment, Safety and Health (ES&H) Budget-Risk Management Summary report is prepared to support the annual request to sites in the U.S. Department of Energy (DOE) Complex by DOE, Headquarters. The request requires sites to provide supplementary crosscutting information related to ES&H activities and the ES&H resources that support these activities. The report includes the following: (1) A summary status of fiscal year (FY) 1999 ES&H performance and ES&H execution commitments; (2)Status and plans of Hanford Site Office of Environmental Management (EM) cleanup activities; (3) Safety and health (S&H) risk management issues and compliance vulnerabilities of FY 2001more » Target Case and Below Target Case funding of EM cleanup activities; (4) S&H resource planning and crosscutting information for FY 1999 to 2001; and (5) Description of indirect-funded S&H activities.« less

A decision support tool for adaptive management of native prairie ecosystems

USGS Publications Warehouse

Hunt, Victoria M.; Jacobi, Sarah; Gannon, Jill J.; Zorn, Jennifer E.; Moore, Clinton; Lonsdorf, Eric V.

2016-01-01

The Native Prairie Adaptive Management initiative is a decision support framework that provides cooperators with management-action recommendations to help them conserve native species and suppress invasive species on prairie lands. We developed a Web-based decision support tool (DST) for the U.S. Fish and Wildlife Service and the U.S. Geological Survey initiative. The DST facilitates cross-organizational data sharing, performs analyses to improve conservation delivery, and requires no technical expertise to operate. Each year since 2012, the DST has used monitoring data to update ecological knowledge that it translates into situation-specific management-action recommendations (e.g., controlled burn or prescribed graze). The DST provides annual recommendations for more than 10,000 acres on 20 refuge complexes in four U.S. states. We describe how the DST promotes the long-term implementation of the program for which it was designed and may facilitate decision support and improve ecological outcomes of other conservation efforts.

Managing Complex Problems in Rangeland Ecosystems

USDA-ARS?s Scientific Manuscript database

Management of rangelands, and natural resources in general, has become increasingly complex. There is an atmosphere of increasing expectations for conservation efforts associated with a variety of issues from water quality to endangered species. We argue that many current issues are complex by their...

Competing values in healthcare: balancing the (un)balanced scorecard.

PubMed

Wicks, Angela M; St Clair, Lynda

2007-01-01

Facing a complex environment driven by two decades of dramatic change, healthcare organizations are adopting new strategic frameworks such as the Balanced Scorecard (BSC) to evaluate performance (Kaplan and Norton 1992). The BSC was not originally developed as a performance management tool, however. Rather, it was designed as a tool to communicate strategy and, as such, provides little guidance when actual outcomes fall short of desired outcomes. In addition, although the BSC is an improvement over exclusively financial measures, it has three conceptual limitations that are especially problematic for evaluating healthcare organizations: (1) it underemphasizes the employee perspective, (2) it is founded on a control-based management philosophy, and (3) it emphasizes making trade-offs. To address these limitations, we propose using the Competing Values Framework (CVF), a theoretically grounded, comprehensive approach to understanding and improving organizational and managerial performance by focusing on four action imperatives: competing, controlling, collaborating, and creating. The CVF pays particular attention to the employee perspective, is consistent with a commitment-based management philosophy, and emphasizes transcending apparent paradoxes to identify win-win solutions. Rather than focusing on customer satisfaction or employee satisfaction, the CVF looks for ways to satisfy customers and employees while still addressing financial constraints and growth opportunities. The CVF also can be used to assess both the culture of the organization and the competencies of individual managers, thereby providing a clear link between strategy and implementation.

Analysis of structural dynamic data from Skylab. Volume 1: Technical discussion

NASA Technical Reports Server (NTRS)

Demchak, L.; Harcrow, H.

1976-01-01

A compendium of Skylab structural dynamics analytical and test programs is presented. These programs are assessed to identify lessons learned from the structural dynamic prediction effort and to provide guidelines for future analysts and program managers of complex spacecraft systems. It is a synopsis of the structural dynamic effort performed under the Skylab Integration contract and specifically covers the development, utilization, and correlation of Skylab Dynamic Orbital Models.

Automatic Target Recognition Using Nonlinear Autoregressive Neural Networks

DTIC Science & Technology

2014-03-27

Lee and Chang (2009) employed a NARXNet for studying the thermodynamics in a pulsating heat pipe (PHP), a type of cooling device which contains...in Thermal Dynamics Identifcation of a Pulsating Heat Pipe . Energy Consversion and Management, 1069-1078. Lisboa, P. J. (2002). A review of...function by adjusting the values of the connections between elements. This flexibility allows ANNs to perform complex functions in fields to include

Next Step Toward Widespread Residential Deep Energy Retrofits

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

McIlvaine, J.; Saunders, S.; Bordelon, E.

The complexity of deep energy retrofits warrants additional training to successfully manage multiple improvements that will change whole house air, heat, and moisture flow dynamics. The home performance contracting industry has responded to these challenges by aggregating skilled labor for assessment of and implementation under one umbrella. Two emerging business models are profiled that seek to resolve many of the challenges, weaknesses, opportunities, and threats described for the conventional business models.

A causal loop analysis of the sustainability of integrated community case management in Rwanda.

PubMed

Sarriot, Eric; Morrow, Melanie; Langston, Anne; Weiss, Jennifer; Landegger, Justine; Tsuma, Laban

2015-04-01

Expansion of community health services in Rwanda has come with the national scale up of integrated Community Case Management (iCCM) of malaria, pneumonia and diarrhea. We used a sustainability assessment framework as part of a large-scale project evaluation to identify factors affecting iCCM sustainability (2011). We then (2012) used causal-loop analysis to identify systems determinants of iCCM sustainability from a national systems perspective. This allows us to develop three high-probability future scenarios putting the achievements of community health at risk, and to recommend mitigating strategies. Our causal loop diagram highlights both balancing and reinforcing loops of cause and effect in the national iCCM system. Financial, political and technical scenarios carry high probability for threatening the sustainability through: (1) reduction in performance-based financing resources, (2) political shocks and erosion of political commitment for community health, and (3) insufficient progress in resolving district health systems--"building blocks"--performance gaps. In a complex health system, the consequences of choices may be delayed and hard to predict precisely. Causal loop analysis and scenario mapping make explicit complex cause-and-effects relationships and high probability risks, which need to be anticipated and mitigated. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Controlling changes - lessons learned from waste management facilities

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

Johnson, B.M.; Koplow, A.S.; Stoll, F.E.

This paper discusses lessons learned about change control at the Waste Reduction Operations Complex (WROC) and Waste Experimental Reduction Facility (WERF) of the Idaho National Engineering Laboratory (INEL). WROC and WERF have developed and implemented change control and an as-built drawing process and have identified structures, systems, and components (SSCS) for configuration management. The operations have also formed an Independent Review Committee to minimize costs and resources associated with changing documents. WROC and WERF perform waste management activities at the INEL. WROC activities include storage, treatment, and disposal of hazardous and mixed waste. WERF provides volume reduction of solid low-levelmore » waste through compaction, incineration, and sizing operations. WROC and WERF`s efforts aim to improve change control processes that have worked inefficiently in the past.« less

Data management integration for biomedical core facilities

NASA Astrophysics Data System (ADS)

Zhang, Guo-Qiang; Szymanski, Jacek; Wilson, David

2007-03-01

We present the design, development, and pilot-deployment experiences of MIMI, a web-based, Multi-modality Multi-Resource Information Integration environment for biomedical core facilities. This is an easily customizable, web-based software tool that integrates scientific and administrative support for a biomedical core facility involving a common set of entities: researchers; projects; equipments and devices; support staff; services; samples and materials; experimental workflow; large and complex data. With this software, one can: register users; manage projects; schedule resources; bill services; perform site-wide search; archive, back-up, and share data. With its customizable, expandable, and scalable characteristics, MIMI not only provides a cost-effective solution to the overarching data management problem of biomedical core facilities unavailable in the market place, but also lays a foundation for data federation to facilitate and support discovery-driven research.

A fuzzy logic intelligent diagnostic system for spacecraft integrated vehicle health management

NASA Technical Reports Server (NTRS)

Wu, G. Gordon

1995-01-01

Due to the complexity of future space missions and the large amount of data involved, greater autonomy in data processing is demanded for mission operations, training, and vehicle health management. In this paper, we develop a fuzzy logic intelligent diagnostic system to perform data reduction, data analysis, and fault diagnosis for spacecraft vehicle health management applications. The diagnostic system contains a data filter and an inference engine. The data filter is designed to intelligently select only the necessary data for analysis, while the inference engine is designed for failure detection, warning, and decision on corrective actions using fuzzy logic synthesis. Due to its adaptive nature and on-line learning ability, the diagnostic system is capable of dealing with environmental noise, uncertainties, conflict information, and sensor faults.

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

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

Performance Basis for Airborne Separation

NASA Technical Reports Server (NTRS)

Wing, David J.

2008-01-01

Emerging applications of Airborne Separation Assistance System (ASAS) technologies make possible new and powerful methods in Air Traffic Management (ATM) that may significantly improve the system-level performance of operations in the future ATM system. These applications typically involve the aircraft managing certain components of its Four Dimensional (4D) trajectory within the degrees of freedom defined by a set of operational constraints negotiated with the Air Navigation Service Provider. It is hypothesized that reliable individual performance by many aircraft will translate into higher total system-level performance. To actually realize this improvement, the new capabilities must be attracted to high demand and complexity regions where high ATM performance is critical. Operational approval for use in such environments will require participating aircraft to be certified to rigorous and appropriate performance standards. Currently, no formal basis exists for defining these standards. This paper provides a context for defining the performance basis for 4D-ASAS operations. The trajectory constraints to be met by the aircraft are defined, categorized, and assessed for performance requirements. A proposed extension of the existing Required Navigation Performance (RNP) construct into a dynamic standard (Dynamic RNP) is outlined. Sample data is presented from an ongoing high-fidelity batch simulation series that is characterizing the performance of an advanced 4D-ASAS application. Data of this type will contribute to the evaluation and validation of the proposed performance basis.

The strategic management of organizational knowledge exchange related to hospital quality measurement and reporting.

PubMed

Rangachari, Pavani

2008-01-01

CONTEXT/PURPOSE: With the growing momentum toward hospital quality measurement and reporting by public and private health care payers, hospitals face increasing pressures to improve their medical record documentation and administrative data coding accuracy. This study explores the relationship between the organizational knowledge-sharing structure related to quality and hospital coding accuracy for quality measurement. Simultaneously, this study seeks to identify other leadership/management characteristics associated with coding for quality measurement. Drawing upon complexity theory, the literature on "professional complex systems" has put forth various strategies for managing change and turnaround in professional organizations. In so doing, it has emphasized the importance of knowledge creation and organizational learning through interdisciplinary networks. This study integrates complexity, network structure, and "subgoals" theories to develop a framework for knowledge-sharing network effectiveness in professional complex systems. This framework is used to design an exploratory and comparative research study. The sample consists of 4 hospitals, 2 showing "good coding" accuracy for quality measurement and 2 showing "poor coding" accuracy. Interviews and surveys are conducted with administrators and staff in the quality, medical staff, and coding subgroups in each facility. Findings of this study indicate that good coding performance is systematically associated with a knowledge-sharing network structure rich in brokerage and hierarchy (with leaders connecting different professional subgroups to each other and to the external environment), rather than in density (where everyone is directly connected to everyone else). It also implies that for the hospital organization to adapt to the changing environment of quality transparency, senior leaders must undertake proactive and unceasing efforts to coordinate knowledge exchange across physician and coding subgroups and connect these subgroups with the changing external environment.

Advancing the application of systems thinking in health: managing rural China health system development in complex and dynamic contexts.

PubMed

Zhang, Xiulan; Bloom, Gerald; Xu, Xiaoxin; Chen, Lin; Liang, Xiaoyun; Wolcott, Sara J

2014-08-26

This paper explores the evolution of schemes for rural finance in China as a case study of the long and complex process of health system development. It argues that the evolution of these schemes has been the outcome of the response of a large number of agents to a rapidly changing context and of efforts by the government to influence this adaptation process and achieve public health goals. The study draws on several sources of data including a review of official policy documents and academic papers and in-depth interviews with key policy actors at national level and at a sample of localities. The study identifies three major transition points associated with changes in broad development strategy and demonstrates how the adaptation of large numbers of actors to these contextual changes had a major impact on the performance of the health system. Further, it documents how the Ministry of Health viewed its role as both an advocate for the interests of health facilities and health workers and as the agency responsible for ensuring that government health system objectives were met. It is argued that a major reason for the resilience of the health system and its ability to adapt to rapid economic and institutional change was the ability of the Ministry to provide overall strategy leadership. Additionally, it postulates that a number of interest groups have emerged, which now also seek to influence the pathway of health system development. This history illustrates the complex and political nature of the management of health system development and reform. The paper concludes that governments will need to increase their capacity to analyze the health sector as a complex system and to manage change processes.

Safety Risk Knowledge Elicitation in Support of Aeronautical R and D Portfolio Management: A Case Study

NASA Technical Reports Server (NTRS)

Shih, Ann T.; Ancel, Ersin; Jones, Sharon Monica; Reveley, Mary S.; Luxhoj, James T.

2012-01-01

Aviation is a problem domain characterized by a high level of system complexity and uncertainty. Safety risk analysis in such a domain is especially challenging given the multitude of operations and diverse stakeholders. The Federal Aviation Administration (FAA) projects that by 2025 air traffic will increase by more than 50 percent with 1.1 billion passengers a year and more than 85,000 flights every 24 hours contributing to further delays and congestion in the sky (Circelli, 2011). This increased system complexity necessitates the application of structured safety risk analysis methods to understand and eliminate where possible, reduce, and/or mitigate risk factors. The use of expert judgments for probabilistic safety analysis in such a complex domain is necessary especially when evaluating the projected impact of future technologies, capabilities, and procedures for which current operational data may be scarce. Management of an R&D product portfolio in such a dynamic domain needs a systematic process to elicit these expert judgments, process modeling results, perform sensitivity analyses, and efficiently communicate the modeling results to decision makers. In this paper a case study focusing on the application of an R&D portfolio of aeronautical products intended to mitigate aircraft Loss of Control (LOC) accidents is presented. In particular, the knowledge elicitation process with three subject matter experts who contributed to the safety risk model is emphasized. The application and refinement of a verbal-numerical scale for conditional probability elicitation in a Bayesian Belief Network (BBN) is discussed. The preliminary findings from this initial step of a three-part elicitation are important to project management practitioners as they illustrate the vital contribution of systematic knowledge elicitation in complex domains.

Building quality into medical product software design.

PubMed

Mallory, S R

1993-01-01

The software engineering and quality assurance disciplines are a requisite to the design of safe and effective software-based medical devices. It is in the areas of software methodology and process that the most beneficial application of these disciplines to software development can be made. Software is a product of complex operations and methodologies and is not amenable to the traditional electromechanical quality assurance processes. Software quality must be built in by the developers, with the software verification and validation engineers acting as the independent instruments for ensuring compliance with performance objectives and with development and maintenance standards. The implementation of a software quality assurance program is a complex process involving management support, organizational changes, and new skill sets, but the benefits are profound. Its rewards provide safe, reliable, cost-effective, maintainable, and manageable software, which may significantly speed the regulatory review process and therefore potentially shorten the overall time to market. The use of a trial project can greatly facilitate the learning process associated with the first-time application of a software quality assurance program.

Pancreas preserving total duodenectomy for complex duodenal injury.

PubMed

Wig, Jai Dev; Kudari, Ashwinikumar; Yadav, Thakur Deen; Doley, Rudra Prasad; Bharathy, Kishore Gurumoorthy Subramanya; Kalra, Naveen

2009-07-06

To assess the feasibility and safety of a pancreas-preserving total duodenectomy in the management of severe duodenal injury caused by abdominal trauma. Two patients with both extensive injury of the duodenum and diffuse peritonitis underwent pancreas preserving total duodenectomy at our tertiary care centre. These two young male patients (age 20 and 22 years) presented 2 days and 6 hours respectively following blunt abdominal trauma. The duodenum was almost completely separated from the pancreas. Ampulla was seen as a button on the pancreas. Following total duodenectomy, reconstruction was performed by suturing the jejunum to the head of the pancreas anteriorly and posteriorly away from the ampulla (invagination of the pancreas into the jejunum). There were no complications attributable to the procedure. Both patients are well on follow up. A Pancreas-preserving total duodenectomy offers a safe alternative to the Whipple procedure in managing complex duodenal injury. This procedure avoids unnecessary resection of the adjacent pancreas and anastomosis to undilated hepatic and pancreatic ducts.

Risk Management for Human Support Technology Development

NASA Technical Reports Server (NTRS)

jones, Harry

2005-01-01

NASA requires continuous risk management for all programs and projects. The risk management process identifies risks, analyzes their impact, prioritizes them, develops and carries out plans to mitigate or accept them, tracks risks and mitigation plans, and communicates and documents risk information. Project risk management is driven by the project goal and is performed by the entire team. Risk management begins early in the formulation phase with initial risk identification and development of a risk management plan and continues throughout the project life cycle. This paper describes the risk management approach that is suggested for use in NASA's Human Support Technology Development. The first step in risk management is to identify the detailed technical and programmatic risks specific to a project. Each individual risk should be described in detail. The identified risks are summarized in a complete risk list. Risk analysis provides estimates of the likelihood and the qualitative impact of a risk. The likelihood and impact of the risk are used to define its priority location in the risk matrix. The approaches for responding to risk are either to mitigate it by eliminating or reducing the effect or likelihood of a risk, to accept it with a documented rationale and contingency plan, or to research or monitor the risk, The Human Support Technology Development program includes many projects with independently achievable goals. Each project must do independent risk management, considering all its risks together and trading them against performance, budget, and schedule. Since the program can succeed even if some projects fail, the program risk has a complex dependence on the individual project risks.

Complexity of physiological responses decreases in high-stress musical performance.

PubMed

Williamon, Aaron; Aufegger, Lisa; Wasley, David; Looney, David; Mandic, Danilo P

2013-12-06

For musicians, performing in front of an audience can cause considerable apprehension; indeed, performance anxiety is felt throughout the profession, with wide ranging symptoms arising irrespective of age, skill level and amount of practice. A key indicator of stress is frequency-specific fluctuations in the dynamics of heart rate known as heart rate variability (HRV). Recent developments in sensor technology have made possible the measurement of physiological parameters reflecting HRV non-invasively and outside of the laboratory, opening research avenues for real-time performer feedback to help improve stress management. However, the study of stress using standard algorithms has led to conflicting and inconsistent results. Here, we present an innovative and rigorous approach which combines: (i) a controlled and repeatable experiment in which the physiological response of an expert musician was evaluated in a low-stress performance and a high-stress recital for an audience of 400 people, (ii) a piece of music with varying physical and cognitive demands, and (iii) dynamic stress level assessment with standard and state-of-the-art HRV analysis algorithms such as those within the domain of complexity science which account for higher order stress signatures. We show that this offers new scope for interpreting the autonomic nervous system response to stress in real-world scenarios, with the evolution of stress levels being consistent with the difficulty of the music being played, superimposed on the stress caused by performing in front of an audience. For an emerging class of algorithms that can analyse HRV independent of absolute data scaling, it is shown that complexity science performs a more accurate assessment of average stress levels, thus providing greater insight into the degree of physiological change experienced by musicians when performing in public.

Complexity of physiological responses decreases in high-stress musical performance

PubMed Central

Williamon, Aaron; Aufegger, Lisa; Wasley, David; Looney, David; Mandic, Danilo P.

2013-01-01

For musicians, performing in front of an audience can cause considerable apprehension; indeed, performance anxiety is felt throughout the profession, with wide ranging symptoms arising irrespective of age, skill level and amount of practice. A key indicator of stress is frequency-specific fluctuations in the dynamics of heart rate known as heart rate variability (HRV). Recent developments in sensor technology have made possible the measurement of physiological parameters reflecting HRV non-invasively and outside of the laboratory, opening research avenues for real-time performer feedback to help improve stress management. However, the study of stress using standard algorithms has led to conflicting and inconsistent results. Here, we present an innovative and rigorous approach which combines: (i) a controlled and repeatable experiment in which the physiological response of an expert musician was evaluated in a low-stress performance and a high-stress recital for an audience of 400 people, (ii) a piece of music with varying physical and cognitive demands, and (iii) dynamic stress level assessment with standard and state-of-the-art HRV analysis algorithms such as those within the domain of complexity science which account for higher order stress signatures. We show that this offers new scope for interpreting the autonomic nervous system response to stress in real-world scenarios, with the evolution of stress levels being consistent with the difficulty of the music being played, superimposed on the stress caused by performing in front of an audience. For an emerging class of algorithms that can analyse HRV independent of absolute data scaling, it is shown that complexity science performs a more accurate assessment of average stress levels, thus providing greater insight into the degree of physiological change experienced by musicians when performing in public. PMID:24068177

Automatic Fault Characterization via Abnormality-Enhanced Classification

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

Bronevetsky, G; Laguna, I; de Supinski, B R

Enterprise and high-performance computing systems are growing extremely large and complex, employing hundreds to hundreds of thousands of processors and software/hardware stacks built by many people across many organizations. As the growing scale of these machines increases the frequency of faults, system complexity makes these faults difficult to detect and to diagnose. Current system management techniques, which focus primarily on efficient data access and query mechanisms, require system administrators to examine the behavior of various system services manually. Growing system complexity is making this manual process unmanageable: administrators require more effective management tools that can detect faults and help tomore » identify their root causes. System administrators need timely notification when a fault is manifested that includes the type of fault, the time period in which it occurred and the processor on which it originated. Statistical modeling approaches can accurately characterize system behavior. However, the complex effects of system faults make these tools difficult to apply effectively. This paper investigates the application of classification and clustering algorithms to fault detection and characterization. We show experimentally that naively applying these methods achieves poor accuracy. Further, we design novel techniques that combine classification algorithms with information on the abnormality of application behavior to improve detection and characterization accuracy. Our experiments demonstrate that these techniques can detect and characterize faults with 65% accuracy, compared to just 5% accuracy for naive approaches.« less

An evaluation of MPI message rate on hybrid-core processors

DOE PAGES

Barrett, Brian W.; Brightwell, Ron; Grant, Ryan; ...

2014-11-01

Power and energy concerns are motivating chip manufacturers to consider future hybrid-core processor designs that may combine a small number of traditional cores optimized for single-thread performance with a large number of simpler cores optimized for throughput performance. This trend is likely to impact the way in which compute resources for network protocol processing functions are allocated and managed. In particular, the performance of MPI match processing is critical to achieving high message throughput. In this paper, we analyze the ability of simple and more complex cores to perform MPI matching operations for various scenarios in order to gain insightmore » into how MPI implementations for future hybrid-core processors should be designed.« less

Job Superscheduler Architecture and Performance in Computational Grid Environments

NASA Technical Reports Server (NTRS)

Shan, Hongzhang; Oliker, Leonid; Biswas, Rupak

2003-01-01

Computational grids hold great promise in utilizing geographically separated heterogeneous resources to solve large-scale complex scientific problems. However, a number of major technical hurdles, including distributed resource management and effective job scheduling, stand in the way of realizing these gains. In this paper, we propose a novel grid superscheduler architecture and three distributed job migration algorithms. We also model the critical interaction between the superscheduler and autonomous local schedulers. Extensive performance comparisons with ideal, central, and local schemes using real workloads from leading computational centers are conducted in a simulation environment. Additionally, synthetic workloads are used to perform a detailed sensitivity analysis of our superscheduler. Several key metrics demonstrate that substantial performance gains can be achieved via smart superscheduling in distributed computational grids.

Invited review: Helping dairy farmers to improve economic performance utilizing data-driving decision support tools.

PubMed

Cabrera, V E

2018-01-01

The objective of this review paper is to describe the development and application of a suite of more than 40 computerized dairy farm decision support tools contained at the University of Wisconsin-Madison (UW) Dairy Management website http://DairyMGT.info. These data-driven decision support tools are aimed to help dairy farmers improve their decision-making, environmental stewardship and economic performance. Dairy farm systems are highly dynamic in which changing market conditions and prices, evolving policies and environmental restrictions together with every time more variable climate conditions determine performance. Dairy farm systems are also highly integrated with heavily interrelated components such as the dairy herd, soils, crops, weather and management. Under these premises, it is critical to evaluate a dairy farm following a dynamic integrated system approach. For this approach, it is crucial to use meaningful data records, which are every time more available. These data records should be used within decision support tools for optimal decision-making and economic performance. Decision support tools in the UW-Dairy Management website (http://DairyMGT.info) had been developed using combination and adaptation of multiple methods together with empirical techniques always with the primary goal for these tools to be: (1) highly user-friendly, (2) using the latest software and computer technologies, (3) farm and user specific, (4) grounded on the best scientific information available, (5) remaining relevant throughout time and (6) providing fast, concrete and simple answers to complex farmers' questions. DairyMGT.info is a translational innovative research website in various areas of dairy farm management that include nutrition, reproduction, calf and heifer management, replacement, price risk and environment. This paper discusses the development and application of 20 selected (http://DairyMGT.info) decision support tools.

Understanding the motivation and performance of community health volunteers involved in the delivery of health programmes in Kampala, Uganda: a realist evaluation

PubMed Central

Vareilles, Gaëlle; Marchal, Bruno; Kane, Sumit; Petrič, Taja; Pictet, Gabriel; Pommier, Jeanine

2015-01-01

Objectives This paper presents the results of a realist evaluation that aimed to understand how, why and under what circumstances a Red Cross (RC) capacity-building intervention influences the motivation and the performance of RC community health volunteers involved in the delivery of an immunisation programme in Kampala, Uganda. Method Given the complexity of the intervention, we adopted realist evaluation as our methodological approach and the case study as our study design. Data collection included document review, participant observation and interviews. The constant comparative method was used for the analysis. Two contrasted cases were selected within the five Kampala districts. Each case covers the management of the immunisation programme implemented at a RC branch. In each case, a programme manager and 15 RC volunteers were interviewed. The selection of the volunteers was purposive. Results We found that a capacity-building programme including supervision supportive of autonomy, skills and knowledge enhancement, and adapted to the different subgroups of volunteers, leads to satisfaction of the three key drivers of volunteer motivation: feelings of autonomy, competence and connectedness. This contributes to higher retention, and better task performance and well-being among the volunteers. Enabling contextual conditions include the responsiveness of the Uganda Red Cross Society (URCS) to community needs, and recognition of the work of the volunteers, from the URCS and the community. Conclusions A management approach that caters for the different motivational states and changing needs of the volunteers will lead to better performance. The findings will inform not only the management of community health volunteers, but also the management of all kinds of health workers. PMID:26525721

Videogame training strategy-induced change in brain function during a complex visuomotor task.

PubMed

Lee, Hyunkyu; Voss, Michelle W; Prakash, Ruchika Shaurya; Boot, Walter R; Vo, Loan T K; Basak, Chandramallika; Vanpatter, Matt; Gratton, Gabriele; Fabiani, Monica; Kramer, Arthur F

2012-07-01

Although changes in brain function induced by cognitive training have been examined, functional plasticity associated with specific training strategies is still relatively unexplored. In this study, we examined changes in brain function during a complex visuomotor task following training using the Space Fortress video game. To assess brain function, participants completed functional magnetic resonance imaging (fMRI) before and after 30 h of training with one of two training regimens: Hybrid Variable-Priority Training (HVT), with a focus on improving specific skills and managing task priority, or Full Emphasis Training (FET), in which participants simply practiced the game to obtain the highest overall score. Control participants received only 6 h of FET. Compared to FET, HVT learners reached higher performance on the game and showed less brain activation in areas related to visuo-spatial attention and goal-directed movement after training. Compared to the control group, HVT exhibited less brain activation in right dorsolateral prefrontal cortex (DLPFC), coupled with greater performance improvement. Region-of-interest analysis revealed that the reduction in brain activation was correlated with improved performance on the task. This study sheds light on the neurobiological mechanisms of improved learning from directed training (HVT) over non-directed training (FET), which is related to visuo-spatial attention and goal-directed motor planning, while separating the practice-based benefit, which is related to executive control and rule management. Copyright © 2012 Elsevier B.V. All rights reserved.

Efficacy of Noninvasive Stellate Ganglion Blockade Performed Using Physical Agent Modalities in Patients with Sympathetic Hyperactivity-Associated Disorders: A Systematic Review and Meta-Analysis

PubMed Central

Liao, Chun-De; Tsauo, Jau-Yih; Liou, Tsan-Hon

2016-01-01

Background Stellate ganglion blockade (SGB) is mainly used to relieve symptoms of neuropathic pain in conditions such as complex regional pain syndrome and has several potential complications. Noninvasive SGB performed using physical agent modalities (PAMs), such as light irradiation and electrical stimulation, can be clinically used as an alternative to conventional invasive SGB. However, its application protocols vary and its clinical efficacy remains controversial. This study investigated the use of noninvasive SGB for managing neuropathic pain or other disorders associated with sympathetic hyperactivity. Materials and Methods We performed a comprehensive search of the following online databases: Medline, PubMed, Excerpta Medica Database, Cochrane Library Database, Ovid MEDLINE, Europe PubMed Central, EBSCOhost Research Databases, CINAHL, ProQuest Research Library, Physiotherapy Evidence Database, WorldWideScience, BIOSIS, and Google Scholar. We identified and included quasi-randomized or randomized controlled trials reporting the efficacy of SGB performed using therapeutic ultrasound, transcutaneous electrical nerve stimulation, light irradiation using low-level laser therapy, or xenon light or linearly polarized near-infrared light irradiation near or over the stellate ganglion region in treating complex regional pain syndrome or disorders requiring sympatholytic management. The included articles were subjected to a meta-analysis and risk of bias assessment. Results Nine randomized and four quasi-randomized controlled trials were included. Eleven trials had good methodological quality with a Physiotherapy Evidence Database (PEDro) score of ≥6, whereas the remaining two trials had a PEDro score of <6. The meta-analysis results revealed that the efficacy of noninvasive SGB on 100-mm visual analog pain score is higher than that of a placebo or active control (weighted mean difference, −21.59 mm; 95% CI, −34.25, −8.94; p = 0.0008). Conclusions Noninvasive SGB performed using PAMs effectively relieves pain of various etiologies, making it a valuable addition to the contemporary pain management armamentarium. However, this evidence is limited by the potential risk of bias. PMID:27911934

Exploring HRD in two Welsh NHS Trusts: analysing the discursive resources used by senior managers.

PubMed

Sambrook, Sally

2007-01-01

The purpose of this paper is to examine human resource development (HRD) in the UK National Health Service (NHS), and particularly in two Welsh NHS Trusts, to help illuminate the various ways in which learning, training and development are talked about. The NHS is a complex organisation, not least with its recent devolution and separation into the four distinct countries of the UK. Within this, there are multiple and often conflicting approaches to human resource development associated with the various forms of employee, professional (nursing, medical etc.), managerial and organisational development. How people are developed is crucial to developing a modern health service, and yet, with the diverse range of health workers, HRD is a complex process, and one which receives little attention. Managers have a key role and their perceptions of HRD can be analysed through the discursive resources they employ. From an interpretivist stance, the paper employs semi-structured interviews with seven Directorate-General Managers, and adopts discourse analysis to explore how HRD is talked about in two Welsh NHS Trusts. The paper finds some of the different discourses used by different managers, including those with a nursing background and those without. It examines how they talk about HRD, and also explores their own (management) development and the impact this has had on their sense of identity. The paper highlights some of the tensions associated with HRD in the NHS, including ambiguities between professional and managerial development, the functional and physical fragmentation of HRD, conflict between a focus on performance/service delivery and the need to learn, discursive dissonance between the use of the terms training and learning, a delicate balance between "going on courses" and informal, work-related learning, inequities regarding "protected time" and discourses shifting between competition and cooperation. These tensions are exposed to help develop a shared understanding of the complexities of HRD within the NHS. The paper concludes with a summary of the different discursive resources employed by senior managers to articulate and accomplish HRD. These are "surfaced" to enable managers and HRD practitioners, amongst others, to construct common repertoires and shared meaning.

Complexity Theory, School Leadership and Management: Questions for Theory and Practice

ERIC Educational Resources Information Center

Morrison, Keith

2010-01-01

Complexity theory (CT) has had a meteoric rise in management literature and the social sciences. Its fledgling importation into school leadership and management raises several questions and concerns. This article takes one view of CT and argues that, though its key elements have much to offer school leadership and management, caution has to be…

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

NASA Astrophysics Data System (ADS)

Wang, Ling; Lin, Li

2004-02-01

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

Simplifying the complexity surrounding ICU work processes--identifying the scope for information management in ICU settings.

PubMed

Munir, Samina K; Kay, Stephen

2005-08-01

A multi-site study, conducted in two English and two Danish intensive care units, investigates the complexity of work processes in intensive care, and the implications of this complexity for information management with regards to clinical information systems. Data were collected via observations, shadowing of clinical staff, interviews and questionnaires. The construction of role activity diagrams enabled the capture of critical care work processes. Upon analysing these diagrams, it was found that intensive care work processes consist of 'simplified-complexity', these processes are changed with the introduction of information systems for the everyday use and management of all clinical information. The prevailing notion of complexity surrounding critical care clinical work processes was refuted and found to be misleading; in reality, it is not the work processes that cause the complexity, the complexity is rooted in the way in which clinical information is used and managed. This study emphasises that the potential for clinical information systems that consider integrating all clinical information requirements is not only immense but also very plausible.

Pilot workload, performance and aircraft control automation

NASA Technical Reports Server (NTRS)

Hart, S. G.; Sheridan, T. B.

1984-01-01

Conceptual and practical issues associated with the design, operation, and performance of advanced systems and the impact of such systems on the human operators are reviewed. The development of highly automated systems is driven by the availability of new technology and the requirement that operators safely and economically perform more and more activities in increasingly difficult and hostile environments. It is noted that the operators workload may become a major area of concern in future design considerations. Little research was done to determine how automation and workload relate to each other, although it is assumed that the abstract, supervisory, or management roles that are performed by operators of highly automated systems will impose increased mental workload. The relationship between performance and workload is discussed in relation to highly complex and automated environments.

Integrated Risk Management Within NASA Programs/Projects

NASA Technical Reports Server (NTRS)

Connley, Warren; Rad, Adrian; Botzum, Stephen

2004-01-01

As NASA Project Risk Management activities continue to evolve, the need to successfully integrate risk management processes across the life cycle, between functional disciplines, stakeholders, various management policies, and within cost, schedule and performance requirements/constraints become more evident and important. Today's programs and projects are complex undertakings that include a myriad of processes, tools, techniques, management arrangements and other variables all of which must function together in order to achieve mission success. The perception and impact of risk may vary significantly among stakeholders and may influence decisions that may have unintended consequences on the project during a future phase of the life cycle. In these cases, risks may be unintentionally and/or arbitrarily transferred to others without the benefit of a comprehensive systemic risk assessment. Integrating risk across people, processes, and project requirements/constraints serves to enhance decisions, strengthen communication pathways, and reinforce the ability of the project team to identify and manage risks across the broad spectrum of project management responsibilities. The ability to identify risks in all areas of project management increases the likelihood a project will identify significant issues before they become problems and allows projects to make effective and efficient use of shrinking resources. By getting a total team integrated risk effort, applying a disciplined and rigorous process, along with understanding project requirements/constraints provides the opportunity for more effective risk management. Applying an integrated approach to risk management makes it possible to do a better job at balancing safety, cost, schedule, operational performance and other elements of risk. This paper will examine how people, processes, and project requirements/constraints can be integrated across the project lifecycle for better risk management and ultimately improve the chances for mission success.

Multi-agent systems: effective approach for cancer care information management.

PubMed

Mohammadzadeh, Niloofar; Safdari, Reza; Rahimi, Azin

2013-01-01

Physicians, in order to study the causes of cancer, detect cancer earlier, prevent or determine the effectiveness of treatment, and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive, and timely cancer data. The cancer care environment has become more complex because of the need for coordination and communication among health care professionals with different skills in a variety of roles and the existence of large amounts of data with various formats. The goals of health care systems in such a complex environment are correct health data management, providing appropriate information needs of users to enhance the integrity and quality of health care, timely access to accurate information and reducing medical errors. These roles in new systems with use of agents efficiently perform well. Because of the potential capability of agent systems to solve complex and dynamic health problems, health care system, in order to gain full advantage of E- health, steps must be taken to make use of this technology. Multi-agent systems have effective roles in health service quality improvement especially in telemedicine, emergency situations and management of chronic diseases such as cancer. In the design and implementation of agent based systems, planning items such as information confidentiality and privacy, architecture, communication standards, ethical and legal aspects, identification opportunities and barriers should be considered. It should be noted that usage of agent systems only with a technical view is associated with many problems such as lack of user acceptance. The aim of this commentary is to survey applications, opportunities and barriers of this new artificial intelligence tool for cancer care information as an approach to improve cancer care management.

Using intervention mapping to develop a theory-driven, group-based complex intervention to support self-management of osteoarthritis and low back pain (SOLAS).

PubMed

Hurley, Deirdre A; Murphy, Laura Currie; Hayes, David; Hall, Amanda M; Toomey, Elaine; McDonough, Suzanne M; Lonsdale, Chris; Walsh, Nicola E; Guerin, Suzanne; Matthews, James

2016-04-26

The Medical Research Council framework provides a useful general approach to designing and evaluating complex interventions, but does not provide detailed guidance on how to do this and there is little evidence of how this framework is applied in practice. This study describes the use of intervention mapping (IM) in the design of a theory-driven, group-based complex intervention to support self-management (SM) of patients with osteoarthritis (OA) and chronic low back pain (CLBP) in Ireland's primary care health system. The six steps of the IM protocol were systematically applied to develop the self-management of osteoarthritis and low back pain through activity and skills (SOLAS) intervention through adaptation of the Facilitating Activity and Self-management in Arthritis (FASA) intervention. A needs assessment including literature reviews, interviews with patients and physiotherapists and resource evaluation was completed to identify the programme goals, determinants of SM behaviour, consolidated definition of SM and required adaptations to FASA to meet health service and patient needs and the evidence. The resultant SOLAS intervention behavioural outcomes, performance and change objectives were specified and practical application methods selected, followed by organised programme, adoption, implementation and evaluation plans underpinned by behaviour change theory. The SOLAS intervention consists of six weekly sessions of 90-min education and exercise designed to increase participants' physical activity level and use of evidence-based SM strategies (i.e. pain self-management, pain coping, healthy eating for weight management and specific exercise) through targeting of individual determinants of SM behaviour (knowledge, skills, self-efficacy, fear, catastrophizing, motivation, behavioural regulation), delivered by a trained physiotherapist to groups of up to eight individuals using a needs supportive interpersonal style based on self-determination theory. Strategies to support SOLAS intervention adoption and implementation included a consensus building workshop with physiotherapy stakeholders, development of a physiotherapist training programme and a pilot trial with physiotherapist and patient feedback. The SOLAS intervention is currently being evaluated in a cluster randomised controlled feasibility trial. IM is a time-intensive collaborative process, but the range of methods and resultant high level of transparency is invaluable and allows replication by future complex intervention and trial developers.

Managing Science: Management for R&D Laboratories

NASA Astrophysics Data System (ADS)

Gelès, Claude; Lindecker, Gilles; Month, Mel; Roche, Christian

1999-10-01

A unique "how-to" manual for the management of scientific laboratories This book presents a complete set of tools for the management of research and development laboratories and projects. With an emphasis on knowledge rather than profit as a measure of output and performance, the authors apply standard management principles and techniques to the needs of high-flux, open-ended, separately funded science and technology enterprises. They also propose the novel idea that failure, and incipient failure, is an important measure of an organization's potential. From the management of complex, round-the-clock, high-tech operations to strategies for long-term planning, Managing Science: Management for R&D Laboratories discusses how to build projects with the proper research and development, obtain and account for funding, and deal with rapidly changing technologies, facilities, and trends. The entire second part of the book is devoted to personnel issues and the impact of workplace behavior on the various functions of a knowledge-based organization. Drawing on four decades of involvement with the management of scientific laboratories, the authors thoroughly illustrate their philosophy with real-world examples from the physics field and provide tables and charts. Managers of scientific laboratories as well as scientists and engineers expecting to move into management will find Managing Science: Management for R&D Laboratories an invaluable practical guide.

A realist evaluation of the management of a well- performing regional hospital in Ghana

PubMed Central

2010-01-01

Background Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. Methods We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. Results We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. Conclusion This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers. PMID:20100330

A realist evaluation of the management of a well-performing regional hospital in Ghana.

PubMed

Marchal, Bruno; Dedzo, McDamien; Kegels, Guy

2010-01-25

Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers.

Performance optimisations for distributed analysis in ALICE

NASA Astrophysics Data System (ADS)

Betev, L.; Gheata, A.; Gheata, M.; Grigoras, C.; Hristov, P.

2014-06-01

Performance is a critical issue in a production system accommodating hundreds of analysis users. Compared to a local session, distributed analysis is exposed to services and network latencies, remote data access and heterogeneous computing infrastructure, creating a more complex performance and efficiency optimization matrix. During the last 2 years, ALICE analysis shifted from a fast development phase to the more mature and stable code. At the same time, the frameworks and tools for deployment, monitoring and management of large productions have evolved considerably too. The ALICE Grid production system is currently used by a fair share of organized and individual user analysis, consuming up to 30% or the available resources and ranging from fully I/O-bound analysis code to CPU intensive correlations or resonances studies. While the intrinsic analysis performance is unlikely to improve by a large factor during the LHC long shutdown (LS1), the overall efficiency of the system has still to be improved by an important factor to satisfy the analysis needs. We have instrumented all analysis jobs with "sensors" collecting comprehensive monitoring information on the job running conditions and performance in order to identify bottlenecks in the data processing flow. This data are collected by the MonALISa-based ALICE Grid monitoring system and are used to steer and improve the job submission and management policy, to identify operational problems in real time and to perform automatic corrective actions. In parallel with an upgrade of our production system we are aiming for low level improvements related to data format, data management and merging of results to allow for a better performing ALICE analysis.

Trajectory-Oriented Approach to Managing Traffic Complexity: Operational Concept and Preliminary Metrics Definition

NASA Technical Reports Server (NTRS)

Idris, Husni; Vivona, Robert; Garcia-Chico, Jose L.

2008-01-01

This document describes preliminary research on a distributed, trajectory-oriented approach for traffic complexity management. The approach is to manage traffic complexity in a distributed control environment, based on preserving trajectory flexibility and minimizing constraints. In particular, the document presents an analytical framework to study trajectory flexibility and the impact of trajectory constraints on it. The document proposes preliminary flexibility metrics that can be interpreted and measured within the framework.

Trends in data locality abstractions for HPC systems

DOE PAGES

Unat, Didem; Dubey, Anshu; Hoefler, Torsten; ...

2017-05-10

The cost of data movement has always been an important concern in high performance computing (HPC) systems. It has now become the dominant factor in terms of both energy consumption and performance. Support for expression of data locality has been explored in the past, but those efforts have had only modest success in being adopted in HPC applications for various reasons. However, with the increasing complexity of the memory hierarchy and higher parallelism in emerging HPC systems, locality management has acquired a new urgency. Developers can no longer limit themselves to low-level solutions and ignore the potential for productivity andmore » performance portability obtained by using locality abstractions. Fortunately, the trend emerging in recent literature on the topic alleviates many of the concerns that got in the way of their adoption by application developers. Data locality abstractions are available in the forms of libraries, data structures, languages and runtime systems; a common theme is increasing productivity without sacrificing performance. Furthermore, this paper examines these trends and identifies commonalities that can combine various locality concepts to develop a comprehensive approach to expressing and managing data locality on future large-scale high-performance computing systems.« less

Treatment for residual stones using flexible ureteroscopy and holmium laser lithotripsy after the management of complex calculi with single-tract percutaneous nephrolithotomy.

PubMed

Chen, L; Sha, M-L; Li, D; Zhuo, J; Jiang, C-Y; Zhu, Y-P; Xia, S-J; Lu, J; Shao, Y

2017-04-01

This study validated the effectiveness and safety of the treatment for residual stones using flexible ureteroscopy (fURS) and holmium laser (0.6-1.2 J, 20-30 Hz) lithotripsy via a fiber with a 200-μm core diameter and 0.22 numerical aperture (NA) after the management of complex calculi with single-tract percutaneous nephrolithotomy (PCNL). Between January 2014 and June 2016, 27 consecutive patients with complex calculi underwent fURS and holmium laser lithotripsy after a planned single-tract PCNL. Among the 27 patients with complex calculi, 9 had full staghorn calculi, 7 had partial staghorn calculi, and 11 had multiple calculi. After the first single-tract PCNL session, the mean stone size and mean stone surface area were 18.0 ± 10.7 mm and 181.9 ± 172.2 mm 2 , respectively. Treatment for residual stones with fURS and holmium laser lithotripsy was successfully completed and was performed without intraoperative complications. The mean operative time of the fURS procedure was 69.1 ± 23.6 min, and the mean hospital stay was 5.3 ± 2.4 days. The mean decrease in the hemoglobin level was 7.3 ± 6.5 g/l. After the fURS procedure, the overall stone-free rate was 88.9%. The overall postoperative complication rate was 14.8% (Clavien grade I 11.1%; Clavien grade II 3.7%). The current approach tested here combines the advantages of both PCNL and fURS and effectively manages complex calculi with a high stone-free rate (SFR) (88.9%). This approach also reduced the number of treatment sessions, the number of percutaneous access tracts, and the blood loss and potential morbidity associated with multiple tracts.

Socio-ecological dynamics and challenges to the governance of Neglected Tropical Disease control.

PubMed

Michael, Edwin; Madon, Shirin

2017-02-06

The current global attempts to control the so-called "Neglected Tropical Diseases (NTDs)" have the potential to significantly reduce the morbidity suffered by some of the world's poorest communities. However, the governance of these control programmes is driven by a managerial rationality that assumes predictability of proposed interventions, and which thus primarily seeks to improve the cost-effectiveness of implementation by measuring performance in terms of pre-determined outputs. Here, we argue that this approach has reinforced the narrow normal-science model for controlling parasitic diseases, and in doing so fails to address the complex dynamics, uncertainty and socio-ecological context-specificity that invariably underlie parasite transmission. We suggest that a new governance approach is required that draws on a combination of non-equilibrium thinking about the operation of complex, adaptive, systems from the natural sciences and constructivist social science perspectives that view the accumulation of scientific knowledge as contingent on historical interests and norms, if more effective control approaches sufficiently sensitive to local disease contexts are to be devised, applied and managed. At the core of this approach is an emphasis on the need for a process that assists with the inclusion of diverse perspectives, social learning and deliberation, and a reflexive approach to addressing system complexity and incertitude, while balancing this flexibility with stability-focused structures. We derive and discuss a possible governance framework and outline an organizational structure that could be used to effectively deal with the complexity of accomplishing global NTD control. We also point to examples of complexity-based management structures that have been used in parasite control previously, which could serve as practical templates for developing similar governance structures to better manage global NTD control. Our results hold important wider implications for global health policy aiming to effectively control and eradicate parasitic diseases across the world.

Atrial flutter after surgical maze: incidence, diagnosis, and management.

PubMed

Dresen, William; Mason, Pamela K

2016-01-01

The prevalence of atrial fibrillation is increasing and surgical ablation is becoming more common, both as a stand-alone procedure and when performed concomitantly with other cardiac surgery. Although surgical ablation is effective, with it unique challenges arise, including iatrogenic macroreentrant tachycardias that are often highly symptomatic and difficult to manage conservatively. Postsurgical ablation, localization of the arrhythmic circuit is difficult to determine using surface ECG alone because of alterations in the atrial myocardium, and multiple different pathways are often present. Most, however, localize to the left atrium, and percutaneous catheter ablation is emerging as an effective treatment modality. Patients with complex postoperative arrhythmias should be referred to a dedicated atrial fibrillation center when possible and symptomatic arrhythmias mapped and ablated. Knowledge of the previously performed surgical lesion set is of vital importance in understanding the mechanism of the arrhythmia and increasing procedural success rates. http://links.lww.com/HCO/A31.

Development of an estuarine assessment scheme for the management of a highly urbanised catchment/estuary system, Sydney estuary, Australia.

PubMed

Birch, G F; Gunns, T J; Chapman, D; Harrison, D

2016-05-01

As coastal populations increase, considerable pressures are exerted on estuarine environments. Recently, there has been a trend towards the development and use of estuarine assessment schemes as a decision support tool in the management of these environments. These schemes offer a method by which complex environmental data is converted into a readily understandable and communicable format for informed decision making and effective distribution of limited management resources. Reliability and effectiveness of these schemes are often limited due to a complex assessment framework, poor data management and use of ineffective environmental indicators. The current scheme aims to improve reliability in the reporting of estuarine condition by including a concise assessment framework, employing high-value indicators and, in a unique approach, employing fuzzy logic in indicator evaluation. Using Sydney estuary as a case study, each of the 15 sub-catchment/sub-estuary systems were assessed using the current scheme. Results identified that poor sediment quality was a significant issue in Blackwattle/Rozelle Bay, Iron Cove and Hen and Chicken Bay while poor water quality was of particular concern in Duck River, Homebush Bay and the Parramatta River. Overall results of the assessment scheme were used to prioritise the management of each sub-catchment/sub-estuary assessed with Blackwattle/Rozelle Bay, Homebush Bay, Iron Cove and Duck River considered to be in need of a high priority management response. A report card format, using letter grades, was employed to convey the results of the assessment in a readily understood manner to estuarine managers and members of the public. Letter grades also provide benchmarking and performance monitoring ability, allowing estuarine managers to set improvement targets and assesses the effectiveness of management strategies. The current assessment scheme provides an effective, integrated and consistent assessment of estuarine health and provides an effective decision support tool to maximise the efficient distribution of limited management resources.

Hierarchical Control Using Networks Trained with Higher-Level Forward Models

PubMed Central

Wayne, Greg; Abbott, L.F.

2015-01-01

We propose and develop a hierarchical approach to network control of complex tasks. In this approach, a low-level controller directs the activity of a “plant,” the system that performs the task. However, the low-level controller may only be able to solve fairly simple problems involving the plant. To accomplish more complex tasks, we introduce a higher-level controller that controls the lower-level controller. We use this system to direct an articulated truck to a specified location through an environment filled with static or moving obstacles. The final system consists of networks that have memorized associations between the sensory data they receive and the commands they issue. These networks are trained on a set of optimal associations that are generated by minimizing cost functions. Cost function minimization requires predicting the consequences of sequences of commands, which is achieved by constructing forward models, including a model of the lower-level controller. The forward models and cost minimization are only used during training, allowing the trained networks to respond rapidly. In general, the hierarchical approach can be extended to larger numbers of levels, dividing complex tasks into more manageable sub-tasks. The optimization procedure and the construction of the forward models and controllers can be performed in similar ways at each level of the hierarchy, which allows the system to be modified to perform other tasks, or to be extended for more complex tasks without retraining lower-levels. PMID:25058706

A Generic Framework of Performance Measurement in Networked Enterprises

NASA Astrophysics Data System (ADS)

Kim, Duk-Hyun; Kim, Cheolhan

Performance measurement (PM) is essential for managing networked enterprises (NEs) because it greatly affects the effectiveness of collaboration among members of NE.PM in NE requires somewhat different approaches from PM in a single enterprise because of heterogeneity, dynamism, and complexity of NE’s. This paper introduces a generic framework of PM in NE (we call it NEPM) based on the Balanced Scorecard (BSC) approach. In NEPM key performance indicators and cause-and-effect relationships among them are defined in a generic strategy map. NEPM could be applied to various types of NEs after specializing KPIs and relationships among them. Effectiveness of NEPM is shown through a case study of some Korean NEs.

Using the balanced scorecard to align strategy and performance in long-term care.

PubMed

Macdonald, M

1998-01-01

The Sisters of Charity of Ottawa Health Service (SCOHS) is a Canadian health care corporation that has adapted Kaplan and Norton's balanced scorecard to enhance strategic management and measurement in a multisite health care facility comprising long term care, continuing complex care, rehabilitative services, palliative care and ambulatory care. This article discusses how the SCOHS has incorporated the following principles into the balanced scorecard: demonstration of cause and effect; inclusion of outcomes and performance drivers; linkage to fiscal and utilization indicators; and integration of the mission and values of the organization. Examples of corporate level outcomes and performance measures are provided in the form of lead and lag indicators.

Identifying behaviour patterns of construction safety using system archetypes.

PubMed

Guo, Brian H W; Yiu, Tak Wing; González, Vicente A

2015-07-01

Construction safety management involves complex issues (e.g., different trades, multi-organizational project structure, constantly changing work environment, and transient workforce). Systems thinking is widely considered as an effective approach to understanding and managing the complexity. This paper aims to better understand dynamic complexity of construction safety management by exploring archetypes of construction safety. To achieve this, this paper adopted the ground theory method (GTM) and 22 interviews were conducted with participants in various positions (government safety inspector, client, health and safety manager, safety consultant, safety auditor, and safety researcher). Eight archetypes were emerged from the collected data: (1) safety regulations, (2) incentive programs, (3) procurement and safety, (4) safety management in small businesses (5) production and safety, (6) workers' conflicting goals, (7) blame on workers, and (8) reactive and proactive learning. These archetypes capture the interactions between a wide range of factors within various hierarchical levels and subsystems. As a free-standing tool, they advance the understanding of dynamic complexity of construction safety management and provide systemic insights into dealing with the complexity. They also can facilitate system dynamics modelling of construction safety process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Modeling and Performance Considerations for Automated Fault Isolation in Complex Systems

NASA Technical Reports Server (NTRS)

Ferrell, Bob; Oostdyk, Rebecca

2010-01-01

The purpose of this paper is to document the modeling considerations and performance metrics that were examined in the development of a large-scale Fault Detection, Isolation and Recovery (FDIR) system. The FDIR system is envisioned to perform health management functions for both a launch vehicle and the ground systems that support the vehicle during checkout and launch countdown by using suite of complimentary software tools that alert operators to anomalies and failures in real-time. The FDIR team members developed a set of operational requirements for the models that would be used for fault isolation and worked closely with the vendor of the software tools selected for fault isolation to ensure that the software was able to meet the requirements. Once the requirements were established, example models of sufficient complexity were used to test the performance of the software. The results of the performance testing demonstrated the need for enhancements to the software in order to meet the demands of the full-scale ground and vehicle FDIR system. The paper highlights the importance of the development of operational requirements and preliminary performance testing as a strategy for identifying deficiencies in highly scalable systems and rectifying those deficiencies before they imperil the success of the project

Crew workload strategies in advanced cockpits

NASA Technical Reports Server (NTRS)

Hart, Sandra G.

1990-01-01

Many methods of measuring and predicting operator workload have been developed that provide useful information in the design, evaluation, and operation of complex systems and which aid in developing models of human attention and performance. However, the relationships between such measures, imposed task demands, and measures of performance remain complex and even contradictory. It appears that we have ignored an important factor: people do not passively translate task demands into performance. Rather, they actively manage their time, resources, and effort to achieve an acceptable level of performance while maintaining a comfortable level of workload. While such adaptive, creative, and strategic behaviors are the primary reason that human operators remain an essential component of all advanced man-machine systems, they also result in individual differences in the way people respond to the same task demands and inconsistent relationships among measures. Finally, we are able to measure workload and performance, but interpreting such measures remains difficult; it is still not clear how much workload is too much or too little nor the consequences of suboptimal workload on system performance and the mental, physical, and emotional well-being of the human operators. The rationale and philosophy of a program of research developed to address these issues will be reviewed and contrasted to traditional methods of defining, measuring, and predicting human operator workload. Viewgraphs are given.

Monti's procedure as an alternative technique in complex urethral distraction defect.

PubMed

Hosseini, Jalil; Kaviani, Ali; Mazloomfard, Mohammad M; Golshan, Ali R

2010-01-01

Pelvic fracture urethral distraction defect is usually managed by the end to end anastomotic urethroplasty. Surgical repair of those patients with post-traumatic complex posterior urethral defects, who have undergone failed previous surgical treatments, remains one of the most challenging problems in urology. Appendix urinary diversion could be used in such cases. However, the appendix tissue is not always usable. We report our experience on management of patients with long urethral defect with history of one or more failed urethroplasties by Monti channel urinary diversion. From 2001 to 2007, we evaluated data from 8 male patients aged 28 to 76 years (mean age 42.5) in whom the Monti technique was performed. All cases had history of posterior urethral defect with one or more failed procedures for urethral reconstruction including urethroplasty. A 2 to 2.5 cm segment of ileum, which had a suitable blood supply, was cut. After the re-anastomosis of the ileum, we closed the opened ileum transversely surrounding a 14-16 Fr urethral catheter using running Vicryl sutures. The newly built tube was used as an appendix during diversion. All patients performed catheterization through the conduit without difficulty and stomal stenosis. Mild stomal incontinence occurred in one patient in the supine position who became continent after adjustment of the catheterization intervals. There was no dehiscence, necrosis or perforation of the tube. Based on our data, Monti's procedure seems to be a valuable technique in patients with very long complicated urethral defect who cannot be managed with routine urethroplastic techniques.

Habitat complexity influences fine scale hydrological processes and the incidence of stormwater runoff in managed urban ecosystems.

PubMed

Ossola, Alessandro; Hahs, Amy Kristin; Livesley, Stephen John

2015-08-15

Urban ecosystems have traditionally been considered to be pervious features of our cities. Their hydrological properties have largely been investigated at the landscape scale and in comparison with other urban land use types. However, hydrological properties can vary at smaller scales depending upon changes in soil, surface litter and vegetation components. Management practices can directly and indirectly affect each of these components and the overall habitat complexity, ultimately affecting hydrological processes. This study aims to investigate the influence that habitat components and habitat complexity have upon key hydrological processes and the implications for urban habitat management. Using a network of urban parks and remnant nature reserves in Melbourne, Australia, replicate plots representing three types of habitat complexity were established: low-complexity parks, high-complexity parks, and high-complexity remnants. Saturated soil hydraulic conductivity in low-complexity parks was an order of magnitude lower than that measured in the more complex habitat types, due to fewer soil macropores. Conversely, soil water holding capacity in low-complexity parks was significantly higher compared to the two more complex habitat types. Low-complexity parks would generate runoff during modest precipitation events, whereas high-complexity parks and remnants would be able to absorb the vast majority of rainfall events without generating runoff. Litter layers on the soil surface would absorb most of precipitation events in high-complexity parks and high-complexity remnants. To minimize the incidence of stormwater runoff from urban ecosystems, land managers could incrementally increase the complexity of habitat patches, by increasing canopy density and volume, preserving surface litter and maintaining soil macropore structure. Copyright © 2015 Elsevier Ltd. All rights reserved.

Integrated nanomaterials for extreme thermal management: a perspective for aerospace applications

NASA Astrophysics Data System (ADS)

Barako, Michael T.; Gambin, Vincent; Tice, Jesse

2018-04-01

Nanomaterials will play a disruptive role in next-generation thermal management for high power electronics in aerospace platforms. These high power and high frequency devices have been experiencing a paradigm shift toward designs that favor extreme integration and compaction. The reduction in form factor amplifies the intensity of the thermal loads and imposes extreme requirements on the thermal management architecture for reliable operation. In this perspective, we introduce the opportunities and challenges enabled by rationally integrating nanomaterials along the entire thermal resistance chain, beginning at the high heat flux source up to the system-level heat rejection. Using gallium nitride radio frequency devices as a case study, we employ a combination of viewpoints comprised of original research, academic literature, and industry adoption of emerging nanotechnologies being used to construct advanced thermal management architectures. We consider the benefits and challenges for nanomaterials along the entire thermal pathway from synthetic diamond and on-chip microfluidics at the heat source to vertically-aligned copper nanowires and nanoporous media along the heat rejection pathway. We then propose a vision for a materials-by-design approach to the rational engineering of complex nanostructures to achieve tunable property combinations on demand. These strategies offer a snapshot of the opportunities enabled by the rational design of nanomaterials to mitigate thermal constraints and approach the limits of performance in complex aerospace electronics.

Integrated nanomaterials for extreme thermal management: a perspective for aerospace applications.

PubMed

Barako, Michael T; Gambin, Vincent; Tice, Jesse

2018-04-02

Nanomaterials will play a disruptive role in next-generation thermal management for high power electronics in aerospace platforms. These high power and high frequency devices have been experiencing a paradigm shift toward designs that favor extreme integration and compaction. The reduction in form factor amplifies the intensity of the thermal loads and imposes extreme requirements on the thermal management architecture for reliable operation. In this perspective, we introduce the opportunities and challenges enabled by rationally integrating nanomaterials along the entire thermal resistance chain, beginning at the high heat flux source up to the system-level heat rejection. Using gallium nitride radio frequency devices as a case study, we employ a combination of viewpoints comprised of original research, academic literature, and industry adoption of emerging nanotechnologies being used to construct advanced thermal management architectures. We consider the benefits and challenges for nanomaterials along the entire thermal pathway from synthetic diamond and on-chip microfluidics at the heat source to vertically-aligned copper nanowires and nanoporous media along the heat rejection pathway. We then propose a vision for a materials-by-design approach to the rational engineering of complex nanostructures to achieve tunable property combinations on demand. These strategies offer a snapshot of the opportunities enabled by the rational design of nanomaterials to mitigate thermal constraints and approach the limits of performance in complex aerospace electronics.

Anaesthetic management of breast surgery in a patient with Eisenmenger syndrome.

PubMed

Galán Gutiérrez, J C; Fernández Suárez, F E; Miranda García, P; Sopena Zubiria, L A

2017-01-01

Eisenmenger syndrome (ES) is a complex combination of cardiovascular abnormalities defined as pulmonary hypertension with investment or bidirectional flow through an intracardiac or aortopulmonary communication, usually secondary to a congenital heart disease not resolved promptly. It carries a significant risk of perioperative mortality, with an incidence close to 30% for non-cardiac surgery. We report the anaesthetic management in a ES patient undergoing breast surgery, which was successfully performed under general anaesthesia combined with thoracic analgesic blocks. The main pathophysiological implications of this syndrome are discussed, emphasizing the importance of appropriate preoperative evaluation with thorough assessment of associated risks, careful intraoperative management, and postoperative care, which should be initially performed in a critical care unit. The need to individualize and tailor the choice of drugs and anesthetic technique to the hemodynamic condition of the patient and the surgical procedure is highlighted. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Development of Innovative Business Model of Modern Manager's Qualities

ERIC Educational Resources Information Center

Yashkova, Elena V.; Sineva, Nadezda L.; Shkunova, Angelika A.; Bystrova, Natalia V.; Smirnova, Zhanna V.; Kolosova, Tatyana V.

2016-01-01

The paper defines a complex of manager's qualities based on theoretical and methodological analysis and synthesis methods, available national and world literature, research papers and publications. The complex approach methodology was used, which provides an innovative view of the development of modern manager's qualities. The methodological…

Policy experimentation and innovation as a response to complexity in China's management of health reforms.

PubMed

Husain, Lewis

2017-08-03

There are increasing criticisms of dominant models for scaling up health systems in developing countries and a recognition that approaches are needed that better take into account the complexity of health interventions. Since Reform and Opening in the late 1970s, Chinese government has managed complex, rapid and intersecting reforms across many policy areas. As with reforms in other policy areas, reform of the health system has been through a process of trial and error. There is increasing understanding of the importance of policy experimentation and innovation in many of China's reforms; this article argues that these processes have been important in rebuilding China's health system. While China's current system still has many problems, progress is being made in developing a functioning system able to ensure broad population access. The article analyses Chinese thinking on policy experimentation and innovation and their use in management of complex reforms. It argues that China's management of reform allows space for policy tailoring and innovation by sub-national governments under a broad agreement over the ends of reform, and that shared understandings of policy innovation, alongside informational infrastructures for the systemic propagation and codification of useful practices, provide a framework for managing change in complex environments and under conditions of uncertainty in which 'what works' is not knowable in advance. The article situates China's use of experimentation and innovation in management of health system reform in relation to recent literature which applies complex systems thinking to global health, and concludes that there are lessons to be learnt from China's approaches to managing complexity in development of health systems for the benefit of the poor.

Fuzzy Entropy Method for Quantifying Supply Chain Networks Complexity

NASA Astrophysics Data System (ADS)

Zhang, Jihui; Xu, Junqin

Supply chain is a special kind of complex network. Its complexity and uncertainty makes it very difficult to control and manage. Supply chains are faced with a rising complexity of products, structures, and processes. Because of the strong link between a supply chain’s complexity and its efficiency the supply chain complexity management becomes a major challenge of today’s business management. The aim of this paper is to quantify the complexity and organization level of an industrial network working towards the development of a ‘Supply Chain Network Analysis’ (SCNA). By measuring flows of goods and interaction costs between different sectors of activity within the supply chain borders, a network of flows is built and successively investigated by network analysis. The result of this study shows that our approach can provide an interesting conceptual perspective in which the modern supply network can be framed, and that network analysis can handle these issues in practice.

Using multisensory cues to facilitate air traffic management.

PubMed

Ngo, Mary K; Pierce, Russell S; Spence, Charles

2012-12-01

In the present study, we sought to investigate whether auditory and tactile cuing could be used to facilitate a complex, real-world air traffic management scenario. Auditory and tactile cuing provides an effective means of improving both the speed and accuracy of participants' performance in a variety of laboratory-based visual target detection and identification tasks. A low-fidelity air traffic simulation task was used in which participants monitored and controlled aircraft.The participants had to ensure that the aircraft landed or exited at the correct altitude, speed, and direction and that they maintained a safe separation from all other aircraft and boundaries. The performance measures recorded included en route time, handoff delay, and conflict resolution delay (the performance measure of interest). In a baseline condition, the aircraft in conflict was highlighted in red (visual cue), and in the experimental conditions, this standard visual cue was accompanied by a simultaneously presented auditory, vibrotactile, or audiotactile cue. Participants responded significantly more rapidly, but no less accurately, to conflicts when presented with an additional auditory or audiotactile cue than with either a vibrotactile or visual cue alone. Auditory and audiotactile cues have the potential for improving operator performance by reducing the time it takes to detect and respond to potential visual target events. These results have important implications for the design and use of multisensory cues in air traffic management.

The History and Evolution of Internal Maxillary Artery Bypass.

PubMed

Wang, Long; Cai, Li; Lu, Shuaibin; Qian, Hai; Lawton, Michael T; Shi, Xiang'en

2018-05-01

Internal maxillary artery (IMA) bypass has gained momentum in the last 5 years for the treatment of complex cerebrovascular disorders and skull base tumors. However, some issues regarding this treatment modality have been proposed. As one of the most experienced neurosurgical teams to perform internal maxillary artery bypass in the world (>100 clinical cases), we reviewed the literature in aspects of basic anatomy of maxillary artery with its variations to the lateral pterygoid muscle, initial anastomosis modalities, and subsequent exposure techniques in cadaver studies, preoperative arterial evaluation methods, optimal interposed graft selections, and surgical outcome in the management of complex aneurysms, skull base tumors, and steno-occlusive disorders. Copyright © 2018 Elsevier Inc. All rights reserved.

Application of Complex Adaptive Systems in Portfolio Management

ERIC Educational Resources Information Center

Su, Zheyuan

2017-01-01

Simulation-based methods are becoming a promising research tool in financial markets. A general Complex Adaptive System can be tailored to different application scenarios. Based on the current research, we built two models that would benefit portfolio management by utilizing Complex Adaptive Systems (CAS) in Agent-based Modeling (ABM) approach.…

The Role of Mental Models in Dynamic Decision-Making

DTIC Science & Technology

2009-03-01

Humansystems® Incorporated 111 Farquhar St., Guelph, ON N1H 3N4 Project Manager : Lisa A. Rehak PWGSC Contract No.: W7711-078110/001/TOR Call...simulate the processes that people use to manage complex systems. These analogies, moreover, represent one way to help people to form more accurate...make complex decisions. Control theory’s primary emphasis is on the role of feedback while managing a complex system. What is common to all of these

Some thoughts on the management of large, complex international space ventures

NASA Technical Reports Server (NTRS)

Lee, T. J.; Kutzer, Ants; Schneider, W. C.

1992-01-01

Management issues relevant to the development and deployment of large international space ventures are discussed with particular attention given to previous experience. Management approaches utilized in the past are labeled as either simple or complex, and signs of efficient management are examined. Simple approaches include those in which experiments and subsystems are developed for integration into spacecraft, and the Apollo-Soyuz Test Project is given as an example of a simple multinational approach. Complex approaches include those for ESA's Spacelab Project and the Space Station Freedom in which functional interfaces cross agency and political boundaries. It is concluded that individual elements of space programs should be managed by individual participating agencies, and overall configuration control is coordinated by level with a program director acting to manage overall objectives and project interfaces.

Kaiser Permanente's performance improvement system, Part 4: Creating a learning organization.

PubMed

Schilling, Lisa; Dearing, James W; Staley, Paul; Harvey, Patti; Fahey, Linda; Kuruppu, Francesca

2011-12-01

In 2006, recognizing variations in performance in quality, safety, service, and efficiency, Kaiser Permanente leaders initiated the development of a performance improvement (PI) system. Kaiser Permanente has implemented a strategy for creating the systemic capacity for continuous improvement that characterizes a learning organization. Six "building blocks" were identified to enable Kaiser Permanente to make the transition to becoming a learning organization: real-time sharing of meaningful performance data; formal training in problem-solving methodology; workforce engagement and informal knowledge sharing; leadership structures, beliefs, and behaviors; internal and external benchmarking; and technical knowledge sharing. Putting each building block into place required multiple complex strategies combining top-down and bottom-up approaches. Although the strategies have largely been successful, challenges remain. The demand for real-time meaningful performance data can conflict with prioritized changes to health information systems. It is an ongoing challenge to teach PI, change management, innovation, and project management to all managers and staff without consuming too much training time. Challenges with workforce engagement include low initial use of tools intended to disseminate information through virtual social networking. Uptake of knowledge-sharing technologies is still primarily by innovators and early adopters. Leaders adopt new behaviors at varying speeds and have a range of abilities to foster an environment that is psychologically safe and stimulates inquiry. A learning organization has the capability to improve, and it develops structures and processes that facilitate the acquisition and sharing of knowledge.

Simplicity-minded management. A practical guide to stripping complexity out of your organization.

PubMed

Ashkenas, Ron

2007-12-01

Large organizations are by nature complex, but over the years new business challenges--globalization, innovative technologies, and regulations, to name a few--have conspired to add layer upon layer of complexity to corporate structure and management. Organizations have become increasingly ungovernable and unwieldy: Performance is declining, accountability is unclear, decision rights are muddy, and data are crunched repeatedly, often with no clear purpose in mind. To avoid frustration and inefficiency, executives need to systematically attack the causes of complexity in their companies. Ashkenas and his partners at Robert H. Schaffer & Associates have worked with dozens of firms to help them develop strategies for simplifying. In this article, the author details the elements of a simplicity-minded strategy: Streamline the structure; prune products, services, and features; build disciplined processes; and improve managerial habits. ConAgra Foods' experience illustrates how one company turned itself around through careful execution of a simplicity strategy. The packaged-food supplier had become enormously successful by acquiring well-known brands and then allowing them to operate autonomously, evolving into a $14 billion organization with more than 100 brands, a food services business, and a commodity trading operation. ConAgra, however, had no common method for reporting, tracking, or analyzing results. Over time, therefore, it became a highly unwieldy enterprise, riddled with inefficiencies and unable to communicate adequately with investors and other stakeholders. When CEO Gary Rodkin came on board, in 2005, he invested in a series of initiatives to combat complexity. The tactic not only made life easier for customers and employees but also saved millions of dollars in costs. This article has an online interactive questionnaire that can help you assess your own company's level of complexity.

Complex and open fractures: a straightforward approach to management in the cat.

PubMed

Corr, Sandra

2012-01-01

Cats often present with traumatic injuries of the limbs, including complex and open fractures, frequently as a result of road traffic accidents. On initial assessment, complex and open fractures may appear to require expertise beyond the experience of the general practitioner and, in some cases, referral to a specialist may be indicated or amputation should be considered. Many cases, however, can be managed using straightforward principles. This review describes a logical and practical approach to treating such injuries. It discusses general principles of fracture management, highlights the treatment of open fractures, and describes the use of external skeletal fixation for stabilisation of both open and complex fractures. Most fractures can be stabilised using equipment and expertise available in general practice if the basic principles of fracture fixation are understood and rigorously applied. Many textbooks and journal articles have been published on the management of fractures in companion animals, presenting case studies, case series and original biomechanical research. The simple strategy for managing complex injuries that is provided in this review is based on the published literature and the author's clinical experience.

Project Management Using Modern Guidance, Navigation and Control Theory

NASA Technical Reports Server (NTRS)

Hill, Terry R.

2011-01-01

Implementing guidance, navigation, and control (GN&C) theory principles and applying them to the human element of project management and control is not a new concept. As both the literature on the subject and the real-world applications are neither readily available nor comprehensive with regard to how such principles might be applied, this paper has been written to educate the project manager on the "laws of physics" of his or her project (not to teach a GN&C engineer how to become a project manager) and to provide an intuitive, mathematical explanation as to the control and behavior of projects. This paper will also address how the fundamental principles of modern GN&C were applied to the National Aeronautics and Space Administration's (NASA) Constellation Program (CxP) space suit project, ensuring the project was managed within cost, schedule, and budget. A project that is akin to a physical system can be modeled and managed using the same over arching principles of GN&C that would be used if that project were a complex vehicle, a complex system(s), or complex software with time-varying processes (at times nonlinear) containing multiple data inputs of varying accuracy and a range of operating points. The classic GN&C theory approach could thus be applied to small, well-defined projects; yet when working with larger, multiyear projects necessitating multiple organizational structures, numerous external influences, and a multitude of diverse resources, modern GN&C principles are required to model and manage the project. The fundamental principles of a GN&C system incorporate these basic concepts: State, Behavior, Feedback Control, Navigation, Guidance and Planning Logic systems. The State of a system defines the aspects of the system that can change over time; e.g., position, velocity, acceleration, coordinate-based attitude, and temperature, etc. The Behavior of the system focuses more on what changes are possible within the system; this is denoted in the state of the system. The behavior of a system, as captured in the system modeling, when properly done will aid in accurately predicting future system performance. The Feedback Control system understands the state and behavior of the system and uses feedback to adjust control inputs into the system. The feedback, which is the right arm of the Control system, allows change to be affected in the overall system; it therefore is important to not only correctly identify the system feedback inputs, but also the system response to the feedback inputs. The Navigation system takes multiple data inputs and based on a priori knowledge of the inputs, develops a statistically based weighting of the inputs and measurements to determine the system's state. Guidance and Planning Logic of the system, complete with an understanding of where the system is (provided by the Navigation system), will in turn determine where the system needs to be and how to get it there. With any system/project, it is critical that the objective of the system/project be clearly defined -- not only to plan but to measure performance and to aid in guiding the system or the project. The system principles discussed above, which can be and have been applied to the current CxP space suit development project, can also be mapped to real-world constituents, thus allowing project managers to apply systems theories that are well defined in engineering and mathematics to a discipline (i.e., Project Management) that historically has been based in personal experience and intuition. This mapping of GN&C theory to Project Management will, in turn, permit a direct, methodical approach to Project Management, planning and control providing a tool to help predict (and guide) performance and an understanding of the project constraints, how the project can be controlled, and the impacts to external influences and inputs. This approach, to a project manager, flows down to the three bottom-line variables of cost, schedule, and scope ando the needed control of these three variables to successfully perform and complete a project.

The MEM of spectral analysis applied to L.O.D.

NASA Astrophysics Data System (ADS)

Fernandez, L. I.; Arias, E. F.

The maximum entropy method (MEM) has been widely applied for polar motion studies taking advantage of its performance on the management of complex time series. The authors used the algorithm of the MEM to estimate Cross Spectral function in order to compare interannual Length-of-Day (LOD) time series with Southern Oscillation Index (SOI) and Sea Surface Temperature (SST) series, which are close related to El Niño-Southern Oscillation (ENSO) events.

The Next Step Toward Widespread Residential Deep Energy Retrofits

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

McIlvaine, J.; Martin, E.; Saunders, S.

The complexity of deep energy retrofits warrants additional training to successfully manage multiple improvements that will change whole house air, heat, and moisture flow dynamics. The home performance contracting industry has responded to these challenges by aggregating skilled labor for assessment of and implementation under one umbrella. Two emerging business models are profiled that seek to resolve many of the challenges, weaknesses, opportunities, and threats described for the conventional business models.

Federal Reserve Could Improve the Efficiency of Bank Holding Company Inspections.

DTIC Science & Technology

1981-08-18

examiners have the essential qualifications and experience needed to perform many such tasks, and it would seem to require little additional effort...activities and where the holding company and subsidiary bank management are essentially the same. (See p. 32.) AGENCY COMMENTS The Federal Reserve has...consider- ably more complex and thus moe difficult to evaluate. Most small companies are tax shells and operate essentially as banks. The risk in small

76 FR 56770 - Food and Drug Administration/Xavier University Global Outsourcing Conference

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

..., Pharma Case Study on How to Manage a Global Complex Supply Chain, USP : Good Storage and Distribution... through topics such as Strategic Procurement, End-to-End lifecycle product management, Managing Global Complex Supply Chains, and other topics. The experience level of our audience has fostered engaged dialog...

Complexity in Nature and Society: Complexity Management in the Age of Globalization

NASA Astrophysics Data System (ADS)

Mainzer, Klaus

The theory of nonlinear complex systems has become a proven problem-solving approach in the natural sciences from cosmic and quantum systems to cellular organisms and the brain. Even in modern engineering science self-organizing systems are developed to manage complex networks and processes. It is now recognized that many of our ecological, social, economic, and political problems are also of a global, complex, and nonlinear nature. What are the laws of sociodynamics? Is there a socio-engineering of nonlinear problem solving? What can we learn from nonlinear dynamics for complexity management in social, economic, financial and political systems? Is self-organization an acceptable strategy to handle the challenges of complexity in firms, institutions and other organizations? It is a main thesis of the talk that nature and society are basically governed by nonlinear and complex information dynamics. How computational is sociodynamics? What can we hope for social, economic and political problem solving in the age of globalization?.

Complying with Executive Order 13148 using the Enterprise Environmental Safety And Occupational Health Management Information System.

PubMed

McFarland, Michael J; Nelson, Tim M; Rasmussen, Steve L; Palmer, Glenn R; Olivas, Arthur C

2005-03-01

All U.S. Department of Defense (DoD) facilities are required under Executive Order (EO) 13148, "Greening the Government through Leadership in Environmental Management," to establish quality-based environmental management systems (EMSs) that support environmental decision-making and verification of continuous environmental improvement by December 31, 2005. Compliance with EO 13148 as well as other federal, state, and local environmental regulations places a significant information management burden on DoD facilities. Cost-effective management of environmental data compels DoD facilities to establish robust database systems that not only address the complex and multifaceted environmental monitoring, record-keeping, and reporting requirements demanded by these rules but enable environmental management decision-makers to gauge improvements in environmental performance. The Enterprise Environmental Safety and Occupational Health Management Information System (EESOH-MIS) is a new electronic database developed by the U.S. Air Force to manage both the data needs associated with regulatory compliance programs across its facilities as well as the non-regulatory environmental information that supports installation business practices. The U.S. Air Force, which has adopted the Plan-Do-Check-Act methodology as the EMS standard that it will employ to address EO 13148 requirements.

Time management strategies in nursing practice.

PubMed

Waterworth, Susan

2003-09-01

With the increasing emphasis on efficiency and effectiveness in health care, how a nurse manages her time is an important consideration. Whilst time management is recognized as an important component of work performance and professional nursing practice, the reality of this process in nursing practice has been subject to scant empirical investigation. To explore how nurses organize and manage their time. A qualitative study was carried out, incorporating narratives (22 nurses), focus groups (24 nurses) and semi-structured interviews (22 nurses). In my role as practitioner researcher I undertook observation and had informal conversations, which provided further data. Study sites were five health care organizations in the United Kingdom during 1995-1999. Time management is complex, with nurses using a range of time management strategies and a repertoire of actions. Two of these strategies, namely routinization and prioritizing, are discussed, including their implications for understanding time management by nurses in clinical practice. Ignoring the influence of 'others', the team and the organization perpetuates a rather individualistic and self-critical perspective of time management. This may lead to a failure to address problems in the organizing of work, and the co-ordinating of care involving other health care workers.

Erector spinae plane (ESP) block in the management of post thoracotomy pain syndrome: A case series.

PubMed

Forero, Mauricio; Rajarathinam, Manikandan; Adhikary, Sanjib; Chin, Ki Jinn

2017-10-01

Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics. Most of these procedures are technically complex and are associated with risks and complications due to the proximity of the targets to neuraxial structures and pleura. The ultrasound-guided erector spinae plane (ESP) block is a novel technique for thoracic analgesia that promises to be a relatively simple and safe alternative to more complex and invasive techniques of neural blockade. We have explored the application of the ESP block in the management of PTPS and report our preliminary experience to illustrate its therapeutic potential. The ESP block was performed in a pain clinic setting in a cohort of 7 patients with PTPS following thoracic surgery with lobectomy or pneumonectomy for lung cancer. The blocks were performed with ultrasound guidance by injecting 20-30mL of ropivacaine, with or without steroid, into a fascial plane between the deep surface of erector spinae muscle and the transverse processes of the thoracic vertebrae. This paraspinal tissue plane is distant from the pleura and the neuraxis, thus minimizing the risk of complications associated with injury to these structures. The patients were followed up by telephone one week after each block and reviewed in the clinic 4-6 weeks later to evaluate the analgesic response as well as the need for further injections and modification to the overall analgesic plan. All the patients had excellent immediate pain relief following each ESP block, and 4 out of the 7 patients experienced prolonged analgesic benefit lasting 2 weeks or more. The ESP blocks were combined with optimization of multimodal analgesia, resulting in significant improvement in the pain experience in all patients. No complications related to the blocks were seen. The results observed in this case series indicate that the ESP block may be a valuable therapeutic option in the management of PTPS. Its immediate analgesic efficacy provides patients with temporary symptomatic relief while other aspects of chronic pain management are optimized, and it may also often confer prolonged analgesia. The relative simplicity and safety of the ESP block offer advantages over other interventional procedures for thoracic pain; there are few contraindications, the risk of serious complications (apart from local anesthetic systemic toxicity) is minimal, and it can be performed in an outpatient clinic setting. This, combined with the immediate and profound analgesia that follows the block, makes it an attractive option in the management of intractable chronic thoracic pain. The ESP block may also be applied to management of acute pain management following thoracotomy or thoracic trauma (e.g. rib fractures), with similar analgesic benefits expected. Further studies to validate our observations are warranted. Copyright © 2017 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

PubMed Central

Busetto, Luca; Dicker, Dror; Azran, Carmil; Batterham, Rachel L.; Farpour-Lambert, Nathalie; Fried, Martin; Hjelmesæth, Jøran; Kinzl, Johann; Leitner, Deborah R.; Makaronidis, Janine M.; Schindler, Karin; Toplak, Hermann; Yumuk, Volkan

2018-01-01

Bariatric surgery is today the most effective long-term therapy for the management of patients with severe obesity, and its use is recommended by the relevant guidelines of the management of obesity in adults. Bariatric surgery is in general safe and effective, but it can cause new clinical problems and is associated with specific diagnostic, preventive and therapeutic needs. For clinicians, the acquisition of special knowledge and skills is required in order to deliver appropriate and effective care to the post-bariatric patient. In the present recommendations, the basic notions needed to provide first-level adequate medical care to post-bariatric patients are summarised. Basic information about nutrition, management of co-morbidities, pregnancy, psychological issues as well as weight regain prevention and management is derived from current evidences and existing guidelines. A short list of clinical practical recommendations is included for each item. It remains clear that referral to a bariatric multidisciplinary centre, preferably the one performing the original procedure, should be considered in case of more complex clinical situations. PMID:29207379

Management of Acute Upper Gastrointestinal Disease While at Sea.

PubMed

Carr, Matthew J; Oxner, Christopher; Elster, Eric A; Ritter, Eric M; Vicente, Diego

2018-02-06

Management of complex acute surgical pathology in austere environments necessitates rapid evaluation and resource appropriate management to avoid time-associated morbidity and potentially mortality. Obstructive upper gastrointestinal (UGI) pathologies can be particularly challenging and associated with significant morbidity. Herein, we present six patients with UGI obstructions encountered over the course of an 8-mo deployment onboard a US Navy Aircraft Carrier. Each patient presented to our medical department with signs and symptoms of obstructive UGI pathology including one gastric volvulus requiring operative management at sea, one with a new diagnosis of achalasia requiring transportation and continental United States outpatient evaluation, and four patients with food impaction requiring urgent endoscopic management. Although UGI pathology is seldom encountered at sea, definitive surgical interventions, including prompt evaluation and management of these acute pathologies, can be performed in an austere environment. We wish to call attention to these potential encounters in order that underway deployed medical units and supporting resources ashore are prepared and equipped to intervene on acute UGI obstructive pathology. © Association of Military Surgeons of the United States 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Recording information on protein complexes in an information management system

PubMed Central

Savitsky, Marc; Diprose, Jonathan M.; Morris, Chris; Griffiths, Susanne L.; Daniel, Edward; Lin, Bill; Daenke, Susan; Bishop, Benjamin; Siebold, Christian; Wilson, Keith S.; Blake, Richard; Stuart, David I.; Esnouf, Robert M.

2011-01-01

The Protein Information Management System (PiMS) is a laboratory information management system (LIMS) designed for use with the production of proteins in a research environment. The software is distributed under the CCP4 licence, and so is available free of charge to academic laboratories. Like most LIMS, the underlying PiMS data model originally had no support for protein–protein complexes. To support the SPINE2-Complexes project the developers have extended PiMS to meet these requirements. The modifications to PiMS, described here, include data model changes, additional protocols, some user interface changes and functionality to detect when an experiment may have formed a complex. Example data are shown for the production of a crystal of a protein complex. Integration with SPINE2-Complexes Target Tracker application is also described. PMID:21605682

Recording information on protein complexes in an information management system.

PubMed

Savitsky, Marc; Diprose, Jonathan M; Morris, Chris; Griffiths, Susanne L; Daniel, Edward; Lin, Bill; Daenke, Susan; Bishop, Benjamin; Siebold, Christian; Wilson, Keith S; Blake, Richard; Stuart, David I; Esnouf, Robert M

2011-08-01

The Protein Information Management System (PiMS) is a laboratory information management system (LIMS) designed for use with the production of proteins in a research environment. The software is distributed under the CCP4 licence, and so is available free of charge to academic laboratories. Like most LIMS, the underlying PiMS data model originally had no support for protein-protein complexes. To support the SPINE2-Complexes project the developers have extended PiMS to meet these requirements. The modifications to PiMS, described here, include data model changes, additional protocols, some user interface changes and functionality to detect when an experiment may have formed a complex. Example data are shown for the production of a crystal of a protein complex. Integration with SPINE2-Complexes Target Tracker application is also described. Copyright © 2011 Elsevier Inc. All rights reserved.

Space Flight Resource Management for ISS Operations

NASA Technical Reports Server (NTRS)

Schmidt, Lacey L.; Slack, Kelley; Holland, Albert; Huning, Therese; O'Keefe, William; Sipes, Walter E.

2010-01-01

Although the astronaut training flow for the International Space Station (ISS) spans 2 years, each astronaut or cosmonaut often spends most of their training alone. Rarely is it operationally feasible for all six ISS crewmembers to train together, even more unlikely that crewmembers can practice living together before launch. Likewise, ISS Flight Controller training spans 18 months of learning to manage incredibly complex systems remotely in plug-and-play ground teams that have little to no exposure to crewmembers before a mission. How then do all of these people quickly become a team - a team that must respond flexibly yet decisively to a variety of situations? The answer implemented at NASA is Space Flight Resource Management (SFRM), the so-called "soft skills" or team performance skills. Based on Crew Resource Management, SFRM was developed first for shuttle astronauts and focused on managing human errors during time-critical events (Rogers, et al. 2002). Given the nature of life on ISS, the scope of SFRM for ISS broadened to include teamwork during prolonged and routine operations (O'Keefe, 2008). The ISS SFRM model resembles a star with one competency for each point: Communication, Cross-Culture, Teamwork, Decision Making, Team Care, Leadership/Followership, Conflict Management, and Situation Awareness. These eight competencies were developed with international participation by the Human Behavior and Performance Training Working Group. Over the last two years, these competencies have been used to build a multi-modal SFRM training flow for astronaut candidates and flight controllers that integrates team performance skills into the practice of technical skills. Preliminary results show trainee skill increases as the flow progresses; and participants find the training invaluable to performing well and staying healthy during ISS operations. Future development of SFRM training will aim to help support indirect handovers as ISS operations evolve further with the retirement of the Space Shuttle Program.

Improving Care for Children With Complex Needs

ClinicalTrials.gov

2017-10-10

Medically Complex Children; Care Coordination; Case Manager; Care Manager; Collaborative Care; Disease Management; Patient Care Team or Organization; Managed Care; Children With Chronic Conditions; Children With Special Health Care Needs; Shared Care Plan; Patient Care Plan; Health Care and Resource Utilization; Adherence to Care; Functional Status and Productivity; Health Related Quality of Life; Satisfaction With Care; Care Coordinator; Family Experience of Care; Quality Health Care

The pre-audit assessment: A homework assignment for auditors

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

Marschman, S.C.

1993-02-01

The role of the quality assurance audit is evolving from compliance verification to a much broader assessment of programmatic and management performance. In the past, audits were poorly understood and caused fear and trepidation. Auditees turned an audit into a cat-and-mouse game using coverup strategies and decoy discrepancies. These games were meant to ``give the auditors what they want, namely a few findings that could later be easily corrected. At Pacific Northwest Laboratory (PNL), I observed auditing become a spectator sport. Matching a compliance-oriented auditor against a crafty group of scientists provided hours of entertainment. As a program manager, itmore » was clear these games were neither productive useful nor cost effective. Fortunately, over the past few years several concepts embraced by ``total quality management` have begun to emerge at PNL. These concepts are being adopted by most successful organizations, and based on these concepts new tools and ideas are emerging to help organizations improve productivity and quality. Successful organizations have been and are continuing to develop management strategies that rely on participative approaches to their operations. These approaches encourage the empowerment of organization staff at all levels, with the goal of instilling ownership of quality in every staff member. As management philosophies are changing, so are the responsibilities and expectations of managers. Managers everywhere are experimenting with new tools to help them improve their operations and competitiveness. As the quality audit evolves, managers and other customers of the audit process have developed expectations for the auditing process that never existed in years past. These expectations have added complexity to the audit process. It is no longer adequate to prepare a checklist, perform the audit, and document the results. When viewed as a tool for verifying performance, a quality audit becomes more than a compliance checklist.« less

The pre-audit assessment: A homework assignment for auditors

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

Marschman, S.C.

1993-02-01

The role of the quality assurance audit is evolving from compliance verification to a much broader assessment of programmatic and management performance. In the past, audits were poorly understood and caused fear and trepidation. Auditees turned an audit into a cat-and-mouse game using coverup strategies and decoy discrepancies. These games were meant to give the auditors what they want, namely a few findings that could later be easily corrected. At Pacific Northwest Laboratory (PNL), I observed auditing become a spectator sport. Matching a compliance-oriented auditor against a crafty group of scientists provided hours of entertainment. As a program manager, itmore » was clear these games were neither productive useful nor cost effective. Fortunately, over the past few years several concepts embraced by total quality management' have begun to emerge at PNL. These concepts are being adopted by most successful organizations, and based on these concepts new tools and ideas are emerging to help organizations improve productivity and quality. Successful organizations have been and are continuing to develop management strategies that rely on participative approaches to their operations. These approaches encourage the empowerment of organization staff at all levels, with the goal of instilling ownership of quality in every staff member. As management philosophies are changing, so are the responsibilities and expectations of managers. Managers everywhere are experimenting with new tools to help them improve their operations and competitiveness. As the quality audit evolves, managers and other customers of the audit process have developed expectations for the auditing process that never existed in years past. These expectations have added complexity to the audit process. It is no longer adequate to prepare a checklist, perform the audit, and document the results. When viewed as a tool for verifying performance, a quality audit becomes more than a compliance checklist.« less

Error framing effects on performance: cognitive, motivational, and affective pathways.

PubMed

Steele-Johnson, Debra; Kalinoski, Zachary T

2014-01-01

Our purpose was to examine whether positive error framing, that is, making errors salient and cuing individuals to see errors as useful, can benefit learning when task exploration is constrained. Recent research has demonstrated the benefits of a newer approach to training, that is, error management training, that includes the opportunity to actively explore the task and framing errors as beneficial to learning complex tasks (Keith & Frese, 2008). Other research has highlighted the important role of errors in on-the-job learning in complex domains (Hutchins, 1995). Participants (N = 168) from a large undergraduate university performed a class scheduling task. Results provided support for a hypothesized path model in which error framing influenced cognitive, motivational, and affective factors which in turn differentially affected performance quantity and quality. Within this model, error framing had significant direct effects on metacognition and self-efficacy. Our results suggest that positive error framing can have beneficial effects even when tasks cannot be structured to support extensive exploration. Whereas future research can expand our understanding of error framing effects on outcomes, results from the current study suggest that positive error framing can facilitate learning from errors in real-time performance of tasks.

Planning and management of the Nido Reef Complex Oil Field development, Philippines

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

Harry, R.Y.

1981-01-01

As Operator for the Northeast Palawan consortium, Philippines-Cities Service, Inc., commenced the Philippines first commercial offshore oil production from the Nido Reef Complex Oil Field on February 1, 1979, some 11 months after a decision by management to start development. The relative speed at which design, fabrication, and construction were accomplished is attributed to the use of the concepts of project planning, task force approach, and project management. This paper presents the above concepts as applied to the Nido Complex.

Selective Iterative Waterfilling for Digital Subscriber Lines

NASA Astrophysics Data System (ADS)

Xu, Yang; Le-Ngoc, Tho; Panigrahi, Saswat

2007-12-01

This paper presents a high-performance, low-complexity, quasi-distributed dynamic spectrum management (DSM) algorithm suitable for DSL systems. We analytically demonstrate that the rate degradation of the distributed iterative waterfilling (IW) algorithm in near-far scenarios is caused by the insufficient utilization of all available frequency and power resources due to its nature of noncooperative game theoretic formulation. Inspired by this observation, we propose the selective IW (SIW) algorithm that can considerably alleviate the performance degradation of IW by applying IW selectively to different groups of users over different frequency bands so that all the available resources can be fully utilized. For [InlineEquation not available: see fulltext.] users, the proposed SIW algorithm needs at most [InlineEquation not available: see fulltext.] times the complexity of the IW algorithm, and is much simpler than the centralized optimal spectrum balancing (OSB), while it can offer a rate performance much better than that of the IW and close to the maximum possible rate region computed by the OSB in realistic near-far DSL scenarios. Furthermore, its predominantly distributed structure makes it suitable for DSL implementation.

Evaluation of Supply Chain Efficiency Based on a Novel Network of Data Envelopment Analysis Model

NASA Astrophysics Data System (ADS)

Fu, Li Fang; Meng, Jun; Liu, Ying

2015-12-01

Performance evaluation of supply chain (SC) is a vital topic in SC management and inherently complex problems with multilayered internal linkages and activities of multiple entities. Recently, various Network Data Envelopment Analysis (NDEA) models, which opened the “black box” of conventional DEA, were developed and applied to evaluate the complex SC with a multilayer network structure. However, most of them are input or output oriented models which cannot take into consideration the nonproportional changes of inputs and outputs simultaneously. This paper extends the Slack-based measure (SBM) model to a nonradial, nonoriented network model named as U-NSBM with the presence of undesirable outputs in the SC. A numerical example is presented to demonstrate the applicability of the model in quantifying the efficiency and ranking the supply chain performance. By comparing with the CCR and U-SBM models, it is shown that the proposed model has higher distinguishing ability and gives feasible solution in the presence of undesirable outputs. Meanwhile, it provides more insights for decision makers about the source of inefficiency as well as the guidance to improve the SC performance.

Towards a Next-Generation Catalogue Cross-Match Service

NASA Astrophysics Data System (ADS)

Pineau, F.; Boch, T.; Derriere, S.; Arches Consortium

2015-09-01

We have been developing in the past several catalogue cross-match tools. On one hand the CDS XMatch service (Pineau et al. 2011), able to perform basic but very efficient cross-matches, scalable to the largest catalogues on a single regular server. On the other hand, as part of the European project ARCHES1, we have been developing a generic and flexible tool which performs potentially complex multi-catalogue cross-matches and which computes probabilities of association based on a novel statistical framework. Although the two approaches have been managed so far as different tracks, the need for next generation cross-match services dealing with both efficiency and complexity is becoming pressing with forthcoming projects which will produce huge high quality catalogues. We are addressing this challenge which is both theoretical and technical. In ARCHES we generalize to N catalogues the candidate selection criteria - based on the chi-square distribution - described in Pineau et al. (2011). We formulate and test a number of Bayesian hypothesis which necessarily increases dramatically with the number of catalogues. To assign a probability to each hypotheses, we rely on estimated priors which account for local densities of sources. We validated our developments by comparing the theoretical curves we derived with the results of Monte-Carlo simulations. The current prototype is able to take into account heterogeneous positional errors, object extension and proper motion. The technical complexity is managed by OO programming design patterns and SQL-like functionalities. Large tasks are split into smaller independent pieces for scalability. Performances are achieved resorting to multi-threading, sequential reads and several tree data-structures. In addition to kd-trees, we account for heterogeneous positional errors and object's extension using M-trees. Proper-motions are supported using a modified M-tree we developed, inspired from Time Parametrized R-trees (TPR-tree). Quantitative tests in comparison with the basic cross-match will be presented.

Cultural differences in Research project management

NASA Astrophysics Data System (ADS)

Barbier, Michele

2016-04-01

Scientific Projects today have increased in complexity, requiring multidisciplinarity, and requiring a mix of diverse individuals from different countries who must be integrated into an effective project. Effective team building is one of the prime responsibilities of the project manager. When the project is supported by a funding, the integration and the implication of the different partners are quite easy. Particularly when partners are developing high-performing teams. However, management of research project requires further skills when the budget is not very high and/or when partners are from non-European countries and are not using the same vocabulary. The various cultures, values, beliefs and social usages, particularly with Mediterranean countries cause a special style of communication for an individual or group of individuals. This communication style participates in the success of the project and encompasses a lot of diplomatic skills which will be highlighted.

77 FR 14567 - Draft General Management Plan/Environmental Impact Statement for the Ice Age Complex at Cross...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-12

... Impact Statement for the Ice Age Complex at Cross Plains, Cross Plains, Wisconsin AGENCY: National Park... General Management Plan/Environmental Impact Statement for the Ice Age Complex at Cross Plains, Wisconsin... also send comments to Superintendent, Ice Age National Scenic Trail, 700 Rayovac Drive, Suite 100...