Indoor air quality: A psychosocial perspective

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

Boxer, P.A.

1990-05-01

The incidence of indoor air quality problems has increased dramatically over the past decade. Investigation of these problems has yielded a definitive cause in only one third of the cases. Psychosocial factors may play a key role in the development and propagation of symptoms attributed to poor indoor air quality. Guidelines for managing indoor air quality problems from the organizational perspective are based upon psychosocial principles and elements of risk perception.

The quality movement in higher education in the United States.

PubMed

Buchanan, H S

1995-09-01

Continuous quality improvement (CQI), often implemented as part of an integrated management system called total quality management (TQM), has been institutionalized within many manufacturing, military and service organizations in the USA as a response to declining market share, low productivity and customer complaints about poor quality. Signs and symptoms suggest that higher education has similar problems which are systematic and relate to the quality ot higher education, financing, facilities, curriculum and graduates. In the 1990S, the quality movement has begun to spread to the field of education as a means of diagnosing and treating the problems widely recognized as residing in US educational institutions, especially in colleges and universities. Many business leaders and authors believe that 'quality is the most important strategic issue facing top management in the 1990s'. This belief arises partly due to the fact that managers are beginning to understand the relationship between healthy, high quality organizations and healthy profits. This article traces the recent US quality movement from its roots in manufacturing and the military, its adoption by service institutions, and its more recent application by higher education institutions.

7 CFR 634.12 - Eligible project areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... agricultural portion of a 208 water quality management plan, or revised portions thereof, and have identified agricultural nonpoint source water quality problems are eligible for authorization under RCWP. Those critical areas or sources of pollutants significantly contributing to the water quality problems are eligible for...

Freshwater Ecosystem Research in Water Quality Management

ERIC Educational Resources Information Center

Ferris, James J.; And Others

1974-01-01

Describes the use of modeling techniques to contribute to the basic knowledge of ecologic science, and in solving problems of biological production, resource-use planning and management, and environmental quality. (JR)

40 CFR 35.917-5 - Public participation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... coordination between the appropriate Water Quality Management public participation program under subpart G of... for coordination between the appropriate Water Quality Management agency public participation program... become involved in the following: (1) The assessment of local water quality problems and needs; (2) The...

Ergonomics and quality management--humans in interaction with technology, work environment, and organization.

PubMed

Eklund, J A

1999-01-01

In many studies, ergonomics has been shown to influence human performance. The aim of this paper was to demonstrate important ergonomics influences on quality in industrial production, from the perspective of interactions between humans, technology, organization, and work environment. A second aim was to elaborate on the implications of these findings for the development of quality management strategies. This paper shows that ergonomics problems in terms of adverse work environmental conditions, inappropriate design of technology, and an unsuitable organization are important causes of quality deficiencies. Problem solving aimed at improving ergonomics, quality, and productivity simultaneously is likely to obtain support from most of the interest parties of the company, and may also enhance participation. Ergonomics has the potential of becoming a driving force for the development of new quality management strategies.

Total Quality Management (TQM): Group Dynamics Workshop

DTIC Science & Technology

1990-05-15

interactions with other OSD decision-making bodies. " Remove barriers /facilitate implementation. " Direct action on unresolved process problems referred...TQM leadership. - Total Quality Management FUNCTIONS: * Translate goals to tangible internal initiatives. " Remove barriers . " Establish and...Quality Management FUNCTIONS: • Identify and remove barriers . " Develop practical process improvements. " Install solutions and measurement systems for

Environmental Quality Management in the United States in the 1980s and Beyond: An Appraisal.

ERIC Educational Resources Information Center

Bower, Blair T.

1984-01-01

Presents an overview of: (1) the institutional context of the environmental pollution sector of environmental quality management (EQM); accomplishments and problems in some representative subsectors (including water quality, soil erosion, air quality, and hazardous wastes); and (3) future prospects. Also considers role of government and…

Total Quality Management in Libraries. ERIC Digest.

ERIC Educational Resources Information Center

Masters, Denise G.

Total Quality Management (TQM) is "a system of continuous improvement employing participative management and centered on the needs of customers." Key components of TQM are employee involvement and training, problem-solving teams, statistical methods, long-term goals and thinking, and recognition that the system, not people, produces…

Human Capital: Attracting and Retaining a High-Quality Information Technology Workforce. Testimony before the Subcommittee on Technology and Procurement Policy, Committee on Government Reform, U.S. House of Representatives.

ERIC Educational Resources Information Center

McClure, David L.

The General Accounting Office examined the problem of attracting and retaining a high-quality information technology (IT) workforce in federal government agencies. The problem was traced to a longstanding lack of effective leadership and management and lack of a strategic approach to marshaling, managing, and maintaining the human capital needed…

Problems of Accreditation and Quality Assurance of Engineering Education in Developing Countries.

ERIC Educational Resources Information Center

Bordia, Surek

2001-01-01

Discusses the relationship between funding, management, and quality assurance in engineering education in developing countries. Presents a few case studies on problems of accreditation and quality assessment in larger developing countries such as India and the Philippines, and also in very small developing countries such as Papua New Guinea, Fiji,…

EPA'S WATERSHED MANAGEMENT AND MODELING RESEARCH PROGRAM

EPA Science Inventory

Watershed management presumes that community groups can best solve many water quality and ecosystem problems at the watershed level rather than at the individual site, receiving waterbody, or discharger level. After assessing and ranking watershed problems, and setting environ...

SCREENING TO IDENTIFY AND PREVENT URBAN STORM WATER PROBLEMS: ESTIMATING IMPERVIOUS AREA ACCURATELY AND INEXPENSIVELY

EPA Science Inventory

Complete identification and eventual prevention of urban water quality problems pose significant monitoring, "smart growth" and water quality management challenges. Uncontrolled increase of impervious surface area (roads, buildings, and parking lots) causes detrimental hydrologi...

Determining the Effectiveness and Evaluating the Implementation Process of a Quality/Performance Circles System Model to Assist in Institutional Decision Making and Problem Solving at Lakeshore Technical Institute.

ERIC Educational Resources Information Center

Ladwig, Dennis J.

During the 1982-83 school year, a quality/performance circles system model was implemented at Lakeshore Technical Institute (LTI) to promote greater participation by staff in decision making and problem solving. All management staff at the college (N=45) were invited to participate in the process, and 39 volunteered. Non-management staff (N=240)…

METRO-APEX Volume 8.1: Water Quality Manager's Manual. Revised.

ERIC Educational Resources Information Center

University of Southern California, Los Angeles. COMEX Research Project.

The water Quality Manager's Manual is one of a set of twenty-one manuals used in METRO-APEX 1974, a computerized college and professional level, computer-supported, role-play, simulation exercise of a community with "normal" problems. Stress is placed on environmental quality considerations. APEX 1974 is an expansion of APEX--Air…

[A strategy of constructing the technological system for quality control of Chinese medicine based on process control and management].

PubMed

Cheng, Yi-Yu; Qian, Zhong-Zhi; Zhang, Bo-Li

2017-01-01

The current situation, bottleneck problems and severe challenges in quality control technology of Chinese Medicine (CM) are briefly described. It is presented to change the phenomenon related to the post-test as the main means and contempt for process control in drug regulation, reverse the situation of neglecting the development of process control and management technology for pharmaceutical manufacture and reconstruct the technological system for quality control of CM products. The regulation and technology system based on process control and management for controlling CM quality should be established to solve weighty realistic problems of CM industry from the root causes, including backwardness of quality control technology, weakness of quality risk control measures, poor reputation of product quality and so on. By this way, the obstacles from poor controllability of CM product quality could be broken. Concentrating on those difficult problems and weak links in the technical field of CM quality control, it is proposed to build CMC (Chemistry, Manufacturing and Controls) regulation for CM products with Chinese characteristics and promote the regulation international recognition as soon as possible. The CMC technical framework, which is clinical efficacy-oriented, manufacturing manner-centered and process control-focused, was designed. To address the clinical characteristics of traditional Chinese medicine (TCM) and the production feature of CM manufacture, it is suggested to establish quality control engineering for CM manufacturing by integrating pharmaceutical analysis, TCM chemistry, TCM pharmacology, pharmaceutical engineering, control engineering, management engineering and other disciplines. Further, a theoretical model of quality control engineering for CM manufacturing and the methodology of digital pharmaceutical engineering are proposed. A technology pathway for promoting CM standard and realizing the strategic goal of CM internationalization is elaborated. Copyright© by the Chinese Pharmaceutical Association.

Determinants of quality management systems implementation in hospitals.

PubMed

Wardhani, Viera; Utarini, Adi; van Dijk, Jitse Pieter; Post, Doeke; Groothoff, Johan Willem

2009-03-01

To identify the problems and facilitating factors in the implementation of quality management system (QMS) in hospitals through a systematic review. A search strategy was performed on the Medline database for articles written in English published between 1992 and early 2006. Using the thesaurus terms 'Total Quality Management' and 'Quality Assurance Health Care', combined with the term 'hospital' and 'implement*', we identified 533 publications. The screening process was based on empirical articles describing organization-wide QMS implementation. Fourteen empirical articles fulfilled the inclusion criteria and were reviewed in this paper. An organization culture emphasizing standards and values associated with affiliation, teamwork and innovation, assumption of change and risk taking, play as the key success factor in QMS implementation. This culture needs to be supported by sufficient technical competence to apply a scientific problem-solving approach. A clear distribution of QMS function within the organizational structure is more important than establishing a formal quality structure. In addition to management leadership, physician involvement also plays an important role in implementing QMS. Six supporting and limiting factors determining QMS implementation are identified in this review. These are the organization culture, design, leadership for quality, physician involvement, quality structure and technical competence.

Water quality modelling of Jadro spring.

PubMed

Margeta, J; Fistanic, I

2004-01-01

Management of water quality in karst is a specific problem. Water generally moves very fast by infiltration processes but far more by concentrated flows through fissures and openings in karst. This enables the entire surface pollution to be transferred fast and without filtration into groundwater springs. A typical example is the Jadro spring. Changes in water quality at the spring are sudden, but short. Turbidity as a major water quality problem for the karst springs regularly exceeds allowable standards. Former practice in problem solving has been reduced to intensive water disinfection in periods of great turbidity without analyses of disinfection by-products risks for water users. The main prerequisite for water quality control and an optimization of water disinfection is the knowledge of raw water quality and nature of occurrence. The analysis of monitoring data and their functional relationship with hydrological parameters enables establishment of a stochastic model that will help obtain better information on turbidity in different periods of the year. Using the model a great number of average monthly and extreme daily values are generated. By statistical analyses of these data possibility of occurrence of high turbidity in certain months is obtained. This information can be used for designing expert system for water quality management of karst springs. Thus, the time series model becomes a valuable tool in management of drinking water quality of the Jadro spring.

W. Edwards Deming, quality analysis, and total behavior management.

PubMed

Saunders, R R; Saunders, J L

1994-01-01

During the past 10 years, the inclusion of the word "quality" in descriptions of production methods, management approaches, educational systems, service system changes, and so forth, has grown exponentially. It appears that no new approach to any problem is likely to be given much consideration today without overt acknowledgment that some improvement in quality must be the outcome. The origins of the importance of quality are primarily rooted in the awakening recognition of the influence of W. Edwards Deming in the post-World War II restoration of Japanese industry. We provide a brief overview of Deming's approach to modernizing management methods and discuss recent criticisms from the field of organizational behavior management that his approach lacks emphasis on the role of reinforcement. We offer a different analysis of Deming's approach and relate its evolution to the contingencies of reinforcement for the behavior of consulting. We also provide an example of problem solving with Deming's approach in a social service setting familiar to many behavior analysts.

Defense Manufacturing Management Guide for Program Managers, Third Edition

DTIC Science & Technology

1989-04-01

Crosby (Quality goals of quality, cost, schedule, mission need, College), Genechi Taguchi (Experimental 5-1 Design), Dr. Kaoru Ishikawa (Cause/Effect...the remaining problems were resolved. 5-7 6. Ishikawa Diagram 7. Control Charts This technique was developed by Dr. In the minds of some quality Kaoru ... Ishikawa , one of the foremost professionals and nonprofesslonals alike, the authorities on quality control in Japan. The control chart is synonymous

Improving Software Quality and Management Through Use of Service Level Agreements

DTIC Science & Technology

2005-03-01

many who believe that the quality of the development process is the best predictor of software product quality. ( Fenton ) Repeatable software processes...reduced errors per KLOC for small projects ( Fenton ), and the quality management metric (QMM) (Machniak, Osmundson). There are also numerous IEEE 14...attention to cosmetic user interface issues and any problems that may arise with the prototype. (Sawyer) The validation process is also another check

Total Quality Training: The Quality Culture and Quality Trainer.

ERIC Educational Resources Information Center

Thomas, Brian

This book examines the application of total quality management (TQM) principles to training and development. It contains 10 chapters on the following topics: the quality revolution (the nature of and rationale for quality); major barriers to achieving quality (supplier-led approaches, problems with customers, throughput orientation, variable…

A proposed simulation optimization model framework for emergency department problems in public hospital

NASA Astrophysics Data System (ADS)

Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

2015-12-01

The Emergency Department (ED) is a very complex system with limited resources to support increase in demand. ED services are considered as good quality if they can meet the patient's expectation. Long waiting times and length of stay is always the main problem faced by the management. The management of ED should give greater emphasis on their capacity of resources in order to increase the quality of services, which conforms to patient satisfaction. This paper is a review of work in progress of a study being conducted in a government hospital in Selangor, Malaysia. This paper proposed a simulation optimization model framework which is used to study ED operations and problems as well as to find an optimal solution to the problems. The integration of simulation and optimization is hoped can assist management in decision making process regarding their resource capacity planning in order to improve current and future ED operations.

Characteristics of neurogenic bowel in spinal cord injury and perceived quality of life.

PubMed

Pardee, Connie; Bricker, Diedre; Rundquist, Jeanine; MacRae, Christi; Tebben, Cherisse

2012-01-01

To investigate the association between characteristics of individuals with spinal cord injury and neurogenic bowel and their perceived quality of life. The study design is an exploratory, descriptive correlational design. To measure the variables of the study the Quality of Life Survey developed by Randell et al. (2001) was used to measure perceived quality of life related to bowel management. Individual bowel management preferences and subjective costs and benefits of the preferences were gathered through the Neurogenic Bowel Characteristics Survey. PARTICIPANTS/METHOD: Data were collected from a random half of the individuals who met the inclusion criteria from the patient database (n=1193). Two hundred and forty one surveys were analyzed for this study. More than half of the sample (n=134) provided their own bowel management consisting of digital stimulation, suppositories, and other aids; 8% (n=19) had a colostomy. Regardless of the bowel management program 54% (n=127) were satisfied with current methods. Although time reported to complete bowel programs ranged from 1 to 120 minutes, there was no difference in rating of satisfaction with time. There was a statistically significant difference between those satisfied and dissatisfied with current bowel management and quality of life; those satisfied demonstrated a higher quality of life on three subscales, work function (p= .021), bowel problems (p< .001), and social function (p< .001). Those dissatisfied with their bowel program perceived a lower quality of life and indicated problems of time (p= .001), pain or discomfort (p= .033), and poor results (p< .001). Research data provide the patient's perspective on bowel management characteristics, complications, satisfaction, and their perceived quality of life. Results of this research will be incorporated into bowel management education and possible modification of the current inpatient bowel management program. © 2012 Association of Rehabilitation Nurses.

Coping and social problem solving correlates of asthma control and quality of life.

PubMed

McCormick, Sean P; Nezu, Christine M; Nezu, Arthur M; Sherman, Michael; Davey, Adam; Collins, Bradley N

2014-02-01

In a sample of adults with asthma receiving care and medication in an outpatient pulmonary clinic, this study tested for statistical associations between social problem-solving styles, asthma control, and asthma-related quality of life. These variables were measured cross sectionally as a first step toward more systematic application of social problem-solving frameworks in asthma self-management training. Recruitment occurred during pulmonology clinic service hours. Forty-four adults with physician-confirmed diagnosis of asthma provided data including age, gender, height, weight, race, income, and comorbid conditions. The Asthma Control Questionnaire, the Mini Asthma Quality of Life Questionnaire (Short Form), and peak expiratory force measures offered multiple views of asthma health at the time of the study. Maladaptive coping (impulsive and careless problem-solving styles) based on transactional stress models of health were assessed with the Social Problem-Solving Inventory-Revised: Short Form. Controlling for variance associated with gender, age, and income, individuals reporting higher impulsive-careless scores exhibited significantly lower scores on asthma control (β = 0.70, p = 0.001, confidence interval (CI) [0.37-1.04]) and lower asthma-related quality of life (β = 0.79, p = 0.017, CI [0.15-1.42]). These findings suggest that specific maladaptive problem-solving styles may uniquely contribute to asthma health burdens. Because problem-solving coping strategies are both measureable and teachable, behavioral interventions aimed at facilitating adaptive coping and problem solving could positively affect patient's asthma management and quality of life.

DEMONSTRATION OF A MULTI-SCALE INTEGRATED MONITORING AND ASSESSMENT IN NY/NJ HARBOR

EPA Science Inventory

The Clean Water Act (CWA) requires states and tribes to assess the overall quality of their waters (Sec 305(b)), determine whether that quality is changing over time, identify problem areas and management actions necessary to resolve those problems, and evaluate the effectiveness...

Examining the Relationship between Electronic Health Record Interoperability and Quality Management

ERIC Educational Resources Information Center

Purcell, Bernice M.

2013-01-01

A lack of interoperability impairs data quality among health care providers' electronic health record (EHR) systems. The problem is whether the International Organization for Standardization (ISO) 9000 principles relate to the problem of interoperability in implementation of EHR systems. The purpose of the nonexperimental quantitative research…

An Analysis of Oregon State University's Total Quality Management Pilot Program.

ERIC Educational Resources Information Center

Coate, L. Edwin

1993-01-01

Adaptation of the Total Quality Management approach to organizational improvement at Oregon State University involved creation of 10 pilot finance and administration teams and implementation of a 10-step problem-solving process. The approach has improved staff morale as well as client services. (MSE)

Total Quality Management: The Emperor's Tailor.

ERIC Educational Resources Information Center

Alexander, Gary C.; Keeler, Carolyn M.

Conversations among educators, business leaders, legislators, and educational reformers have generated support for the application of Total Quality Management (TQM) to education. This paper considers whether TQM is indeed the solution to education's problems. After a brief explanation of TQM theory, the paper is organized around four broad issues…

A review study of maintenance and management issues in Malaysian commercial building towards sustainable future practice

NASA Astrophysics Data System (ADS)

Nawi, Mohd Nasrun Mohd; Baharum, Faizal; Ibrahim, Siti Halipah; Riazi, Salman Riazi Mehdi

2017-10-01

Good management of the building will be able to influence the quality of the buildings that remain long, safe and beautiful without any damage and problems. This research paper aims to explore the issue of maintenance and management that appear in managing the commercial building in Malaysian construction and property industry. The data in this research has been gathered through the reviewing process of secondary data such as journals, proceeding, thesis etc. in the area that related to maintenance and management issue in commercial building. As highlighted by previous study, building a good management can ensure that the facilities available in the building are well and meet the standard. Thus, exposure to the problems and needs in the management of the building would be able to improve the quality of building management systems to be more effective and fulfil the client needs and features.

Service Discovery Oriented Management System Construction Method

NASA Astrophysics Data System (ADS)

Li, Huawei; Ren, Ying

2017-10-01

In order to solve the problem that there is no uniform method for design service quality management system in large-scale complex service environment, this paper proposes a distributed service-oriented discovery management system construction method. Three measurement functions are proposed to compute nearest neighbor user similarity at different levels. At present in view of the low efficiency of service quality management systems, three solutions are proposed to improve the efficiency of the system. Finally, the key technologies of distributed service quality management system based on service discovery are summarized through the factor addition and subtraction of quantitative experiment.

[Requirements for the organization of pain therapy in hospitals: interdepartmental comparison for pain management from the employees' perspective].

PubMed

Erlenwein, J; Ufer, G; Hecke, A; Pfingsten, M; Bauer, M; Petzke, F

2013-12-01

In recent decades, the focus of pain management in hospitals was the organization and quality of control of postoperative pain, although there is a similar demand in nonsurgical departments. The aim of this study was to assess the employees' perspective on problems and corresponding solutions in pain management in a university hospital and to further clarify whether the implementation of concepts and tools of pain management across disciplines is feasible. Physicians and nursing staff of all inpatient departments of the University Hospital Göttingen were asked about problems in pain management and the importance of various established instruments using a standardized questionnaire. Ratings were recorded on a numeric rating scale (0-10). The analysis was primarily descriptive, the Kruskal-Wallis and Mann-Whitney U test were used when appropriate. In all, 149 medical and 501 nursing employees were included. The quality of pain management was perceived as better in surgical departments than in the conservative and pediatric departments. In all areas, the lack of an adequate order for baseline- and rescue-analgesic, and accordingly the nursing staff's limited ability to act was rated as problematic. In contrast to the conservative and pediatric departments, the predominant problem of surgical departments was the lack of availability of physicians on the ward. As a solution, the advice provided by pain consultation services was rated highly by the staff in all areas. The importance of implementation of standardized analgesic concepts was also supported equally in all areas. The evaluation of the quality of pain management was related to the employee's estimation of their ability to actively treat pain. Physicians rated problems in quality and organization lower compared to nursing stuff. The results demonstrate that from the employee's perspective problems in pain management in surgical and nonsurgical departments are very similar. Transferring concepts and structures of surgical pain management, such as standardized concepts and advice and or care through pain services, would meet high levels of acceptance. The results also indicate that the nursing staff's ability to treat should be increased by the provision of adequate rescue-analgesics. To close deficits in the management of care, established concepts of pain management could be extended to all departments of a hospital. Similarities outweigh differences in the employee's assessment.

Improving consistency and quality of service delivery: implications for the addiction treatment field.

PubMed

Knott, Anne Marie; Corredoira, Rafael; Kimberly, John

2008-09-01

Addiction treatment providers face serious problems in delivering consistent, high-quality services over time. Among those providers with multiple treatment sites, there is also intersite variability. This is a serious problem in the addiction field, likely to be made worse as new technologies are introduced and/or as there is industry consolidation (Corredoira, R., Kimberly, J. (2006) Industry evolution through consolidation: Implications for addiction treatment. Journal of Substance Abuse Treatment 31, 255-265.). Although serious, these problems in managing and monitoring to assure consistent service quality have been faced by many other industries. Here, we review evidence from research in other industries regarding three different forms of management (vertical integration, franchising, and licensing) across a chain of individual service providers. We show how each management form affects the level, consistency, and improvement of service delivery over time. In addition, we discuss how such performance advantages affect customer demand as well as regulatory endorsement of the consolidated firm and its approach.

Managing Global Problems.

ERIC Educational Resources Information Center

Stanley, C. Maxwell

The book examines the historical background of and accomplishments in seven global problem areas. It is hypothesized that effective management within today's framework is the only way to progress toward the political and economic order that is necessary to assure peace and security, justice, and human rights, and to improve the quality of life. It…

Managing Strategic Change through TQM: Learning from Failure.

ERIC Educational Resources Information Center

Redman, Tom; Grieves, Jim

1999-01-01

Case study of a manufacturing firm that implemented total quality management (TQM) found that the initiative may have failed because the company was undergoing rapid, radical structural change. Other problems included short-term focus, communication problems, and employee concerns about job security. TQM may be more compatible with continuous…

Conflicting Expertise and Uncertainty: Quality Assurance in High-Level Radioactive Waste Management.

ERIC Educational Resources Information Center

Fitzgerald, Michael R.; McCabe, Amy Snyder

1991-01-01

Dynamics of a large, expensive, and controversial surface and underground evaluation of a radioactive waste management program at the Yucca Mountain power plant are reviewed. The use of private contractors in the quality assurance study complicates the evaluation. This case study illustrates high stakes evaluation problems. (SLD)

School Development Applications in Turkey

ERIC Educational Resources Information Center

Hosgörür, Vural

2014-01-01

This study aims to define and explain the establishment, functioning and problems of school development management teams (SDMTs), similar to quality circles used in total quality management practices, for the purposes of continuous development and improvement of schools on the basis of the planned school development model. This is a qualitative…

QUALITY ASSURANCE AND QUALITY CONTROL IN THE DEVELOPMENT AND APPLICATION OF THE AUTOMATED GEOSPATIAL WATERSHED ASSESSMENT (AGWA) TOOL

EPA Science Inventory

Planning and assessment in land and water resource management are evolving from simple, local-scale problems toward complex, spatially explicit regional ones. Such problems have to be addressed with distributed models that can compute runoff and erosion at different spatial and t...

Nurse Managers' Decisions: Fast and Favoring Remediation

PubMed Central

Effken, Judith A.; Verran, Joyce A.; Logue, Melanie D.; Hsu, Ya-Chuan

2010-01-01

How do nurse managers make decisions about quality issues on their units? We asked 10 nurse managers in 3 Arizona hospitals to describe how they resolved a recent quality issue. The managers tended to use a linear, but cognitively expensive strategy, often jumping from problem to solution without a clear goal and selecting solutions biased toward remedial education. Decision support tools should help managers think more systemically, systematically and efficiently, while encouraging consideration of more alternatives to reach targeted goals. PMID:20305465

Evaluating the link between human resource management decisions and patient satisfaction with quality of care.

PubMed

Oppel, Eva-Maria; Winter, Vera; Schreyögg, Jonas

Patient satisfaction with quality of care is becoming increasingly important in the competitive hospital market. Simultaneously, the growing shortage of clinical staff poses a considerable challenge to ensuring a high quality of care. In this context, a question emerges regarding whether and how human resource management (HRM) might serve as a means to reduce staff shortage problems and to increase patient satisfaction. Although considerable efforts have been devoted to understanding the concepts of patient satisfaction and HRM, little is known about the interrelationships between these concepts or about the link between staff shortage problems and patients' satisfaction with quality of care. The aim of this study was to investigate the relationship between strategic human resource management (SHRM), staff shortage problems, and patients' satisfaction with care. Furthermore, we analyze how the HRM decision to fill short-term vacancies through temporary staffing affects patient satisfaction. We differentiate between physicians and nurses. We develop and empirically test a theoretical model. The data (n = 165) are derived from a survey on SHRM that was sent to 732 German hospitals and from a survey on patient satisfaction that comprises 436,848 patient satisfaction ratings. We use a structural equation modeling approach to test the model. The results indicate that SHRM significantly reduces staff shortage problems for both occupational groups. Having fewer physician shortage problems is significantly associated with higher levels of patient satisfaction, whereas this effect is not significant for nurses. Furthermore, the use of temporary staffing considerably reduces patients' satisfaction with care. Hospital managers are advised to consider the effects of HRM decisions on patients' satisfaction with care. In particular, investments in SHRM targeted at physicians have significantly positive effects on patient satisfaction, whereas the temporary staffing of physicians and nurses should be avoided.

Red River of the North Reconnaissance Report: Buffalo River Subbasin.

DTIC Science & Technology

1980-12-01

Flood Damages....oo........ 09 Environental Con eornso. **.o . . # 12 Recreation Problems . . . 0 . . . . . . . . . . . 13 Water Quality Proble s...Wastewater Management . . . . o o . . . . . . 0 . 16 IPublic Perception of Problem and Solutions. . o * * 18 IV DESCRIPTION OF SUBBASIN RESOURCES...Wildlife Management Areas. .... . . 0 . . . 48 Threatened or Endangered Species . . . . . . . . 48 other Important Species. .. .. .. .. . .. 50 Natural

Objective, Way and Method of Faculty Management Based on Ergonomics

ERIC Educational Resources Information Center

WANG, Hong-bin; Liu, Yu-hua

2008-01-01

The core problem that influences educational quality of talents in colleges and universities is the faculty management. Without advanced faculty, it is difficult to cultivate excellent talents. With regard to some problems in present faculty construction of colleges and universities, this paper puts forward the new objectives, ways and methods of…

Managing Smallness: Promising Fiscal Practices for Rural School District Administrators.

ERIC Educational Resources Information Center

Freitas, Deborah Inman

Based on a mail survey of over 100 rural school administrators in 34 states, this handbook outlines common problems and successful strategies in the financial management of rural, small school districts. Major problems are related to revenue and cash flow, increasing expenditures, providing quality education programs, and staffing to handle the…

40 CFR 35.418 - Award limitations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... STATE AND LOCAL ASSISTANCE Environmental Program Grants Water Quality Management Planning Grants... the nature, extent, and causes of water quality problems in various areas of the State and interstate...

In collaboration with mask suppliers for change management enhancement

NASA Astrophysics Data System (ADS)

Deng, Erwin; Lee, Chun Der; Lee, Rachel

2013-06-01

For those wafer fabs that have no their own maskshops, the main target of mask quality department is to gain stable mask quality performance through effective supplier management, and therefore achieves competitive business results. After dealing with lots of mask data preparation (MDP) quality problems with suppliers, we have found that incomplete change management procedures are one of major sources that induce incorrect mask data for writing. This article will share our experience in how to enhance change management flows with mask suppliers together and will also show the utility after a series of flow improvement actions.

Integrating Six Sigma Concepts in an MBA Quality Management Class

ERIC Educational Resources Information Center

Weinstein, Larry B.; Petrick, Joseph; Castellano, Joseph; Vokurka, Robert J.

2008-01-01

Instructors face enormous challenges in presenting effective instruction on concepts and tools of quality management. Most textbooks focus on presenting individual concepts or tools and fail to address complex issues confronted in real-world problem-solving situations. The supplementary use of cases does not help students to understand the dynamic…

Building Air Quality Guide: A Guide for Building Owners and Facility Managers

EPA Pesticide Factsheets

The Building Air Quality, developed by the EPA and the National Institute for Occupational Safety and Health, provides practical suggestions on preventing, identifying, and resolving indoor air quality (IAQ) problems in public and commercial buildings.

Watershed modeling and monitoring for assessing nutrient ...

EPA Pesticide Factsheets

Presentation for the American Water Works Association Water Sustainability Conference. The presentation highlights latest results from water quality trading research conducted by ORD using the East Fork Watershed in Southwestern Ohio as a case study. The watershed has a nutrient enrichment problem that is creating harmful algal blooms in a reservoir used for drinking water and recreation. Innovative modeling and monitoring is combined to understand how to best manage this water quality problem and costs associated with this endeavor. The presentation will provide an overview of the water quality trading feasibility research. The research includes the development and evaluation of innovative modeling and monitoring approaches to manage watersheds for nutrient pollution using a whole systems approach.

A management-oriented framework for selecting metrics used to assess habitat- and path-specific quality in spatially structured populations

USGS Publications Warehouse

Nicol, Sam; Wiederholt, Ruscena; Diffendorfer, James E.; Mattsson, Brady; Thogmartin, Wayne E.; Semmens, Darius J.; Laura Lopez-Hoffman,; Norris, Ryan

2016-01-01

Mobile species with complex spatial dynamics can be difficult to manage because their population distributions vary across space and time, and because the consequences of managing particular habitats are uncertain when evaluated at the level of the entire population. Metrics to assess the importance of habitats and pathways connecting habitats in a network are necessary to guide a variety of management decisions. Given the many metrics developed for spatially structured models, it can be challenging to select the most appropriate one for a particular decision. To guide the management of spatially structured populations, we define three classes of metrics describing habitat and pathway quality based on their data requirements (graph-based, occupancy-based, and demographic-based metrics) and synopsize the ecological literature relating to these classes. Applying the first steps of a formal decision-making approach (problem framing, objectives, and management actions), we assess the utility of metrics for particular types of management decisions. Our framework can help managers with problem framing, choosing metrics of habitat and pathway quality, and to elucidate the data needs for a particular metric. Our goal is to help managers to narrow the range of suitable metrics for a management project, and aid in decision-making to make the best use of limited resources.

Quality circles and their potential application to rural health care in Papua New Guinea.

PubMed

Cibulskis, R E; Edwards, K N

1993-06-01

A quality circle is a group of service providers who meet regularly to solve problems relating to the quality of their work. This is an example of bottom-up rather than top-down management which has found considerable success in the industries of the developed world. This article describes the principles which govern the operation of quality circles, the expected benefits and how best to introduce them. The problems relating to the provision of quality health care in rural areas and the potential application of the quality circle methodology are discussed.

Dementia Care Management in an Underserved Community: The Comparative Effectiveness of Two Different Approaches.

PubMed

Chodosh, Joshua; Colaiaco, Benjamin A; Connor, Karen Ilene; Cope, Dennis Wesley; Liu, Hangsheng; Ganz, David Avram; Richman, Mark Jason; Cherry, Debra Lynn; Blank, Joseph Moshe; Carbone, Raquel Del Pilar; Wolf, Sheldon Mark; Vickrey, Barbara Grace

2015-08-01

To compare the effectiveness and costs of telephone-only approach to in-person plus telephone for delivering an evidence-based, coordinated care management program for dementia. We randomized 151 patient-caregiver dyads from an underserved predominantly Latino community to two arms that shared a care management protocol but implemented in different formats: in-person visits at home and/or in the community plus telephone and mail, versus telephone and mail only. We compared between-arm caregiver burden and care-recipient problem behaviors (primary outcomes) and patient-caregiver dyad retention, care quality, health care utilization, and costs (secondary outcomes) at 6- and 12-months follow-up. Care quality improved substantially over time in both arms. Caregiver burden, care-recipient problem behaviors, retention, and health care utilization did not differ across arms but the in-person program cost more to deliver. Dementia care quality improved regardless of how care management was delivered; large differences in effectiveness or cost offsets were not detected. © The Author(s) 2015.

[Quality management in oncology supported by clinical cancer registries].

PubMed

Klinkhammer-Schalke, Monika; Gerken, Michael; Barlag, Hagen; Tillack, Anett

2015-01-01

Efforts in nationwide quality management for oncology have so far failed to comprehensively document all levels of care. New organizational structures such as population-based clinical cancer registries or certified organ cancer centers were supposed to solve this problem more sufficiently, but they have to be accompanied by valid trans-sectoral documentation and evaluation of clinical data. To measure feasibility and qualitative effectiveness of guideline implementation we approached this problem with a nationwide investigation from 2000 to 2011. The rate of neoadjuvant radio/chemotherapy in stage UICC II/III rectum cancer, cut-off point 80% for separating good from insufficient quality, was used as a quality indicator. The nationwide analysis indicates an increase from 45% to 70%, but only with the implementation strategy of CME. The combination of new structures, evidence-based quality indicators, organ cancer center and clinical cancer registries has shown good feasibility and seems promising. Copyright © 2015. Published by Elsevier GmbH.

Achieving Quality Learning in Higher Education.

ERIC Educational Resources Information Center

Nightingale, Peggy; O'Neil, Mike

This volume on quality learning in higher education discusses issues of good practice particularly action learning and Total Quality Management (TQM)-type strategies and illustrates them with seven case studies in Australia and the United Kingdom. Chapter 1 discusses issues and problems in defining quality in higher education. Chapter 2 looks at…

Visual quality assessment of alternative silvicultural practices in upland hardwood management

Treesearch

Tim McDonald; Bryce Stokes

1997-01-01

Visual impacts of forest operations are of increasing concern to forest managers. Tools are available for evaluating, and potentially avoiding, problems in visual quality resulting from poorly designed harvest unit boundaries. One of these visualization tools is applied in comparing various harvest unit shape alternatives in an upland hardwood stand on steeply sloping...

Power quality load management for large spacecraft electrical power systems

NASA Technical Reports Server (NTRS)

Lollar, Louis F.

1988-01-01

In December, 1986, a Center Director's Discretionary Fund (CDDF) proposal was granted to study power system control techniques in large space electrical power systems. Presented are the accomplishments in the area of power system control by power quality load management. In addition, information concerning the distortion problems in a 20 kHz ac power system is presented.

Ethical problems in nursing management: The views of nurse managers.

PubMed

Aitamaa, Elina; Leino-Kilpi, Helena; Iltanen, Silja; Suhonen, Riitta

2016-09-01

Nurse managers have responsibilities relating to the quality of care, the welfare of the staff and running of the organization. Ethics plays significant role in these responsibilities. Ethical problems are part of daily management, but research in this area is limited. The aim of this study was to identify and describe ethical problems nurse managers encounter in their work to get more detailed and extensive view of these problems. The data consisted of nine interviews with nurse managers at different management levels in primary healthcare and specialized healthcare organizations, and it was analysed by inductive content analysis. Permission to conduct the interviews including ethical approval was given at all participating organizations according to national standards. The respondents were informed about the aim of the study, and voluntary participation, anonymous response and confidentiality were explained to them. Four main categories were found: conflicts in practical situations, lack of appreciation, disregard of problems and experienced inadequacy. Problems could also be divided to patient-related, staff-related, organization-related and other problems. The findings correspond with results from earlier studies but add knowledge of the nature and details of nurse managers' ethical problems. New information is produced related to the ethical problems with nurse managers' own courage, motivation and values. Nurse managers identified a variety of different ethical problems in their work. This information is useful in the development of ethics in nursing management. Further research about the frequency and intensity of nurse managers' ethical problems is needed as well as possible differences in different levels of management. © The Author(s) 2015.

Evaluation and management of orofacial pain.

PubMed

Gilkey, Stephanie Joseph; Plaza-Villegas, Francisco

2017-05-01

Challenging to diagnose and manage, orofacial pain is a common and costly problem with a profound effect on quality of life. Delayed diagnosis and management can lead to prolonged patient suffering and disability. This article describes the background, assessment, differential diagnosis, management, and referral of patients with orofacial pain.

Large-Scale Operations Management Test of Use of the White Amur for Control of Problem Aquatic Plants. Report 2. First Year Poststocking Results. Volume VI. The Water and Sediment Quality of Lake Conway, Florida.

DTIC Science & Technology

1982-02-01

AD A113 .5. ORANGE COUNTY POLLUTION CONTROL DEPT ORLANDO FL F/S 6/6 LARGE-SCALE OPERATIONS MANAGEMENT TEST OF USE OF THE WHITE AMUR-ETC(U) FEB 82 H D...Large-Scale Operations Management Test of use of the white amur for control of problem aquatic plants in Lake Conway, Fla. Report 1 of the series presents...as follows: Miller, D. 1982. "Large-Scale Operations Management Test of Use of the White Amur for Control of Problem Aquatic Plants; Report 2, First

Large-Scale Operations Management Test of Use of the White Amur for Control of Problem Aquatic Plants. Report 4. Third Year Poststocking Results. Volume VI. The Water and Sediment Quality of Lake Conway, Florida.

DTIC Science & Technology

1983-01-01

RAI-RI247443 LARGE-SCALE OPERATIONS MANAGEMENT TEST OF USE OF THE i/i UNITE AMUR FOR CONTR.. (U) MILLER RND MILLER INC ORLANDO FL H D MILLER ET RL...LARGE-SCALE OPERATIONS MANAGEMENT TEST OF USE OF THE WHITE AMUR FOR CONTROL OF PROBLEM AQUATIC PLANTS Report 1: Baseline Studies Volume I...Boyd, J. 1983. "Large-Scale Operations Management Test of Use of the White Amur for Control of Problem Aquatic Plants; Report 4, Third Year Poststocking

Labour Markets, Unemployment and Training for Quality: Germany and Japan.

ERIC Educational Resources Information Center

Lange, Thomas; Maguire, Keith

1998-01-01

Although unemployment is a serious problem in Europe, deregulating labor markets is not the solution. Deregulation could lead to decline in quality and competitiveness. The example of Japan shows the interaction of education, training, human resource management, and quality control. (SK)

Quality improvement--boon or boondoggle?

PubMed

Paterson, M A; Wendel, J

1994-01-01

Is quality improvement (QI) reducing healthcare costs while improving patient care? Researchers find that QI has improved employee satisfaction and morale, but it was designed to do more. One solution is to use problem-solving techniques to help teams identify the level at which they want to address a problem, whether that be the subinstitutional, institutional, or system level. If QI is to fulfill its promise, skilled managers must create effective teams capable of defining and solving complex problems.

Improving data quality in the linked open data: a survey

NASA Astrophysics Data System (ADS)

Hadhiatma, A.

2018-03-01

The Linked Open Data (LOD) is “web of data”, a different paradigm from “web of document” commonly used today. However, the huge LOD still suffers from data quality problems such as completeness, consistency, and accuracy. Data quality problems relate to designing effective methods both to manage and to retrieve information at various data quality levels. Based on review from papers and journals, addressing data quality requires some standards functioning to (1) identification of data quality problems, (2) assessment of data quality for a given context, and (3) correction of data quality problems. However, mostly the methods and strategies dealing with the LOD data quality were not as an integrative approach. Hence, based on those standards and an integrative approach, there are opportunities to improve the LOD data quality in the term of incompleteness, inaccuracy and inconsistency, considering to its schema and ontology, namely ontology refinement. Moreover, the term of the ontology refinement means that it copes not only to improve data quality but also to enrich the LOD. Therefore, it needs (1) a standard for data quality assessment and evaluation which is more appropriate to the LOD; (2) a framework of methods based on statistical relational learning that can improve the correction of data quality problems as well as enrich the LOD.

Introducing quality management into primary health care services in Uganda.

PubMed Central

Omaswa, F.; Burnham, G.; Baingana, G.; Mwebesa, H.; Morrow, R.

1997-01-01

In 1994, a national quality assurance programme was established in Uganda to strengthen district-level management of primary health care services. Within 18 months both objective and subjective improvements in the quality of services had been observed. In the examples documented here, there was a major reduction in maternal mortality among pregnant women referred to Jinja District Hospital, a reduction in waiting times and increased patient satisfaction at Masaka District Hospital, and a marked reduction in reported cases of measles in Arua District. Beyond these quantitative improvements, increased morale of district health team members, improved satisfaction among patients, and greater involvement of local government in the decisions of district health committees have been observed. At the central level, the increased coordination of activities has led to new guidelines for financial management and the procurement of supplies. District quality management workshops followed up by regular support visits from the Ministry of Health headquarters have led to a greater understanding by central staff of the issues faced at the district level. The quality assurance programme has also fostered improved coordination among national disease-control programmes. Difficulties encountered at the central level have included delays in carrying out district support visits and the failure to provide appropriate support. At the district level, some health teams tackled problems over which they had little control or which were overly complex; others lacked the management capacity for problem solving. PMID:9185368

Planning and design of studies for river-quality assessment in the Truckee and Carson River basins, California and Nevada

USGS Publications Warehouse

Nowlin, Jon O.; Brown, W.M.; Smith, L.H.; Hoffman, R.J.

1980-01-01

The objectives of the Geological Survey 's river-quality assessment in the Truckee and Carson River basins in California and Nevada are to identify the significant resource management problems; to develop techniques to assess the problems; and to effectively communicate results to responsible managers. Six major elements of the assessment to be completed by October 1981 are (1) a detailing of the legal, institutional, and structural development of water resources in the basins and the current problems and conflicts; (2) a compilation and synthesis of the physical hydrology of the basins; (3) development of a special workshop approach to involve local management in the direction and results of the study; (4) development of a comprehensive streamflow model emcompassing both basins to provide a quantitative hydrologic framework for water-quality analysis; (5) development of a water-quality transport model for selected constituents and characteristics on selected reaches of the Truckee River; and (6) a detailed examination of selected fish habitats for specified reaches of the Truckee River. Progress will be periodically reported in reports, maps, computer data files, mathematical models, a bibliography, and public presentations. In building a basic framework to develop techniques, the basins were viewed as a single hydrologic unit because of interconnecting diversion structures. The framework comprises 13 hydrographic subunits to facilitate modeling and sampling. Several significant issues beyond the scope of the assessment were considered as supplementary proposals; water-quality loadings in Truckee and Carson Rivers, urban runoff in Reno and management alternatives, and a model of limnological processes in Lahontan Reservoir. (USGS)

Efforts To Solve Quality Problems. Background Paper No. 36.

ERIC Educational Resources Information Center

Smith, Michael J.; And Others

Producing goods and services of high quality is not expensive, but correcting poor quality costs U.S. companies as much as 20 percent of sales revenues annually. One survey reported that only 1 out of 300 U.S. companies involved management and engineering staff in quality training. The tendency is to have a quality control department, separate…

76 FR 34091 - Notice of Proposed Information Collection: Comment Request; Form HUD-9834 Management Review for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-10

... Information Collection: Comment Request; Form HUD-9834 Management Review for Multifamily Housing Projects... (CAs) to evaluate the quality of project management; determine the causes of project problems; devise... Management Review for Multifamily Housing Projects. Estimation of the total numbers of hours needed to...

ROLE OF MODELS IN AIR QUALITY MANAGEMENT DECISIONS

EPA Science Inventory

Within the frame of the US-India bilateral agreement on environmental cooperation, a team of US scientists have been helping India in designing emission control policies to address urban air quality problems. This presentation discusses how air quality models need to be used for ...

Small Steps, Big Reward: Quality Improvement through Pilot Groups.

ERIC Educational Resources Information Center

Bindl, Jim; Schuler, Jim

1988-01-01

Because of a need for quality improvement, Wisconsin Power and Light trained two six-person pilot groups in statistical process control, had them apply that knowledge to actual problems, and showed management the dollars-and-cents savings that come from quality improvement. (JOW)

Testing, Requirements, and Metrics

NASA Technical Reports Server (NTRS)

Rosenberg, Linda; Hyatt, Larry; Hammer, Theodore F.; Huffman, Lenore; Wilson, William

1998-01-01

The criticality of correct, complete, testable requirements is a fundamental tenet of software engineering. Also critical is complete requirements based testing of the final product. Modern tools for managing requirements allow new metrics to be used in support of both of these critical processes. Using these tools, potential problems with the quality of the requirements and the test plan can be identified early in the life cycle. Some of these quality factors include: ambiguous or incomplete requirements, poorly designed requirements databases, excessive or insufficient test cases, and incomplete linkage of tests to requirements. This paper discusses how metrics can be used to evaluate the quality of the requirements and test to avoid problems later. Requirements management and requirements based testing have always been critical in the implementation of high quality software systems. Recently, automated tools have become available to support requirements management. At NASA's Goddard Space Flight Center (GSFC), automated requirements management tools are being used on several large projects. The use of these tools opens the door to innovative uses of metrics in characterizing test plan quality and assessing overall testing risks. In support of these projects, the Software Assurance Technology Center (SATC) is working to develop and apply a metrics program that utilizes the information now available through the application of requirements management tools. Metrics based on this information provides real-time insight into the testing of requirements and these metrics assist the Project Quality Office in its testing oversight role. This paper discusses three facets of the SATC's efforts to evaluate the quality of the requirements and test plan early in the life cycle, thus preventing costly errors and time delays later.

World-class materiel flexibility: one plant's victory over materiel-related downtime.

PubMed

Samelson, Q B

1997-05-01

It is not uncommon for the materiel managers in a manufacturing company to be blamed for downtime and the consequent failure to meet production targets. To avoid downtime, materiel managers need to look at their role in solving materiel-related downtime and to address the problems that cause downtime in the same way they would address other process quality problems.

[Animal drugs quality status and reason analysis].

PubMed

Ding, Qing; Qiu, Ya-jing; Fang, Ke-hui; Hu, Hao-bin; Wu, Yue

2015-11-01

In order to reaction the quality present situation, problems on the current quality of animal sources of drugs are summed up by using test data analysis, literature search and marketing research. This paper can also help the improvement of the quality management, the revision of the relevant department policy system and the improvement of standards.

Total Quality Management Analysis of LAMPS MK 1 Aviation Maintenance Data

DTIC Science & Technology

1992-06-05

Qualit Control? The Japanese Way by Dr. Kaoru Ishikawa translated by David J. Lu offers the Japanese version of Total Quality Management. Dr...causes to an effect or problem. It is called the Ishikawa Diagram after its inventor Kaoru Ishikawa , a pioneer in quality control. The name fishbone...pathways involved. 2) Cause and Effect Diagram (also known as an Ishikawa Diagram or a Fishbone Diagram). This diagram used to identify the causes, and

Some Recommendations for Education (and All of Us): Valuing Differences as Collaboration beyond Outcomes Assessment and Total Quality Management/Demingism.

ERIC Educational Resources Information Center

Sadler, Lynn Veach

Recommendations for a national educational agenda that is based on tolerance for cultural diversity and real collaboration are presented in this paper with emphasis on the W. E. Deming model of Total Quality Management, or "Demingism." Two problems in American education are academic performance and the failure of disadvantaged schools. Ten…

Modeling framework for representing long-term effectiveness of best management practices in addressing hydrology and water quality problems: Framework development and demonstraton using a Bayesian method

USDA-ARS?s Scientific Manuscript database

Best management practices (BMPs) are popular approaches used to improve hydrology and water quality. Uncertainties in BMP effectiveness over time may result in overestimating long-term efficiency in watershed planning strategies. To represent varying long-term BMP effectiveness in hydrologic/water q...

Quality Improvement of Ground Works Process with the Use of Chosen Lean Management Tools - Case Study

NASA Astrophysics Data System (ADS)

Nowotarski, Piotr; Paslawski, Jerzy; Wysocki, Bartosz

2017-12-01

Ground works are one of the first processes connected with erecting structures. Based on ground conditions like the type of soil or level of underground water different types and solutions for foundations are designed. Foundations are the base for the buildings, and their proper design and execution is the key for the long and faultless use of the whole construction and might influence on the future costs of the eventual repairs (especially when ground water level is high, and there is no proper water insulation made). Article presents the introduction of chosen Lean Management tools for quality improvement of the process of ground works based on the analysis made on the construction site of vehicle control station located in Poznan, Poland. Processes assessment is made from different perspectives taking into account that 3 main groups of workers were directly involved in the process: blue collar-workers, site manager and site engineers. What is more comparison is made on the 3 points of view to the problems that might occur during this type of works, with details analysis on the causes of such situation? Authors presents also the change of approach of workers directly involved in the mentioned processes regarding introduction of Lean Management methodology, which illustrates the problem of scepticism for new ideas of the people used to perform works and actions in traditional way. Using Lean Management philosophy in construction is a good idea to streamline processes in company, get rid of constantly recurring problems, and in this way improve the productivity and quality of executed activities. Performed analysis showed that different groups of people have very different idea and opinion on the problems connected with executing the same process - ground works and only having full picture of the situation (especially in construction processes) management can take proper problems-preventing actions that consequently can influence on the amount of waste generated on the construction cite which positively influence on the external environment.

[Comprehensive quality management in hospitals--experience and recommendations].

PubMed

Schubert, H J

1999-03-01

Total quality management concepts, increasingly being introduced into hospitals, offer opportunities for integrative leadership concepts because of their multidimensional character viewed from the aspects of results and from the standpoint of organisational design. Customized for leadership and organisation of hospitals in Germany, questions of introduction strategies as well as recommendations for the integration of total quality understanding into the daily practice of management and employees are discussed. The active support of top and middle management and a combination of radical change in selected problem areas and continual incremental improvements on a broad base have been proven as significant factors for the success in the introductory phase. For a lasting integration of the principles of a comprehensive quality management concept in a hospital, it will be necessary to carry out regularly relevant measurements of success. The results become an important part of agreements with management.

Improving the quality of mass produced maps

USGS Publications Warehouse

Simley, J.

2001-01-01

Quality is critical in cartography because key decisions are often made based on the information the map communicates. The mass production of digital cartographic information to support geographic information science has now added a new dimension to the problem of cartographic quality, as problems once limited to small volumes can now proliferate in mass production programs. These problems can also affect the economics of map production by diverting a sizeable portion of production cost to pay for rework on maps with poor quality. Such problems are common to general industry-in response, the quality engineering profession has developed a number of successful methods to overcome these problems. Two important methods are the reduction of error through statistical analysis and addressing the quality environment in which people work. Once initial and obvious quality problems have been solved, outside influences periodically appear that cause adverse variations in quality and consequently increase production costs. Such errors can be difficult to detect before the customer is affected. However, a number of statistical techniques can be employed to detect variation so that the problem is eliminated before significant damage is caused. Additionally, the environment in which the workforce operates must be conductive to quality. Managers have a powerful responsibility to create this environment. Two sets of guidelines, known as Deming's Fourteen Points and ISO-9000, provide models for this environment.

Development of Knowledge Management Model for Developing the Internal Quality Assurance in Educational Opportunity Expansion Schools

ERIC Educational Resources Information Center

Pradabpech, Pipat; Chantarasombat, Chalard; Sriampai, Anan

2015-01-01

This research for: 1) to study the current situation and problem in KM, 2) to develop the KM Model, and 3) to evaluate the finding usage of the KM Model for developing the Internal Quality Assurance of Educational Opportunity Expansion Schools. There were 3 Phases of research implementation. Phase 1: the current situation and problem in KM, was…

Scripted Collaboration in Serious Gaming for Complex Learning: Effects of Multiple Perspectives when Acquiring Water Management Skills

ERIC Educational Resources Information Center

Hummel, Hans G. K.; van Houcke, Jasper; Nadolski, Rob J.; van der Hiele, Tony; Kurvers, Hub; Lohr, Ansje

2011-01-01

This paper examines how learning outcomes from playing serious games can be enhanced by including scripted collaboration in the game play. We compared the quality of advisory reports, that students in the domain of water management had to draw up for an authentic case problem, both before and after collaborating on the problem with (virtual) peer…

40 CFR 35.1603 - Summary of clean lakes assistance program.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and the State must certify that the lake project is consistent with the State Water Quality Management... quality, evaluate possible solutions to existing pollution problems, and recommend a feasible program to restore or preserve the quality of the lake. A Phase 2 cooperative agreement is to be used for...

7TH JAPAN - U.S. CONFERENCE ON DRINKING WATER QUALITY MANAGEMENT AND WASTEWATER CONTROL

EPA Science Inventory

Update on U.S. Drinking Water and Water Quality Research

The U.S. Environmental Protection Agency's (U.S. EPA) Office of Research and development continues to conduct drinking water and water quality related research to address high priority environmental problems. Curr...

Total quality management in the hospital setting.

PubMed

Ernst, D F

1994-01-01

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

Residuals Management and Water Pollution Control Planning.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC. Office of Public Affairs.

This pamphlet addresses the problems associated with residuals and water quality especially as it relates to the National Water Pollution Control Program. The types of residuals and appropriate management systems are discussed. Additionally, one section is devoted to the role of citizen participation in developing management programs. (CS)

A Methodology for Writing High Quality Requirement Specifications and for Evaluating Existing Ones

NASA Technical Reports Server (NTRS)

Rosenberg, Linda; Hammer, Theodore

1999-01-01

Requirements development and management have always been critical in the implementation of software systems-engineers are unable to build what analysts can not define. It is generally accepted that the earlier in the life cycle potential risks are identified the easier it is to eliminate or manage the conditions that introduce that risk. Problems that are not found until testing are approximately 14 times more costly to fix than if the problem was found in the requirement phase. The requirements specification, as the first tangible representation of the capability to be produced, establishes the basis for all of the project's engineering management and assurance functions. If the quality of the requirements specification is poor it can give rise to risks in all areas of the project. Recently, automated tools have become available to support requirements management. The use of these tools not only provides support in the definition and tracing of requirements, but it also opens the door to effective use of metrics in characterizing and assessing the quality of the requirement specifications.

A Methodology for Writing High Quality Requirements Specification and Evaluating Existing Ones

NASA Technical Reports Server (NTRS)

Rosenberg, Linda; Hammer, Theodore

1999-01-01

Requirements development and management have always been critical in the implementation of software systems; engineers are unable to build what analysts can't define. It is generally accepted that the earlier in the life cycle potential risks are identified the easier it is to eliminate or manage the conditions that introduce that risk. Problems that are not found until testing are approximately 14 times more costly to fix than if the problem was found in the requirement phase. The requirements specification, as the first tangible representation of the capability to be produced, establishes the basis for all of the project's engineering management and assurance functions. If the quality of the requirements specification is poor it can give rise to risks in all areas of the project. Recently, automated tools have become available to support requirements management. The use of these tools not only provides support in the definition and tracing of requirements, but it also opens the door to effective use of metrics in characterizing and assessing the quality of the requirement specifications.

The role of trees in urban stormwater management

EPA Science Inventory

Urban impervious surfaces convert precipitation to stormwater runoff, which causes water quality and quantity problems. While traditional stormwater management has relied on gray infrastructure such as piped conveyances to collect and convey stormwater to wastewater treatment fac...

Relationships between parental sleep quality, fatigue, cognitions about infant sleep, and parental depression pre and post-intervention for infant behavioral sleep problems.

PubMed

Hall, Wendy A; Moynihan, Melissa; Bhagat, Radhika; Wooldridge, Joanne

2017-04-04

Maternal and paternal depression has been associated with infants' behavioral sleep problems. Behavioral sleep interventions, which alter parental cognitions about infant sleep, have improved infant sleep problems. This study reports relationships between parental depression, fatigue, sleep quality, and cognitions about infant sleep pre and post-intervention for a behavioral sleep problem. This secondary analysis of data from Canadian parents (n = 455), with healthy infants aged 6-to-8-months exposed to a behavioral sleep intervention, examined baseline data and follow-up data from 18 or 24 weeks post intervention (group teaching or printed material) exposure. Parents reported on sleep quality, fatigue, depression, and cognitions about infant sleep. Data were analyzed using Pearson's r and stepwise regression analysis. Parents' fatigue, sleep quality, sleep cognitions, and depression scores were correlated at baseline and follow-up. At baseline, sleep quality (b = .52, 95% CI .19-.85), fatigue (b = .48, 95% CI .33-.63), doubt about managing infant sleep (b = .44, 95% CI .19-.69), and anger about infant sleep (b = .69, 95% CI .44-.94) were associated with mothers' depression. At baseline, fathers' depression related to sleep quality (b = .42, 95% CI .01-.83), fatigue (b = .47, 95% CI .32-.63), and doubt about managing infant sleep (b = .50, 95% CI .24-.76). At follow-up, mothers' depression was associated with sleep quality (b = .76, 95% CI .41-1.12), fatigue (b = .25, 95% CI .14-.37), doubt about managing infant sleep (b = .44, 95% CI .16-.73), sleep anger (b = .31, 95% CI .02-.59), and setting sleep limits (b = -.22, 95% CI -.41-[-.03]). At follow-up, fathers' depression related to sleep quality (b = .84, 95% CI .46-1.22), fatigue (b = .31, 95% CI .17-.45), sleep doubt (b = .34, 95% CI .05-.62), and setting sleep limits (b = .25, 95% CI .01-.49). Mothers' and fathers' cognitions about infant sleep demonstrate complex relationships with their depression scores. While mothers' setting sleep limit scores are associated with decreased depression scores, fathers' setting limits scores are associated with increased depression scores. Parental doubts about managing infant sleep and difficulties with setting sleep limits require attention in interventions.

A proactive approach for managing indoor air quality

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

Greene, R.E.; Casey, J.M.; Williams, P.L.

1997-11-01

Ventilation and maintenance, followed by psychosocial issues, are the factors most often implicated in indoor air quality (IAQ) investigations. The absence of accepted exposure standards and the presence of a wide variety of building designs, ages, ventilation systems, and usages often make IAQ complaint investigations ineffective. Thus, the best approach to achieving IAQ is to prevent problems from occurring. This paper presents the framework for a proactive approach to managing the causes most often implicated in IAQ investigations. It is the aim of this proactive protocol to provide a cost-effective guide for preventing IAQ problems in nonindustrial settings and inmore » buildings for which there are no current IAQ complaints. The proposed protocol focuses on heating, ventilation, and air-conditioning (HVAC) system maintenance and operation; psychosocial factors; and the handling and investigation of complaints. An IAQ manager is designated to implement and manage the protocol. The HVAC system portion of the protocol focuses on proper maintenance of the components often identified as sources of problems in IAQ studies, documentation of the maintenance procedures, and training of individuals responsible for building maintenance. The protocol addresses the psychosocial factors with an environmental survey that rates the occupants` perceptions of the indoor air to identify potential IAQ problems. The psychosocial portion of the protocol also incorporates occupant education and awareness. Finally, a three-step initial investigation procedure for addressing IAQ problems is presented.« less

[Quality assessment in anesthesia].

PubMed

Kupperwasser, B

1996-01-01

Quality assessment (assurance/improvement) is the set of methods used to measure and improve the delivered care and the department's performance against pre-established criteria or standards. The four stages of the self-maintained quality assessment cycle are: problem identification, problem analysis, problem correction and evaluation of corrective actions. Quality assessment is a measurable entity for which it is necessary to define and calibrate measurement parameters (indicators) from available data gathered from the hospital anaesthesia environment. Problem identification comes from the accumulation of indicators. There are four types of quality indicators: structure, process, outcome and sentinel indicators. The latter signal a quality defect, are independent of outcomes, are easier to analyse by statistical methods and closely related to processes and main targets of quality improvement. The three types of methods to analyse the problems (indicators) are: peer review, quantitative methods and risks management techniques. Peer review is performed by qualified anaesthesiologists. To improve its validity, the review process should be explicited and conclusions based on standards of practice and literature references. The quantitative methods are statistical analyses applied to the collected data and presented in a graphic format (histogram, Pareto diagram, control charts). The risks management techniques include: a) critical incident analysis establishing an objective relationship between a 'critical' event and the associated human behaviours; b) system accident analysis, based on the fact that accidents continue to occur despite safety systems and sophisticated technologies, checks of all the process components leading to the impredictable outcome and not just the human factors; c) cause-effect diagrams facilitate the problem analysis in reducing its causes to four fundamental components (persons, regulations, equipment, process). Definition and implementation of corrective measures, based on the findings of the two previous stages, are the third step of the evaluation cycle. The Hawthorne effect is an outcome improvement, before the implementation of any corrective actions. Verification of the implemented actions is the final and mandatory step closing the evaluation cycle.

Increasing the relevance of research to health care managers: hospital CEO imperatives for improving quality and lowering costs.

PubMed

Alexander, Jeffrey A; Hearld, Larry R; Jiang, H Joanna; Fraser, Irene

2007-01-01

Evidence-based management assumes that available research evidence is consistent with the problems and decision-making conditions faced by those who will utilize this evidence in practice. This article attempts to identify how hospital leaders view key determinants of hospital quality and costs, as well as the fundamental ways these leaders "think" about solutions to quality and cost issues in their organizations. The objective of this analysis is to better inform the research agenda and approaches pursued by health services research so that this research reflects the "realities" of practice in hospitals. We conducted a series of semistructured interviews with a convenience sample of eight hospital and three health system leaders. Questions focused on current and future challenges facing hospitals as they relate to hospital quality, costs, and efficiency, and potential solutions to those challenges. Nine major organizational and managerial factors emerged from the interviews, including staffing, evidence-based practice, information technology, data availability and benchmarking, and leadership. Hospital leaders tend to think about these factors systemically and consider process-related factors as the important drivers of cost and quality. The results suggest a need to expand the methods utilized by health services researchers to make their research more relevant to health care managers. Expanding research methods to reflect the systemic way that managers view the challenges and solutions facing their organizations may enhance the application of research findings into management practice. Finally, better communication is needed between the research and practice communities. Researchers must learn to think more like managers if their research is to be relevant, and managers must learn to more effectively communicate their issues with the research community and frame their problems in researchable terms.

E-Quality in the Workplace: Quality Circles or Quality of Working Life Programs in the US.

ERIC Educational Resources Information Center

Savage, Grant T.; Romano, Richard

Quality Circle (QC) and Quality of Working Life (QWL) in the United States are similar in that both stress participative decision making, preserve management's prerogative to have the final say, and are voluntary. QC and QWL programs differ, however, in that labor unions are more involved in QWLs; QCs deal only with technical problems related to…

Eco-informatics for decision makers advancing a research agenda

USGS Publications Warehouse

Cushing, J.B.; Wilson, T.; Brandt, L.; Gregg, V.; Spengler, S.; Borning, A.; Delcambre, L.; Bowker, G.; Frame, M.; Fulop, J.; Hert, C.; Hovy, E.; Jones, J.; Landis, E.; Schnase, J.L.; Schweik, C.; Sonntag, W.; ,

2005-01-01

Resource managers often face significant information technology (IT) problems when integrating ecological or environmental information to make decisions. At a workshop sponsored by the NSF and USGS in December 2004, university researchers, natural resource managers, and information managers met to articulate IT problems facing ecology and environmental decision makers. Decision making IT problems were identified in five areas: 1) policy, 2) data presentation, 3) data gaps, 4) tools, and 5) indicators. To alleviate those problems, workshop participants recommended specific informatics research in modeling and simulation, data quality, information integration and ontologies, and social and human aspects. This paper reports the workshop findings, and briefly compares these with research that traditionally falls under the emerging eco-informatics rubric. ?? Springer-Verlag Berlin Heidelberg 2005.

A Process Management System for Networked Manufacturing

NASA Astrophysics Data System (ADS)

Liu, Tingting; Wang, Huifen; Liu, Linyan

With the development of computer, communication and network, networked manufacturing has become one of the main manufacturing paradigms in the 21st century. Under the networked manufacturing environment, there exist a large number of cooperative tasks susceptible to alterations, conflicts caused by resources and problems of cost and quality. This increases the complexity of administration. Process management is a technology used to design, enact, control, and analyze networked manufacturing processes. It supports efficient execution, effective management, conflict resolution, cost containment and quality control. In this paper we propose an integrated process management system for networked manufacturing. Requirements of process management are analyzed and architecture of the system is presented. And a process model considering process cost and quality is developed. Finally a case study is provided to explain how the system runs efficiently.

Known Data Problems | ECHO | US EPA

EPA Pesticide Factsheets

EPA manages a series of national information systems that include data flowing from staff in EPA and state/tribal/local offices. Given this fairly complex set of transactions, occasional problems occur with the migration of data into the national systems. This page is meant to explain known data quality problems with larger sets of data.

An Effect of the Learning Environment Management System toward Student Quality of Thai Secondary School

ERIC Educational Resources Information Center

Wirussawa, Seatuch; Tesaputa, Kowat; Duangpaeng, Amporn

2016-01-01

This study aimed at 1) investigating the element of the learning environment management system in the secondary schools, 2) exploring the current states and problems of the system on the learning environment management in the secondary schools, 3) designing the learning environment management system for the secondary schools, and 4) identifying…

Republication of "Experiencing Management: A Comprehensive, 'Hands-On' Model for the Introductory Undergraduate Management Course"

ERIC Educational Resources Information Center

Miller, John A.

2017-01-01

The purpose of this article is to describe an experiential course designed to overcome the specific problems inherent in working with undergraduate students in introductory management courses. The article grew out of discussions among faculty at the 1988 Academy of Management meetings who shared deep concerns about the quality of undergraduate…

Some Possible Effects of Behaviour Management Training on Teacher Confidence and Competence: Evidence from a Study of Primary School Teachers in Hong Kong

ERIC Educational Resources Information Center

Cooper, Paul; Yan, Zi

2015-01-01

This study aims to explore the relationships between the extent and perceived quality of teachers' experience of training in behaviour management (BM), and their awareness of the nature and extent of behavioural problems among school students, and their confidence in their own competence to deal with such problems. Teachers (n = 183) from Hong…

Draft framework for watershed-based trading

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

NONE

1996-05-30

Effluent trading is an innovative way for water quality agencies and community stakeholders to develop common-sense, cost-effective solutions for water quality problems in their watersheds. Trading can allow communities to grow and prosper while retaining their commitment to water quality. The bulk of this framework discusses effluent trading in watersheds. Remaining sections discuss transactions that, while not technically fulfilling the definition of `effluent` trade, do involve the exchange of valued water quality or other ecological improvements between partners responding to market initiatives. This document therefore includes activities such as trades within a facility (intra-plant trading) and wetland mitigation banking, effluentmore » trading/watersheds/watershed management/water quality protection/water quality management.« less

Effectiveness of a nurse-supported self-management programme for dual sensory impaired older adults in long-term care: a cluster randomised controlled trial

PubMed Central

Roets-Merken, Lieve M; Zuidema, Sytse U; Vernooij-Dassen, Myrra J F J; Teerenstra, Steven; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

2018-01-01

Objective To evaluate the effectiveness of a nurse-supported self-management programme to improve social participation of dual sensory impaired older adults in long-term care homes. Design Cluster randomised controlled trial. Setting Thirty long-term care homes across the Netherlands. Participants Long-term care homes were randomised into intervention clusters (n=17) and control clusters (n=13), involving 89 dual sensory impaired older adults and 56 licensed practical nurses. Intervention Nurse-supported self-management programme. Measurements Effectiveness was evaluated by the primary outcome social participation using a participation scale adapted for visually impaired older adults distinguishing four domains: instrumental activities of daily living, social-cultural activities, high-physical-demand and low-physical-demand leisure activities. A questionnaire assessing hearing-related participation problems was added as supportive outcome. Secondary outcomes were autonomy, control, mood and quality of life and nurses’ job satisfaction. For effectiveness analyses, linear mixed models were used. Sampling and intervention quality were analysed using descriptive statistics. Results Self-management did not affect all four domains of social participation; however. the domain ‘instrumental activities of daily living’ had a significant effect in favour of the intervention group (P=0.04; 95% CI 0.12 to 8.5). Sampling and intervention quality was adequate. Conclusions A nurse-supported self-management programme was effective in empowering the dual sensory impaired older adults to address the domain ‘instrumental activities of daily living’, but no differences were found in addressing the other three participation domains. Self-management showed to be beneficial for managing practical problems, but not for those problems requiring behavioural adaptations of other persons. Trial registration number NCT01217502; Results. PMID:29371264

Managing the System of Higher Education: Competition or Collaboration?

ERIC Educational Resources Information Center

Maguad, Ben A.

2018-01-01

The systems view of quality postulates that product or service quality comes as the result of interactions between various components that comprise a production process. In view of this, most problems in the organization, like an institution of higher education, can be attributed to the system. To be effective, any quality improvement initiative…

Market-Based Approaches to Quality Assessment and Management of Higher Education in the Republic of Kazakhstan

ERIC Educational Resources Information Center

Valikhanova, Zarina

2015-01-01

This article considers the problems of the definition of quality in the educational sphere. Alternative approaches to the concept of quality of education and its evaluation are determined given the different approaches of scientists and experts. The most important criteria in assessing the quality is distinguished and formed in the matrix for…

Total Quality Management: A Guide to Implementation

DTIC Science & Technology

1989-08-01

Kaizen. New York: Random House. 1986. Ishikawa , Kaoru . Guide to Quality Control. Asian Productivity Organization. 1984. Ishikawa , Kaoru . What is Total...with the problems and the new management principles are based on the complexities of the new Systems Age. The theories of Deming, Juran, Ishikawa , and...Progress. Jun 1985. Miller, Jeffery G. and Thomas E. Vollmann. "The Hidden Factory." Harvard Business Review. Sep-Oct 1985. Shimoyamada, Kaoru . "The

A Hybrid Interval-Robust Optimization Model for Water Quality Management.

PubMed

Xu, Jieyu; Li, Yongping; Huang, Guohe

2013-05-01

In water quality management problems, uncertainties may exist in many system components and pollution-related processes ( i.e. , random nature of hydrodynamic conditions, variability in physicochemical processes, dynamic interactions between pollutant loading and receiving water bodies, and indeterminacy of available water and treated wastewater). These complexities lead to difficulties in formulating and solving the resulting nonlinear optimization problems. In this study, a hybrid interval-robust optimization (HIRO) method was developed through coupling stochastic robust optimization and interval linear programming. HIRO can effectively reflect the complex system features under uncertainty, where implications of water quality/quantity restrictions for achieving regional economic development objectives are studied. By delimiting the uncertain decision space through dimensional enlargement of the original chemical oxygen demand (COD) discharge constraints, HIRO enhances the robustness of the optimization processes and resulting solutions. This method was applied to planning of industry development in association with river-water pollution concern in New Binhai District of Tianjin, China. Results demonstrated that the proposed optimization model can effectively communicate uncertainties into the optimization process and generate a spectrum of potential inexact solutions supporting local decision makers in managing benefit-effective water quality management schemes. HIRO is helpful for analysis of policy scenarios related to different levels of economic penalties, while also providing insight into the tradeoff between system benefits and environmental requirements.

Problems of quality and equity in pain management: exploring the role of biomedical culture.

PubMed

Crowley-Matoka, Megan; Saha, Somnath; Dobscha, Steven K; Burgess, Diana J

2009-10-01

To explore how social scientific analyses of the culture of biomedicine may contribute to advancing our understanding of ongoing issues of quality and equity in pain management. Drawing upon the rich body of social scientific literature on the culture of biomedicine, we identify key features of biomedical culture with particular salience for pain management. We then examine how these cultural features of biomedicine may shape key phases of the pain management process in ways that have implications not just for quality, but for equity in pain management as well. We bring together a range of literatures in developing our analysis, including literatures on the culture of biomedicine, pain management and health care disparities. We surveyed the relevant literatures to identify and inter-relate key features of biomedical culture, key phases of the pain management process, and key dimensions of identified problems with suboptimal and inequitable treatment of pain. We identified three key features of biomedical culture with critical implications for pain management: 1) mind-body dualism; 2) a focus on disease vs illness; and 3) a bias toward cure vs care. Each of these cultural features play a role in the key phases of pain management, specifically pain-related communication, assessment and treatment decision-making, in ways that may hinder successful treatment of pain in general -- and of pain patients from disadvantaged groups in particular. Deepening our understanding of the role of biomedical culture in pain management has implications for education, policy and research as part of ongoing efforts to ameliorate problems in both quality and equity in managing pain. In particular, we suggest that building upon the existing the cultural competence movement in medicine to include fostering a deeper understanding of biomedical culture and its impact on physicians may be useful. From a policy perspective, we identify pain management as an area where the need for a shift to a more biopsychosocial model of health care is particularly pressing, and suggest prioritization of inter-disciplinary, multimodal approaches to pain as one key strategy in realizing this shift. Finally, in terms of research, we identify the need for empirical research to assess aspects of biomedical culture that may influence physician's attitudes and behaviors related to pain management, as well as to explore how these cultural values and their effects may vary across different settings within the practice of medicine.

Relationship between total quality management, critical paths, and outcomes management.

PubMed

Lynn, P A

1996-09-01

Total quality management (TQM), clinical paths, and outcomes management are high-profile strategies in today's health care environment. Each strategy is distinct, yet there are interrelationships among them. TQM supports a customer-focused organizational culture, providing tools and techniques to identify and solve problems. Clinical paths are tools for enhancing patient care coordination and for identifying system-wide and patient population specific issues. Outcomes management is an integrated system for measuring the results in patient populations over time. There is a recent shift in outcomes measurement towards expanding both the nature of the outcomes examined and the timeframes in which they are studied.

Outreach pharmacy service in old age homes: a Hong Kong experience.

PubMed

Lau, Wai-Man; Chan, Kit; Yung, Tsz-Ho; Lee, Anna See-Wing

2003-06-01

To explore drug-related problems in old age homes in Hong Kong through outreach pharmacy service. A standard form was used by outreach pharmacists to identify drug-related problems at old age homes. Homes were selected through random sampling, voluntary participation or adverse selection. Initial observation and assessment were performed in the first and second weeks. Appropriate advice and recommendations were given upon assessment and supplemented by a written report. Educational talks were provided to staff of the homes in addition to other drug information materials. At week 7 to 9, evaluations were carried out. Eighty-five homes were assessed and identified to have problems in the drug management system. These problems could generally be classified into physical storage (8.8%), quality of storage (19.2%), drug administration system (13.3%), documentation (16.4%), and drug knowledge of staff of homes (42.2%). Quality of drug storage was the most common problem found, followed by documentation and drug knowledge (73%, 50% and 44% of points assessed with problems, respectively). Apart from lack of drug knowledge and unawareness of potential risks by staff, minimal professional standards unmet may be fundamentally related to lack of professional input and inadequacy in legislation. Most homes demonstrated significant improvements upon simple interventions, from a majority of homes with more than 10 problems to a majority with less than 5 problems. Diverse problems in drug management are common in old age homes, which warrants attention and professional inputs. Simple interventions and education by pharmacists are shown to be effective in improving the quality of drug management and hence care to residents. While future financing of old age home service can be reviewed within the social context to provide incentives for improvement, review of regulatory policy with enforcement may be more fundamental and effective in upholding the service standard.

Strategies for Hard Times in Higher Education.

ERIC Educational Resources Information Center

Desfosses, Louis R.

1996-01-01

Planning and management strategies used in the private sector have practical applications for higher education in a period of systemic and organizational stress. Promising strategies include organizational delayering; employee empowerment; boundless thinking, problem-solving teams; accelerated processes; quality management and improvement; and…

Quest for Quality.

ERIC Educational Resources Information Center

Wilson, Richard B.; Schmoker, Mike

1992-01-01

Unlike traditional school management, Toyota of America recognizes thinking employees and emphasizes problems and measurable approaches to improvement. Instead of meeting to discuss short-term goals, specific problems, and concrete successes, school leaders often alienate staff by leading year-end discussions of standardized test score data.…

Prevention and management of foot problems in diabetes: A Summary Guidance for Daily Practice 2015, based on the IWGDF guidance documents.

PubMed

Schaper, N C; Van Netten, J J; Apelqvist, J; Lipsky, B A; Bakker, K

2017-02-01

Foot problems complicating diabetes are a source of major patient suffering and societal costs. To prevent, or at least reduce, the adverse effects of foot problems in diabetes, the International Working Group on the Diabetic Foot (IWGDF; www.iwgdf.org) was founded in 1996, consisting of experts from almost all the disciplines involved in the care of patients with diabetes and foot problems. An important output of the IWGDF is the international consensus guidance, continuously updated since 1999. To date, the publications have been translated into 26 languages, and more than 100,000 copies have been distributed globally. The "Summary Guidance for Daily Practice" summarises the essentials of prevention and management of foot problems in persons with diabetes for clinicians who work with these patients on a daily basis. This guidance is the result of a long and careful process that started with the empaneling in 2013 of five working groups consisting of 49 international experts. These experts performed seven targeted systematic reviews to provide the evidence supporting the five chapters of the IWGDF Guidance on prevention; footwear and offloading; diagnosis, prognosis and management of peripheral artery disease; diagnosis and management of foot infections; interventions to enhance healing. In total almost 80,000 studies were detected by our literature review. After review of the title and abstract the reviewers of the different working groups selected only studies that fulfilled a minimal set of quality criteria and ended up with 429 articles for complete quality analysis. The GRADE system was used to translate the evidence from the studies into recommendations for daily clinical practice. The rating of each recommendation takes into account both the strength and the quality of the evidence. The IWGDF Guidance 2015 makes a total of 77 recommendations on prevention and management of foot problems in diabetes. These recommendations were condensed by the editorial board into this "Summary Guidance". Encouraging and aiding clinicians to follow the evidence-based recommendations of the IWGDF Guidance 2015, and in particular the principles outlined in the "Summary Guidance", will likely result in a worldwide reduction in, and better outcomes of, foot problems in persons with diabetes, helping to reduce the morbidity and mortality associated with this major health problem. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Organizational management practices for achieving software process improvement

NASA Technical Reports Server (NTRS)

Kandt, Ronald Kirk

2004-01-01

The crisis in developing software has been known for over thirty years. Problems that existed in developing software in the early days of computing still exist today. These problems include the delivery of low-quality products, actual development costs that exceed expected development costs, and actual development time that exceeds expected development time. Several solutions have been offered to overcome out inability to deliver high-quality software, on-time and within budget. One of these solutions involves software process improvement. However, such efforts often fail because of organizational management issues. This paper discusses business practices that organizations should follow to improve their chances of initiating and sustaining successful software process improvement efforts.

The Grand Challenge of Basin-Scale Groundwater Quality Management Modelling

NASA Astrophysics Data System (ADS)

Fogg, G. E.

2017-12-01

The last 50+ years of agricultural, urban and industrial land and water use practices have accelerated the degradation of groundwater quality in the upper portions of many major aquifer systems upon which much of the world relies for water supply. In the deepest and most extensive systems (e.g., sedimentary basins) that typically have the largest groundwater production rates and hold fresh groundwaters on decadal to millennial time scales, most of the groundwater is not yet contaminated. Predicting the long-term future groundwater quality in such basins is a grand scientific challenge. Moreover, determining what changes in land and water use practices would avert future, irreversible degradation of these massive freshwater stores is a grand challenge both scientifically and societally. It is naïve to think that the problem can be solved by eliminating or reducing enough of the contaminant sources, for human exploitation of land and water resources will likely always result in some contamination. The key lies in both reducing the contaminant sources and more proactively managing recharge in terms of both quantity and quality, such that the net influx of contaminants is sufficiently moderate and appropriately distributed in space and time to reverse ongoing groundwater quality degradation. Just as sustainable groundwater quantity management is greatly facilitated with groundwater flow management models, sustainable groundwater quality management will require the use of groundwater quality management models. This is a new genre of hydrologic models do not yet exist, partly because of the lack of modeling tools and the supporting research to model non-reactive as well as reactive transport on large space and time scales. It is essential that the contaminant hydrogeology community, which has heretofore focused almost entirely on point-source plume-scale problems, direct it's efforts toward the development of process-based transport modeling tools and analyses capable of appropriately upscaling advection-dispersion and reactions at the basin scale (10^2 km). A road map for research and development in groundwater quality management modeling and its application toward securing future groundwater resources will be discussed.

7 CFR 634.13 - Project applications.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Project Authorization and Funding... State or areawide 208 water quality management plan. (c) Applications shall contain the following... water quality problem (3) Objectives and planned action, (4) Schedule for carrying out the plan, and (5...

An Office Building Occupants Guide to Indoor Air Quality - Printable Version

EPA Pesticide Factsheets

This guide is intended to help people who work in office buildings learn about the factors that contribute to indoor air quality and comfort problems and the roles of building managers and occupants in maintaining a good indoor environment.

The use of GIS and multi-criteria evaluation (MCE) to identify agricultural land management practices which cause surface water pollution in drinking water supply catchments.

PubMed

Grayson, Richard; Kay, Paul; Foulger, Miles

2008-01-01

Diffuse pollution poses a threat to water quality and results in the need for treatment for potable water supplies which can prove costly. Within the Yorkshire region, UK, nitrates, pesticides and water colour present particular treatment problems. Catchment management techniques offer an alternative to 'end of pipe' solutions and allow resources to be targeted to the most polluting areas. This project has attempted to identify such areas using GIS based modelling approaches in catchments where water quality data were available. As no model exists to predict water colour a model was created using an MCE method which is capable of predicting colour concentrations at the catchment scale. CatchIS was used to predict pesticide and nitrate N concentrations and was found to be generally capable of reliably predicting nitrate N loads at the catchment scale. The pesticides results did not match the historic data possibly due to problems with the historic pesticide data and temporal and spatially variability in pesticide usage. The use of these models can be extended to predict water quality problems in catchments where water quality data are unavailable and highlight areas of concern. IWA Publishing 2008.

Optimizing human resources: a case for preventive health and stress management.

PubMed

Ivancevich, J M; Matteson, M T

1980-01-01

Traditionally, medical treatment in this country has focused on treatment of problems and illness after they've reached the point of crisis and pain. But now, managers are beginning to realize that preventive health and stree management can save money for the organization while improving the quality of worklife for employees.

THE ROLE OF PSYCHOLOGICAL FEATURES IN MANAGEMENT OF PATIENTS WITH TYPE 1 DIABETES (CASE REPORT).

PubMed

Dunicheva, M; Zagorovskaya, T; Patrakeeva, E

2018-04-01

Studies have shown that effective diabetes management (and also self-management) can delay or prevent the micro- and macrovascular complications. But sometimes the way of achieving optimal glycemic control can affect quality of patient's life resulting in different fears and other psychological problems. Our clinical case demonstrates type 1 diabetes (T1D) patient with frequent episodes of hypoglycemia, including severe hypoglycemia, and various psychosocial problems. It confirms the importance of doctor's communication skills and necessity of constant collaboration with psychologist in organization of diabetes care.

Water Resources Research Grant Program Project Descriptions: Fiscal Year 1988

USGS Publications Warehouse

Lew, Melvin; McCoy, Beverly M.

1989-01-01

This report contains information on the 38 new projects funded by the U.S. Geological Survey's Water Resources Research Grant Program in fiscal year 1988 and on 11 projects completed during the year. For the new projects, the report gives the grant number, project title, performing organization, principal investigator(s), project duration, and a project description that includes: (1) identification of water-related problems and problem-solution approach, (2) contribution to problem solution, (3) objectives, and (4) approach. The 38 projects include 14 in the area of ground-water quality problems, 10 in the science and technology of water-quality management, 4 in climate variability and the hydrologic cycle, 7 in institutional change in water-resources management, and 3 in miscellaneous water-resources management problems. For the 11 completed projects, the report gives the grant number, project title, performing organization, principal investigator(s), starting date, date of receipt of final report, and an abstract of the final report. Each project description provides the information needed to obtain a copy of the final report. The report also contains tables showing (1) proposals received according to area of research interest, (2) grant awards and funding according to area of research interest, (3) proposals received according to type of submitting organization, and (4) awards and funding according to type of organization.

Interventions for attention problems after pediatric traumatic brain injury: what is the evidence?

PubMed

Backeljauw, Barynia; Kurowski, Brad G

2014-09-01

To gain an understanding of the current state of the evidence for management of attention problems after traumatic brain injury (TBI) in children, determine gaps in the literature, and make recommendations for future research. TYPE: Focused systematic review. PubMed/Medline and PsychINFO databases were searched for relevant articles published in English during the last 20 years. Keywords included "attention" "attention deficit and disruptive behavior disorders," and "brain injuries." Studies were limited to children. Titles were examined first and eliminated based on lack of relevancy to attention problems after brain injury in children. This was followed by an abstract and full text review. Article quality was determined based on the US Preventative Services Task Force recommendations for evidence grading. Four pharmacologic and 10 cognitive therapy intervention studies were identified. These studies varied in level of evidence quality but were primarily nonrandomized or cohort studies. There are studies that demonstrate benefits of varying pharmacologic and cognitive therapies for the management of attention problems after TBI. However, there is a paucity of evidence available to definitively guide management of attention problems after pediatric TBI. Larger randomized, controlled trials and multicenter studies are needed to elucidate optimal treatment strategies in this population. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Role of a quality management system in improving patient safety - laboratory aspects.

PubMed

Allen, Lynn C

2013-09-01

The aim of this study is to describe how implementation of a quality management system (QMS) based on ISO 15189 enhances patient safety. A literature review showed that several European hospitals implemented a QMS based on ISO 9001 and assessed the impact on patient safety. An Internet search showed that problems affecting patient safety have occurred in a number of laboratories across Canada. The requirements of a QMS based on ISO 15189 are outlined, and the impact of the implementation of each requirement on patient safety is summarized. The Quality Management Program - Laboratory Services in Ontario is briefly described, and the experience of Ontario laboratories with Ontario Laboratory Accreditation, based on ISO 15189, is outlined. Several hospitals that implemented ISO 9001 reported either a positive impact or no impact on patient safety. Patient safety problems in Canadian laboratories are described. Implementation of each requirement of the QMS can be seen to have a positive effect on patient safety. Average laboratory conformance on Ontario Laboratory Accreditation is very high, and laboratories must address and resolve any nonconformities. Other standards, practices, and quality requirements may also contribute to patient safety. Implementation of a QMS based on ISO 15189 provides a solid foundation for quality in the laboratory and enhances patient safety. It helps to prevent patient safety issues; when such issues do occur, effective processes are in place for investigation and resolution. Patient safety problems in Canadian laboratories might have been prevented had effective QMSs been in place. Ontario Laboratory Accreditation has had a positive impact on quality in Ontario laboratories. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Saturn S-2 problem resolution history report

NASA Technical Reports Server (NTRS)

Virgil, F. W.

1971-01-01

A summary of S-2 Program problems and the solutions that were implemented is presented. The problems occurred during a period starting with the initial design concepts and continuing through the launch of the tenth S-2 flight stage information is from nine separate disciplines: design, facilities, logistics, manufacturing, material, program management, quality assurance, safety, and tests.

Project officer's perspective: quality assurance as a management tool.

PubMed

Heiby, J

1993-06-01

Advances in the management of health programs in less developed countries (LDC) have not kept pace with the progress of the technology used. The US Agency for International Development mandated the Quality Assurance Project (QAP) to provide quality improvement technical assistance to primary health care systems in LDCs while developing appropriate quality assurance (QA) strategies. The quality of health care in recent years in the US and Europe focused on the introduction of management techniques developed for industry into health systems. The experience of the QAP and its predecessor, the PRICOR Project, shows that quality improvement techniques facilitate measurement of quality of care. A recently developed WHO model for the management of the sick child provides scientifically based standards for actual care. Since 1988, outside investigators measuring how LDC clinicians perform have revealed serious deficiencies in quality compared with the program's own standards. This prompted developed of new QA management initiatives: 1) communicating standards clearly to the program staff; 2) actively monitoring actual performance corresponds to these standards; and 3) taking action to improve performance. QA means that managers are expected to monitor service delivery, undertake problem solving, and set specific targets for quality improvement. Quality improvement methods strengthen supervision as supervisors can objectively assess health worker performance. QA strengthens the management functions that support service delivery, e.g., training, records management, finance, logistics, and supervision. Attention to quality can contribute to improved health worker motivation and effective incentive programs by recognition for a job well done and opportunities for learning new skills. These standards can also address patient satisfaction. QA challenges managers to aim for the optimal level of care attainable.

Implementing quality/productivity improvement initiatives in an engineering environment

NASA Technical Reports Server (NTRS)

Ruda, R. R.

1985-01-01

Quality/Productivity Improvement (QPI) initiatives in the engineering environment at McDonnell Douglas-Houston include several different, distinct activities, each having its own application, yet all targeted toward one common goal - making continuous improvement a way of life. The chief executive and the next two levels of management demonstrate their commitment to QPI with hands-on involvement in several activities. Each is a member of a QPI Council which consists of six panels - Participative Management, Communications, Training, Performance/Productivity, Human Resources Management and Strategic Management. In addition, each manager conducts Workplace Visits and Bosstalks, to enhance communications with employees and to provide a forum for the identification of problems - both real and perceived. Quality Circles and Project Teams are well established within McConnel Douglas as useful and desirable employee involvement teams. The continued growth of voluntary membership in the circles program is strong evidence of the employee interest and management support that have developed within the organization.

Quality improvement in basic histotechnology: the lean approach.

PubMed

Clark, David

2016-01-01

Lean is a comprehensive system of management based on the Toyota production system (TPS), encompassing all the activities of an organization. It focuses management activity on creating value for the end-user by continuously improving operational effectiveness and removing waste. Lean management creates a culture of continuous quality improvement with a strong emphasis on developing the problem-solving capability of staff using the scientific method (Deming's Plan, Do, Check, Act cycle). Lean management systems have been adopted by a number of histopathology departments throughout the world to simultaneously improve quality (reducing errors and shortening turnround times) and lower costs (by increasing efficiency). This article describes the key concepts that make up a lean management system, and how these concepts have been adapted from manufacturing industry and applied to histopathology using a case study of lean implementation and evidence from the literature. It discusses the benefits, limitations, and pitfalls encountered when implementing lean management systems.

The Pharmacological Management of Oppositional Behaviour, Conduct Problems, and Aggression in Children and Adolescents With Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder: A Systematic Review and Meta-Analysis. Part 2: Antipsychotics and Traditional Mood Stabilizers

PubMed Central

Pringsheim, Tamara; Hirsch, Lauren; Gardner, David; Gorman, Daniel A

2015-01-01

Objective: Attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) are among the most common psychiatric diagnoses in childhood. Aggression and conduct problems are a major source of disability and a risk factor for poor long-term outcomes. Methods: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) of antipsychotics, lithium, and anticonvulsants for aggression and conduct problems in youth with ADHD, ODD, and CD. Each medication was given an overall quality of evidence rating based on the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Eleven RCTs of antipsychotics and 7 RCTs of lithium and anticonvulsants were included. There is moderate-quality evidence that risperidone has a moderate-to-large effect on conduct problems and aggression in youth with subaverage IQ and ODD, CD, or disruptive behaviour disorder not otherwise specified, with and without ADHD, and high-quality evidence that risperidone has a moderate effect on disruptive and aggressive behaviour in youth with average IQ and ODD or CD, with and without ADHD. Evidence supporting the use of haloperidol, thioridazine, quetiapine, and lithium in aggressive youth with CD is of low or very-low quality, and evidence supporting the use of divalproex in aggressive youth with ODD or CD is of low quality. There is very-low-quality evidence that carbamazepine is no different from placebo for the management of aggression in youth with CD. Conclusion: With the exception of risperidone, the evidence to support the use of antipsychotics and mood stabilizers is of low quality. PMID:25886656

Introducing quality improvement management methods into primary health care services in Uganda.

PubMed

Omaswa, F; Burnham, G; Baingana, G; Mwebesa, H; Morrow, R

1996-01-01

Uganda's National Quality Assurance Program was established in 1994 to monitor the process of decentralization of primary health care services. Guidelines were developed to address problems (e.g., in obtaining health funds channeled through local government) identified at district meetings. Bringing together District Health Teams with local administrators and political leaders to share responsibility for strengthening health services has been a significant program achievement. A smoother functioning referral system from health units to district hospitals has resulted. The response to a measles outbreak in the Arua district in 1993-94 confirmed the utility of the quality management approach. Weaknesses in the district cold chain, problems with diagnostic accuracy, and a poorly functioning information system were identified as key causative factors, and corrective action in these areas led to a subsequent decline in measles cases. Patient dissatisfaction with long waiting times at Masaka Hospital was another concern addressed through the quality assurance approach. Five salient areas were identified for action: low health worker morale, supply shortages, inadequate supervision by hospital management, poor patient flow, and inefficient drug dispensing. As a result, long delays were eliminated and utilization of hospital outpatient services increased by 28%.

Permeable pavement and stormwater management systems: a review.

PubMed

Imran, H M; Akib, Shatirah; Karim, Mohamed Rehan

2013-01-01

Uncontrolled stormwater runoff not only creates drainage problems and flash floods but also presents a considerable threat to water quality and the environment. These problems can, to a large extent, be reduced by a type of stormwater management approach employing permeable pavement systems (PPS) in urban, industrial and commercial areas, where frequent problems are caused by intense undrained stormwater. PPS could be an efficient solution for sustainable drainage systems, and control water security as well as renewable energy in certain cases. Considerable research has been conducted on the function of PPS and their improvement to ensure sustainable drainage systems and water quality. This paper presents a review of the use of permeable pavement for different purposes. The paper focuses on drainage systems and stormwater runoff quality from roads, driveways, rooftops and parking lots. PPS are very effective for stormwater management and water reuse. Moreover, geotextiles provide additional facilities to reduce the pollutants from infiltrate runoff into the ground, creating a suitable environment for the biodegradation process. Furthermore, recently, ground source heat pumps and PPS have been found to be an excellent combination for sustainable renewable energy. In addition, this study has identified several gaps in the present state of knowledge on PPS and indicates some research needs for future consideration.

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...

Managing Academic Libraries with Fewer Resources.

ERIC Educational Resources Information Center

Riggs, Donald E.

1992-01-01

A discussion of academic library management during retrenchment looks at a variety of issues, including staffing needs in the labor-intensive library environment, acquisitions budgeting, interlibrary cooperation (ownership vs. access to resources), entrepreneurship and strategic planning for problem solving, and use of total quality management…

Total Quality Improvement Guide for Institutions of Higher Education.

ERIC Educational Resources Information Center

Cornesky, Robert A.; McCool, Samuel A.

This book describes the steps and tools of Total Quality Management (TQM) and their use in the academic units of colleges and universities for Total Quality Improvement (TQI), illustrated by a case study from the School of Arts & Sciences at a state university. Section 1 explains how to: (1) identify problems contributing to non-value-added…

Oral health assessment and mouth care for children and young people receiving palliative care. Part one.

PubMed

Sargeant, Stephanie; Chamley, Carol

2013-03-01

This is the first part of two articles exploring oral health problems and treatments for children receiving palliative care, successful management of which can improve considerably the quality of life for this group of children and young people. Part one includes an adapted oral health assessment tool for use in children and young people with complex and palliative healthcare needs that has the potential to help nurses identify and monitor oral health problems and prevent or minimise oral problems from developing. Part two--to be published next month--focuses on basic oral hygiene and the management of specific oral health problems.

Clean the Air and Breathe Easier.

ERIC Educational Resources Information Center

Guevin, John

1997-01-01

Failure to prevent indoor air quality problems or act promptly can result in increased chances for long- or short-term health problems for staff and students, reduced productivity, faster plant deterioration, and strained school-community relations. Basic pollution control measures include source management, local exhausts, ventilation, exposure…

The perceived problem-solving ability of nurse managers.

PubMed

Terzioglu, Fusun

2006-07-01

The development of a problem-solving approach to nursing has been one of the more important changes in nursing during the last decade. Nurse Managers need to have effective problem-solving and management skills to be able to decrease the cost of the health care and to increase the quality of care. This descriptive study was conducted to determine the perceived problem-solving ability of nurse managers. From a population of 87 nurse managers, 71 were selected using the stratified random sampling method, 62 nurse managers agreed to participate. Data were collected through a questionnaire including demographic information and a problem-solving inventory. The problem-solving inventory was developed by Heppner and Petersen in 1982, and validity and readability studies were done. It was adapted to Turkish by Sahin et al (1993). The acquired data have been evaluated on the software spss 10.0 programme, using percentages, mean values, one-way anova and t-test (independent samples t-test). Most of the nurses had 11 or more years of working experience (71%) and work as charge nurses in the clinics. It was determined that 69.4% of the nurse managers did not have any educational training in administration. The most encountered problems stated were issues related to managerial (30.6%) and professional staff (25.8%). It was identified that nurse managers who had received education about management, following scientific publication and scientific meeting and had followed management models, perceived their problem-resolving skills as more adequate than the others (P>0.05). In this study, it was determined that nurses do not perceive that they have problem-solving skills at a desired level. In this context, it is extremely important that this subject be given an important place in both nursing education curriculum and continuing education programmes.

A coupled stochastic inverse-management framework for dealing with nonpoint agriculture pollution under groundwater parameter uncertainty

NASA Astrophysics Data System (ADS)

Llopis-Albert, Carlos; Palacios-Marqués, Daniel; Merigó, José M.

2014-04-01

In this paper a methodology for the stochastic management of groundwater quality problems is presented, which can be used to provide agricultural advisory services. A stochastic algorithm to solve the coupled flow and mass transport inverse problem is combined with a stochastic management approach to develop methods for integrating uncertainty; thus obtaining more reliable policies on groundwater nitrate pollution control from agriculture. The stochastic inverse model allows identifying non-Gaussian parameters and reducing uncertainty in heterogeneous aquifers by constraining stochastic simulations to data. The management model determines the spatial and temporal distribution of fertilizer application rates that maximizes net benefits in agriculture constrained by quality requirements in groundwater at various control sites. The quality constraints can be taken, for instance, by those given by water laws such as the EU Water Framework Directive (WFD). Furthermore, the methodology allows providing the trade-off between higher economic returns and reliability in meeting the environmental standards. Therefore, this new technology can help stakeholders in the decision-making process under an uncertainty environment. The methodology has been successfully applied to a 2D synthetic aquifer, where an uncertainty assessment has been carried out by means of Monte Carlo simulation techniques.

The role of intrinsic motivation in a group of low vision patients participating in a self-management programme to enhance self-efficacy and quality of life.

PubMed

Tay, Kay Chai Peter; Drury, Vicki Blair; Mackey, Sandra

2014-02-01

Self-management programmes have previously been found to decrease health problems, enhance quality of life and increase independence. However, there is no literature that examines the influence of the participants' intrinsic motivation on the outcomes of such programmes. This study examined the role of intrinsic motivation in a pilot low vision self-management programme to enhance self-efficacy and quality of life of the programme participants. A positive association was observed between the female participants' perceived choice and perceived competence, two underlying dimensions of the Intrinsic Motivation Inventory. In addition, a positive correlation was observed between the younger participants' perceived competence and the change in their quality of life. The findings provide some support for consideration of participants' intrinsic motivation in the development of effective self-management programmes. © 2013 Wiley Publishing Asia Pty Ltd.

Ontologies to improve chronic disease management research and quality improvement studies - a conceptual framework.

PubMed

Liyanage, Harshana; Liaw, Siaw-Teng; Kuziemsky, Craig; de Lusignan, Simon

2013-01-01

There is a growing burden of chronic non-communicable disease (CNCD). Managing CNCDs requires use of multiple sources of health and social care data, and information about coordination and outcomes. Many people with CNCDs have multimorbidity. Problems with data quality exacerbate challenges in measuring quality and health outcomes especially where there is multimorbidity. We have developed an ontological toolkit to support research and quality improvement studies in CNCDs using heterogeneous data, with diabetes mellitus as an exemplar. International experts held a workshop meeting, with follow up discussions and consensus building exercise. We generated conceptual statements about problems with a CNCD that ontologies might support, and a generic reference model. There were varying degrees of consensus. We propose a set of tools, and a four step method: (1) Identification and specification of data sources; (2) Conceptualisation of semantic meaning; (3) How available routine data can be used as a measure of the process or outcome of care; (4) Formalisation and validation of the final ontology.

Quality Attribute Techniques Framework

NASA Astrophysics Data System (ADS)

Chiam, Yin Kia; Zhu, Liming; Staples, Mark

The quality of software is achieved during its development. Development teams use various techniques to investigate, evaluate and control potential quality problems in their systems. These “Quality Attribute Techniques” target specific product qualities such as safety or security. This paper proposes a framework to capture important characteristics of these techniques. The framework is intended to support process tailoring, by facilitating the selection of techniques for inclusion into process models that target specific product qualities. We use risk management as a theory to accommodate techniques for many product qualities and lifecycle phases. Safety techniques have motivated the framework, and safety and performance techniques have been used to evaluate the framework. The evaluation demonstrates the ability of quality risk management to cover the development lifecycle and to accommodate two different product qualities. We identify advantages and limitations of the framework, and discuss future research on the framework.

Application of Pesticide Phytoremediation in Irrigated Rice Fields System Using Eceng Gondok (Eichhornia crassipes) Plants

NASA Astrophysics Data System (ADS)

Febriani, Ika Kartika; Hadiyanto

2018-02-01

The problem of environmental pollution especially urban water pollution becomes major issue in Indonesia. The cause of water pollution is not only from industrial factory waste disposal but also other causes which become pollution factor. One cause of water pollution is the existence of agricultural activities with the use of the amount of pesticides that exceed the threshold. As regulated in Government Regulation No. 82/2001 on Water Quality Management and Water Pollution Control, it is necessary to manage water quality and control water pollution wisely by taking into account the interests of current and future generations as well as the ecological balance. To overcome the problem of water pollution due to agricultural activities, it is necessary to conduct research on phytoremediation technique by utilizing eceng gondok plant. It is excepted that using this phytoremediation technique can reduce the problem of water pollution due to the use of pesticides on agricultural activities.

Large-Scale Operations Management Test of Use of the White Amur for Control of Problem Aquatic Plants. Report 3. Second Year Poststocking Results. Volume VI. The Water and Sediment Quality of Lake Conway, Florida.

DTIC Science & Technology

1982-08-01

AD-A-11 701 ORANGE COUNTY POLLUTION CONTROL DEPT ORLANDO FL F/0 6/6 LARGE-SCALE OPERATIONS MANAGEMENT TEST OF USE OF THE WHITE AMUR--ETC(U) AUG 82 H...8217 OPERATIONS MANAGEMENT TEST OF USE OF THE WHITE AMUR FOR CONTROL -OF PROBLEM AQ.UATIC PLANTS SECOND YEAR POSTSTOCKING RESULTS Volume, Vt The Water...and Subetie) S. TYPE OF REPORT & PERIOD COVERED LARGE-SCALE OPERATIONS MANAGEMENT TEST OF USE OF Report 3 of a series THE WHITE AMUR FOR CONTROL OF

Common Problems That Can Affect Your Voice

MedlinePlus

... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources Quality Clinical Data Registry Research Reimbursement ...

Using Problem-solving Therapy to Improve Problem-solving Orientation, Problem-solving Skills and Quality of Life in Older Hemodialysis Patients.

PubMed

Erdley-Kass, Shiloh D; Kass, Darrin S; Gellis, Zvi D; Bogner, Hillary A; Berger, Andrea; Perkins, Robert M

2017-08-24

To determine the effectiveness of Problem-Solving Therapy (PST) in older hemodialysis (HD) patients by assessing changes in health-related quality of life and problem-solving skills. 33 HD patients in an outpatient hemodialysis center without active medical and psychiatric illness were enrolled. The intervention group (n = 15) received PST from a licensed social worker for 6 weeks, whereas the control group (n = 18) received usual care treatment. In comparison to the control group, patients receiving PST intervention reported improved perceptions of mental health, were more likely to view their problems with a positive orientation and were more likely to use functional problem-solving methods. Furthermore, this group was also more likely to view their overall health, activity limits, social activities and ability to accomplish desired tasks with a more positive mindset. The results demonstrate that PST may positively impact mental health components of quality of life and problem-solving coping among older HD patients. PST is an effective, efficient, and easy to implement intervention that can benefit problem-solving abilities and mental health-related quality of life in older HD patients. In turn, this will help patients manage their daily living activities related to their medical condition and reduce daily stressors.

Watershed management in the Black Hills: The status of our knowledge

Treesearch

Howard K. Orr

1975-01-01

Climate, geology, soils, vegetation, and water yields are briefly described, followed by a review and discussion of watershed management research and problems unique to the Black Hills. Research needs with respect to water quality, data collection, and model development are highlighted.

Total quality management and shared governance: synergistic processes.

PubMed

Gardner, D B; Cummings, C

1994-01-01

"Synergism" accurately describes the gains that can be made when total quality management (TQM) and shared governance are employed for reciprocal development. This article explores the relationship between TQM and shared governance from a systems perspective. Systems thinking is the fundamental framework that must be learned by nursing managers. An example of this synergistic process is described from the National Institutes of Health nursing department's experience in implementing TQM and shared governance. The idea that structure is fundamental to problems and solutions when implementing change and focusing upon interdependency issues are the systemic competencies nursing managers need to develop in order to become strong nursing leaders.

Quantifying impact of mosquitoes on quality of life

USDA-ARS?s Scientific Manuscript database

New Jersey, like many eastern states, has a persistent problem of the Asian tiger mosquito. This and other mosquitoes reduce residents’ quality of life from discomfort and possible risk of disease. To guide a comprehensive area-wide pest management project to control Aedes albopictus in two counties...

Containing the Damage: Quality Control of Local Data Production.

ERIC Educational Resources Information Center

Blair, Norman A.

1983-01-01

The ability of operating departments of an institution to mechanically gather, summarize, and report "local" data is discussed. Problems are outlined that arise when departments have the ability to produce data and do so with rigorous quality control by the institution's central information management organization. (MLW)

On the Control of Air Quality: Why the Laws Don't Work

ERIC Educational Resources Information Center

Goldstein, Paul; Ford, Robert

1973-01-01

Studied implementation of air quality management in two western New York counties by interviewing three enforcement agencies and 30 industrial firms. Concluded that critical problems existed in the transient nature of contaminant emissions and the control of regulatory power by industries. (CC)

Aligning institutional priorities: engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements.

PubMed

Flanagan, Meghan R; Foster, Carolyn C; Schleyer, Anneliese; Peterson, Gene N; Mandell, Samuel P; Rudd, Kristina E; Joyner, Byron D; Payne, Thomas H

2016-02-01

House staff quality improvement projects are often not aligned with training institution priorities. House staff are the primary users of inpatient problem lists in academic medical centers, and list maintenance has significant patient safety and financial implications. Improvement of the problem list is an important objective for hospitals with electronic health records under the Meaningful Use program. House staff surveys were used to create an electronic problem list manager (PLM) tool enabling efficient problem list updating. Number of new problems added and house staff perceptions of the problem list were compared before and after PLM intervention. The PLM was used by 654 house staff after release. Surveys demonstrated increased problem list updating (P = .002; response rate 47%). Mean new problems added per day increased from 64 pre-PLM to 125 post-PLM (P < .001). This innovative project serves as a model for successful engagement of house staff in institutional quality and safety initiatives with tangible institutional benefits. Copyright © 2016 Elsevier Inc. All rights reserved.

Is "disease management" the answer to our problems? No! Population health management and (disease) prevention require "management of overall well-being".

PubMed

Cramm, Jane Murray; Nieboer, Anna Petra

2016-09-21

Disease management programs based on the chronic care model have achieved successful and long-term improvement in the quality of chronic care delivery and patients' health behaviors and physical quality of life. However, such programs have not been able to maintain or improve broader self-management abilities or social well-being, which decline over time in chronically ill patients. Disease management efforts, population health management initiatives and innovative primary care solutions are still mainly focused on clinical and functional outcomes and health behaviors (e.g., smoking cessation, exercise, and diet) failing to address individuals' overall quality of life and well-being. Individuals' ability to achieve well-being can be assessed with great specificity through the application of social production function (SPF) theory. This theory asserts that people produce their own well-being by trying to optimize the achievement of instrumental goals (stimulation, comfort, status, behavioral confirmation, affection) that provide the means to achieve the larger, universal goals of physical and social well-being. A shift in focus from the management of physical function, disease limitations, and lifestyle behaviors alone to an approach that fosters self-management abilities such as self-efficacy and resource investment as well as overall quality of life, is urgently needed. Disease management interventions should be aimed at adequately addressing all difficulties chronically ill patients face in life, such as the effects of pain and fatigue on the ability to maintain a job and social life and to participate in activities promoting physical and social well-being. Patients' ability to maintain engagement in stimulating work and social activities with the people who are important to them may be even more important than aspects of disease self-management such as blood pressure or glycemic control. Interventions should aim to make chronically ill patients capable of managing their own well-being and adequately addressing their needs in a broader sense. So, is disease management the answer to our problems in the time of aging populations and increased prevalence of unhealthy lifestyles, chronic illnesses, and comorbidity? No! Effective (disease) prevention, disease management, patient-centered care, and high-quality chronic care and/or population health management calls for management of overall well-being.

A Hybrid Interval–Robust Optimization Model for Water Quality Management

PubMed Central

Xu, Jieyu; Li, Yongping; Huang, Guohe

2013-01-01

Abstract In water quality management problems, uncertainties may exist in many system components and pollution-related processes (i.e., random nature of hydrodynamic conditions, variability in physicochemical processes, dynamic interactions between pollutant loading and receiving water bodies, and indeterminacy of available water and treated wastewater). These complexities lead to difficulties in formulating and solving the resulting nonlinear optimization problems. In this study, a hybrid interval–robust optimization (HIRO) method was developed through coupling stochastic robust optimization and interval linear programming. HIRO can effectively reflect the complex system features under uncertainty, where implications of water quality/quantity restrictions for achieving regional economic development objectives are studied. By delimiting the uncertain decision space through dimensional enlargement of the original chemical oxygen demand (COD) discharge constraints, HIRO enhances the robustness of the optimization processes and resulting solutions. This method was applied to planning of industry development in association with river-water pollution concern in New Binhai District of Tianjin, China. Results demonstrated that the proposed optimization model can effectively communicate uncertainties into the optimization process and generate a spectrum of potential inexact solutions supporting local decision makers in managing benefit-effective water quality management schemes. HIRO is helpful for analysis of policy scenarios related to different levels of economic penalties, while also providing insight into the tradeoff between system benefits and environmental requirements. PMID:23922495

Specific Remedy for Specific Problem: Measuring Service Quality in South African Higher Education

ERIC Educational Resources Information Center

de Jager, Johan; Gbadamosi, Gbolahan

2010-01-01

This study commences a process of developing a scale for the measurement of service quality in higher education in South Africa and also examines the relationship between the measures of service quality on the one hand and some other related variables such as intention to leave the university, trust in management of the university and the overall…

MapReduce Based Parallel Bayesian Network for Manufacturing Quality Control

NASA Astrophysics Data System (ADS)

Zheng, Mao-Kuan; Ming, Xin-Guo; Zhang, Xian-Yu; Li, Guo-Ming

2017-09-01

Increasing complexity of industrial products and manufacturing processes have challenged conventional statistics based quality management approaches in the circumstances of dynamic production. A Bayesian network and big data analytics integrated approach for manufacturing process quality analysis and control is proposed. Based on Hadoop distributed architecture and MapReduce parallel computing model, big volume and variety quality related data generated during the manufacturing process could be dealt with. Artificial intelligent algorithms, including Bayesian network learning, classification and reasoning, are embedded into the Reduce process. Relying on the ability of the Bayesian network in dealing with dynamic and uncertain problem and the parallel computing power of MapReduce, Bayesian network of impact factors on quality are built based on prior probability distribution and modified with posterior probability distribution. A case study on hull segment manufacturing precision management for ship and offshore platform building shows that computing speed accelerates almost directly proportionally to the increase of computing nodes. It is also proved that the proposed model is feasible for locating and reasoning of root causes, forecasting of manufacturing outcome, and intelligent decision for precision problem solving. The integration of bigdata analytics and BN method offers a whole new perspective in manufacturing quality control.

Linkability: Orientation for the 21st Century.

ERIC Educational Resources Information Center

Hoag, Erin; Kisiel, Valerie

This document outlines the steps necessary to develop computer-based student service programs that will improve service quality and alleviate the problems associated with staff shortages and heavy case loads. The analysis phase of the process entails that the project manager complete the following steps: (1) define the problem; (2) conduct a…

Enhancing outpatient clinics management software by reducing patients' waiting time.

PubMed

Almomani, Iman; AlSarheed, Ahlam

The Kingdom of Saudi Arabia (KSA) gives great attention to improving the quality of services provided by health care sectors including outpatient clinics. One of the main drawbacks in outpatient clinics is long waiting time for patients-which affects the level of patient satisfaction and the quality of services. This article addresses this problem by studying the Outpatient Management Software (OMS) and proposing solutions to reduce waiting times. Many hospitals around the world apply solutions to overcome the problem of long waiting times in outpatient clinics such as hospitals in the USA, China, Sri Lanka, and Taiwan. These clinics have succeeded in reducing wait times by 15%, 78%, 60% and 50%, respectively. Such solutions depend mainly on adding more human resources or changing some business or management policies. The solutions presented in this article reduce waiting times by enhancing the software used to manage outpatient clinics services. Both quantitative and qualitative methods have been used to understand current OMS and examine level of patient's satisfaction. Five main problems that may cause high or unmeasured waiting time have been identified: appointment type, ticket numbering, doctor late arrival, early arriving patient and patients' distribution list. These problems have been mapped to the corresponding OMS components. Solutions to the above problems have been introduced and evaluated analytically or by simulation experiments. Evaluation of the results shows a reduction in patient waiting time. When late doctor arrival issues are solved, this can reduce the clinic service time by up to 20%. However, solutions for early arriving patients reduces 53.3% of vital time, 20% of the clinic time and overall 30.3% of the total waiting time. Finally, well patient-distribution lists make improvements by 54.2%. Improvements introduced to the patients' waiting time will consequently affect patients' satisfaction and improve the quality of health care services. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Improving supervision: a team approach.

PubMed

1993-01-01

This issue of "The Family Planning Manager" outlines an interactive team supervision strategy as a means of improving family planning service quality and enabling staff to perform to their maximum potential. Such an approach to supervision requires a shift from a monitoring to a facilitative role. Because supervisory visits to the field are infrequent, the regional supervisor, clinic manager, and staff should form a team to share ongoing supervisory responsibilities. The team approach removes individual blame and builds consensus. An effective team is characterized by shared leadership roles, concrete work problems, mutual accountability, an emphasis on achieving team objectives, and problem resolution within the group. The team supervision process includes the following steps: prepare a visit plan and schedule; meet with the clinic manager and staff to explain how the visit will be conducted; supervise key activity areas (clinical, management, and personnel); conduct a problem-solving team meeting; conduct a debriefing meeting with the clinic manager; and prepare a report on the visit, including recommendations and follow-up plans. In Guatemala's Family Planning Unit, teams identify problem areas on the basis of agreement that a problem exists, belief that the problem can be solved with available resources, and individual willingness to accept responsibility for the specific actions identified to correct the problem.

Development of a Knowledge Management Model for the Development of a Quality Public Sector Management System for the Office of the Primary Educational Service Area

ERIC Educational Resources Information Center

Khotbancha, Wijitra; Chantarasombat, Chalard; Sriampai, Anan

2015-01-01

The objectives of this research were: 1) to study the current situation and problem of Knowledge Management of the office of the primary education service area, 2) to develop a Knowledge Management model, 3) to study the success of the implementation of the Knowledge Management system. There were 25 persons in the target group. There were 2 kinds…

Impact of Past Land Use Changes on Drinking Water Quantity and Quality in Ljubljana Aquifer

NASA Astrophysics Data System (ADS)

Bracic Zeleznik, Branka; Cencur Curk, Barbara

2010-05-01

Most of the practical problems that we face today with the on-site management of drinking water sources and distribution of healthy drinking water, originate from past actions, interventions and political decisions. In Ljubljana, the capital of the Republic of Slovenia, underlying groundwater is the main drinking water source. The main threat to drinking water sources is constant input of pollutant loads from roads, roofs, sewers, industry and agricultural areas. The main problems are directly and indirectly related to the significant decrease of groundwater level and deterioration of groundwater quality observed in the last decades as an effect of land use practices under varying climate conditions. The Vodovod-Kanalizacija Public Utility is responsible for water supply of the city residents as well as for management of the water supply system, its surveillance and maintenance. In the past, the Ljubljana Municipality was responsible for the protection of water resources and the first delineation of groundwater protection areas was issued in Decree in 1955. In 2004 a Decree on the water protection zones for the aquifer of Ljubljansko polje on the state level was issued and passed the competences of proclamation of the water protection zones to the state. Spatial planning is a domain of The Municipality and land use is limited according to water protection legislation. For several observation wells long-time data sets about groundwater levels and quality are available, which enable us to analyse changes in groundwater quantity and quality parameters. From the data it is obvious that climate variations are affecting groundwater recharge. In addition, changing of land use affects groundwater quality. In spite of the Decree on the water protection there is a heavy pressure of investors to change land use plans and regulations on protection zones, which causes every day problems in managing the drinking water source. Groundwater management in Ljubljana demands strong and effective co-operation between state, municipality, public water supply company and consumers.

Management. A continuing bibliography with indexes. [March 1980

NASA Technical Reports Server (NTRS)

1980-01-01

This bibliography cites 604 reports, articles, and other documents introduced into the NASA scientific and technical information system in 1979 covering the management of research and development, contracts, production, logistics, personnel, safety, reliability and quality control. Program, project, and systems management; management policy, philosophy, tools, and techniques; decision making processes for managers; technology assessment; management of urban problems; and information for managers on Federal resources, expenditures, financing, and budgeting are also covered. Abstracts are provided as well as subject, personal author, and corporate source indexes.

Using management information systems to enhance health care quality assurance.

PubMed

Rosser, L H; Kleiner, B H

1995-01-01

Examines how computers and quality assurance are being used to improve the quality of health care delivery. Traditional quality assurance methods have been limited in their ability to effectively manage the high volume of data generated by the health care process. Computers on the other hand are able to handle large volumes of data as well as monitor patient care activities in both the acute care and ambulatory care settings. Discusses the use of computers to collect and analyse patient data so that changes and problems can be identified. In addition, computer models for reminding physicians to order appropriate preventive health measures for their patients are presented. Concludes that the use of computers to augment quality improvement is essential if the quality of patient care and health promotion are to be improved.

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

Coston, V.A.

There is a great deal of emphasis today on management's commitment to quality. Yet with all the hue and cry about this commitment do we find much more happening than just lip service. Are quality professionals aiding and abetting the nonacceptance of quality organizations, resulting in their exclusion from the management. Quality professionals must recognize they cannot divorce themselves from cost and schedule. They must recognize they are not policemen with omnipotent authority. Self-recognition must occur and be acted upon for changes in attitudes and opinions of others to be affected. There are, of course, other factors involved. But inmore » searching for the root cause of the problem, does the evidence of those other factors again point back to the Quality professionals. Quality is not a dirty word. We must convince ourselves before we can convince others.« less

Real-world implications of apathy among older adults: Independent associations with activities of daily living and quality of life.

PubMed

Tierney, Savanna M; Woods, Steven Paul; Weinborn, Michael; Bucks, Romola S

2018-03-13

Apathy is common in older adults and has been linked to adverse health outcomes. The current study examined whether apathy contributes to problems managing activities of daily living (ADLs) and lower quality of life (QoL) in older adults. Participants included 83 community-dwelling older adults. Apathy was assessed using a composite of the self and family-rating scales from the Frontal Systems Behavioral Scale (FrSBe). A knowledgeable informant completed the Activities of Daily Living Questionnaire (ADLQ), and participants completed the World Health Organization Quality of Life (WHOQol) scale. Nominal logistic regressions controlling for age, anxiety and depression symptoms, chronic medical conditions, and global cognition revealed that higher levels of apathy were significantly associated with a wide range of mild ADL problems. In parallel, a multiple linear regression indicated that greater apathy was significantly associated with lower QoL independent of ADL problems, anxious and depressive symptomology, chronic medical conditions, global cognition and age. Findings suggest that apathy confers an increased risk of problems in the independent management of daily activities and poorer well-being among community-dwelling older adults. Neurobehavioral and pharmacological interventions to improve apathy may have beneficial effects on the daily lives of older adults.

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda

PubMed Central

2014-01-01

Background Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. Methods In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. Discussion EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. Trial registration PACTR201311000681314 PMID:24690284

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda.

PubMed

Hanson, Claudia; Waiswa, Peter; Marchant, Tanya; Marx, Michael; Manzi, Fatuma; Mbaruku, Godfrey; Rowe, Alex; Tomson, Göran; Schellenberg, Joanna; Peterson, Stefan

2014-04-02

Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. PACTR201311000681314.

Advancing environmental stewardship in New York state parks and historic sites

Treesearch

Thomas L. Cobb

1995-01-01

Ninety state park and historic site managers were engaged in a cooperative problem-solving training exercise to identify what they suggest needs to be done to more effectively manage and protect the natural and cultural resources of the New York State Park System. The QtP (Quality-through-Participation) management process was used for this purpose, and proved effective...

Forest management guidelines for controlling wild grapevines

Treesearch

H. Clay Smith

1984-01-01

Grapevines (Vitis spp.) are becoming a major problem to forest managers in the Appalachians, especially when clearcutting is done on highly productive hardwood sites. Where present, grapevines can reduce tree quality and growth, and eventually kill the tree. Silvical characteristics of grapevines are discussed as background for grapevine control....

Managing the data explosion

USGS Publications Warehouse

Hooper, Richard P.; Aulenbach, Brent T.

1993-01-01

The 'data explosion' brought on by electronic sensors and automatic samplers can strain the capabilities of existing water-quality data-management systems just when they're needed most to process the information. The U.S. Geological Survey has responded to the problem by setting up an innovative system that allows rapid data analysis.

Management and leadership by nurses.

PubMed

Henry, B; Lorensen, M; Hirschfeld, M J

1994-01-01

Good management and leadership by nurses is essential for the achievement of health for all. Well-prepared nurses are required locally and nationally who can identify problems and needs, work on interdisciplinary teams to formulate development plans for human resources, improve working conditions, and raise the quality of care at reasonable cost.

Medical Management of Constipation

PubMed Central

Portalatin, Meredith; Winstead, Nathaniel

2012-01-01

Constipation is a common clinical problem. Initial management of chronic constipation should include lifestyle maneuvers, and increased fiber and fluids. Polyethylene glycol, sodium picosulfate, bisacodyl, prucalopride, lubiprostone, and linaclotide were all more effective than placebo for treating chronic idiopathic constipation. Many commonly used agents lack quality evidence supporting their use. PMID:23449608

Continuous Improvement and Employee Engagement, Part 2: Design, Implementation, and Outcomes of a Daily Management System.

PubMed

Maurer, Marsha; Browall, Pamela; Phelan, Cynthia; Sanchez, Sandra; Sulmonte, Kimberlyann; Wandel, Jane; Wang, Allison

2018-04-01

A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact quality or work flow and to address them on a daily basis. Through a DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 2 describes the implementation and outcomes of the program.

Building a Culture of Continuous Improvement and Employee Engagement Using a Daily Management System Part 1: Overview.

PubMed

Maurer, Marsha; Canacari, Elena; Eng, Kimberly; Foley, Jane; Phelan, Cynthia; Sulmonte, Kimberlyann; Wandel, Jane

2018-03-01

A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact quality or workflow and to address them on a daily basis. Through DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 1 describes the background and organizing framework of the program.

A review of distributed parameter groundwater management modeling methods

USGS Publications Warehouse

Gorelick, Steven M.

1983-01-01

Models which solve the governing groundwater flow or solute transport equations in conjunction with optimization techniques, such as linear and quadratic programing, are powerful aquifer management tools. Groundwater management models fall in two general categories: hydraulics or policy evaluation and water allocation. Groundwater hydraulic management models enable the determination of optimal locations and pumping rates of numerous wells under a variety of restrictions placed upon local drawdown, hydraulic gradients, and water production targets. Groundwater policy evaluation and allocation models can be used to study the influence upon regional groundwater use of institutional policies such as taxes and quotas. Furthermore, fairly complex groundwater-surface water allocation problems can be handled using system decomposition and multilevel optimization. Experience from the few real world applications of groundwater optimization-management techniques is summarized. Classified separately are methods for groundwater quality management aimed at optimal waste disposal in the subsurface. This classification is composed of steady state and transient management models that determine disposal patterns in such a way that water quality is protected at supply locations. Classes of research missing from the literature are groundwater quality management models involving nonlinear constraints, models which join groundwater hydraulic and quality simulations with political-economic management considerations, and management models that include parameter uncertainty.

A Review of Distributed Parameter Groundwater Management Modeling Methods

NASA Astrophysics Data System (ADS)

Gorelick, Steven M.

1983-04-01

Models which solve the governing groundwater flow or solute transport equations in conjunction with optimization techniques, such as linear and quadratic programing, are powerful aquifer management tools. Groundwater management models fall in two general categories: hydraulics or policy evaluation and water allocation. Groundwater hydraulic management models enable the determination of optimal locations and pumping rates of numerous wells under a variety of restrictions placed upon local drawdown, hydraulic gradients, and water production targets. Groundwater policy evaluation and allocation models can be used to study the influence upon regional groundwater use of institutional policies such as taxes and quotas. Furthermore, fairly complex groundwater-surface water allocation problems can be handled using system decomposition and multilevel optimization. Experience from the few real world applications of groundwater optimization-management techniques is summarized. Classified separately are methods for groundwater quality management aimed at optimal waste disposal in the subsurface. This classification is composed of steady state and transient management models that determine disposal patterns in such a way that water quality is protected at supply locations. Classes of research missing from the literature are groundwater quality management models involving nonlinear constraints, models which join groundwater hydraulic and quality simulations with political-economic management considerations, and management models that include parameter uncertainty.

[Modern problems of maintenance of hygienic safety of drinking water consumption at the regional level].

PubMed

Tulakin, A V; Tsyplakova, G V; Ampleeva, G P; Kozyreva, O N; Pivneva, O S; Trukhina, G M

Problems of hygienic reliability of the drinking water use in regions of the Russian Federation are observed in the article. The optimization of the water use was shown must be based on the bearing in mind of regional peculiarities of the shaping of water quality of groundwater and surface sources of the water use, taking into account of the effectiveness of regional water protection programs, programs for water treatment, coordination of the activity of economic entities and oversight bodies in the management of water quality on the basis of socio-hygienic monitoring. Regional problems requiring hygienic justification and accounting, include such issues as complex hydrological, hydrogeological, climatic and geographical conditions, pronouncement of the severity of anthropogenic pollution of sources of water supply, natural conditions of the shaping of water quality, efficiency of the water treatment. There is need in the improvement of the problems of the water quality monitoring, including with the use of computer technology, which allows to realize regional hygienic monitoring and spatial-temporal analysis of the water quality, to model the water quality management, to predict conditions of the water use by population in regions taking into account peculiarities of the current health situation. In the article there is shown the practicability of the so-called complex concept of multiple barriers suggesting the combined use of chemical oxidation and physical methods of the preparation of drinking water. It is required the further development of legislation for the protection of water bodies from pollution with the bigging up the status of sanitary protection zones; timely revision of the regulatory framework, establishing sanitary-epidemiological requirements to potable water and drinking water supply. The problem of the provision of the population with safe drinking water requires complex solution within the framework of the implementation of target programs adopted at the Federal and regional levels.

A computer based approach for Material, Manpower and Equipment managementin the Construction Projects

NASA Astrophysics Data System (ADS)

Sasidhar, Jaladanki; Muthu, D.; Venkatasubramanian, C.; Ramakrishnan, K.

2017-07-01

The success of any construction project will depend on efficient management of resources in a perfect manner to complete the project with a reasonable budget and time and the quality cannot be compromised. The efficient and timely procurement of material, deployment of adequate labor at correct time and mobilization of machinery lacking in time, all of them causes delay, lack of quality and finally affect the project cost. It is known factor that Project cost can be controlled by taking corrective actions on mobilization of resources at a right time. This research focuses on integration of management systems with the computer to generate the model which uses OOM data structure which decides to include automatic commodity code generation, automatic takeoff execution, intelligent purchase order generation, and components of design and schedule integration to overcome the problems of stock out. To overcome the problem in equipment management system inventory management module is suggested and the data set of equipment registration number, equipment number, description, date of purchase, manufacturer, equipment price, market value, life of equipment, production data of the equipment which includes equipment number, date, name of the job, hourly rate, insurance, depreciation cost of the equipment, taxes, storage cost, interest, oil, grease, and fuel consumption, etc. is analyzed and the decision support systems to overcome the problem arising out improper management is generated. The problem on labor is managed using scheduling, Strategic management of human resources. From the generated support systems tool, the resources are mobilized at a right time and help the project manager to finish project in time and thereby save the abnormal project cost and also provides the percentage that can be improved and also research focuses on determining the percentage of delays that are caused by lack of management of materials, manpower and machinery in different types of projects and how the percentage various from project to project.

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.

Water Resources Research Grant Program project descriptions, fiscal year 1987

USGS Publications Warehouse

,

1987-01-01

This report contains information on the 34 new projects funded by the United States Geological Survey 's Water Resources Research Grant Program in fiscal year 1987 and on 3 projects completed during the year. For the new projects, the report gives the grant number, project title, performing organization, principal investigator(s), and a project description that includes: (1) identification of water related problems and problem-solution approach (2) contribution to problem solution, (3) objectives, and (4) approach. The 34 projects include 12 in the area of groundwater quality problems, 12 in the science and technology of water quality management, 1 in climate variability and the hydrologic cycle, 4 in institutional change in water resources management, and 5 in surface water management. For the three completed projects, the report furnishes the grant number; project title; performing organization; principal investor(s); starting data; data of receipt of final report; and an abstract of the final report. Each project description provides the information needed to obtain a copy of the final report. The report contains tables showing: (1) proposals received according to area of research interest, (2) grant awards and funding according to area of research interest, (3) proposals received according to type of submitting organization, and (4) awards and funding according to type of organization. (Author 's abstract)

A bottom up approach for engineering catchments through sustainable runoff management

NASA Astrophysics Data System (ADS)

Wilkinson, M.; Quinn, P. F.; Jonczyk, J.; Burke, S.

2010-12-01

There is no doubt that our catchments are under great stress. There have been many accounts around the world of severe flood events and water quality issues within channels. As a result of these, ecological habitats in rivers are also under pressure. Within the United Kingdom, all these issues have been identified as key target areas for policy. Traditionally this has been managed by a policy driven top down approach which is usually ineffective. A one ‘size fits all’ attitude often does not work. This paper presents a case study in northern England whereby a bottom up approach is applied to multipurpose managing of catchments at the source (in the order of 1-10km2). This includes simultaneous tackling of water quality, flooding and ecological issues by creating sustainable runoff management solutions such as storage ponds, wetlands, beaver dams and willow riparian features. In order to identify the prevailing issues in a specific catchment, full and transparent stakeholder engagement is essential, with everybody who has a vested interest in the catchment being involved from the beginning. These problems can then be dealt with through the use of a novel catchment management toolkit, which is transferable to similar scale catchments. However, evidence collected on the ground also allows for upscaling of the toolkit. The process gathers the scientific evidence about the effectiveness of existing or new measures, which can really change the catchment functions. Still, we need to get better at communicating the science to policy makers and policy therefore must facilitate a bottom up approach to land and water management. We show a test site for this approach in the Belford burn catchment (6km2), northern England. This catchment has problems with flooding and water quality. Increased sediment loads are affecting the nearby estuary which is an important ecological zone and numerous floods have affected the local village. A catchment engineering toolkit has been developed that puts in place novel measures to tackle diffuse pollution and reduce flood risk whilst collecting the science needed to influence the policy about these measures. This has been possible through four key practices: full stakeholder engagement, a problem solving agenda set in place, a bottom up approach to solving problems, and the collection of the appropriate science to support the benefits. Hands on, multi-objective work is the most cost effective way to manage catchments. Tackling water quality issues and controlling fast pathway runoff at the source in partnership with farmers and local landowners has proved to be the key to success. Tackling issues in sub-catchments can lead to solving problems at the catchment scale.

Effectiveness of a nurse-supported self-management programme for dual sensory impaired older adults in long-term care: a cluster randomised controlled trial.

PubMed

Roets-Merken, Lieve M; Zuidema, Sytse U; Vernooij-Dassen, Myrra J F J; Teerenstra, Steven; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

2018-01-24

To evaluate the effectiveness of a nurse-supported self-management programme to improve social participation of dual sensory impaired older adults in long-term care homes. Cluster randomised controlled trial. Thirty long-term care homes across the Netherlands. Long-term care homes were randomised into intervention clusters (n=17) and control clusters (n=13), involving 89 dual sensory impaired older adults and 56 licensed practical nurses. Nurse-supported self-management programme. Effectiveness was evaluated by the primary outcome social participation using a participation scale adapted for visually impaired older adults distinguishing four domains: instrumental activities of daily living, social-cultural activities, high-physical-demand and low-physical-demand leisure activities. A questionnaire assessing hearing-related participation problems was added as supportive outcome. Secondary outcomes were autonomy, control, mood and quality of life and nurses' job satisfaction. For effectiveness analyses, linear mixed models were used. Sampling and intervention quality were analysed using descriptive statistics. Self-management did not affect all four domains of social participation; however. the domain 'instrumental activities of daily living' had a significant effect in favour of the intervention group (P=0.04; 95% CI 0.12 to 8.5). Sampling and intervention quality was adequate. A nurse-supported self-management programme was effective in empowering the dual sensory impaired older adults to address the domain 'instrumental activities of daily living', but no differences were found in addressing the other three participation domains. Self-management showed to be beneficial for managing practical problems, but not for those problems requiring behavioural adaptations of other persons. NCT01217502; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[About the problems and prospects of improving of governance in the modern hospital associations].

PubMed

Maksimov, I B; Stoliar, V P

2011-10-01

The problems of efficiency of management of officials of hospital healthcare association of manage of remote branch offices and the structural units of the Main Military Clinical Hospital n. a. N.N. Burdenko is examined. Emphasizes the role of improved information exchange, collect and analyze medical and other information. As a tool, that can provide consolidation and optimal utilization of institutional capacity, and all the information and analytical resources offered to create a situational control center (div) of hospital health-care associations. The result of the introduction will increase div validity and quality of management decisions of the leadership of the words: management, hospital treatment and prevention association, communication, situational control center.

Improving Multi-Objective Management of Water Quality Tipping Points: Revisiting the Classical Shallow Lake Problem

NASA Astrophysics Data System (ADS)

Quinn, J. D.; Reed, P. M.; Keller, K.

2015-12-01

Recent multi-objective extensions of the classical shallow lake problem are useful for exploring the conceptual and computational challenges that emerge when managing irreversible water quality tipping points. Building on this work, we explore a four objective version of the lake problem where a hypothetical town derives economic benefits from polluting a nearby lake, but at the risk of irreversibly tipping the lake into a permanently polluted state. The trophic state of the lake exhibits non-linear threshold dynamics; below some critical phosphorus (P) threshold it is healthy and oligotrophic, but above this threshold it is irreversibly eutrophic. The town must decide how much P to discharge each year, a decision complicated by uncertainty in the natural P inflow to the lake. The shallow lake problem provides a conceptually rich set of dynamics, low computational demands, and a high level of mathematical difficulty. These properties maximize its value for benchmarking the relative merits and limitations of emerging decision support frameworks, such as Direct Policy Search (DPS). Here, we explore the use of DPS as a formal means of developing robust environmental pollution control rules that effectively account for deeply uncertain system states and conflicting objectives. The DPS reformulation of the shallow lake problem shows promise in formalizing pollution control triggers and signposts, while dramatically reducing the computational complexity of the multi-objective pollution control problem. More broadly, the insights from the DPS variant of the shallow lake problem formulated in this study bridge emerging work related to socio-ecological systems management, tipping points, robust decision making, and robust control.

An integrated view of data quality in Earth observation

PubMed Central

Yang, X.; Blower, J. D.; Bastin, L.; Lush, V.; Zabala, A.; Masó, J.; Cornford, D.; Díaz, P.; Lumsden, J.

2013-01-01

Data quality is a difficult notion to define precisely, and different communities have different views and understandings of the subject. This causes confusion, a lack of harmonization of data across communities and omission of vital quality information. For some existing data infrastructures, data quality standards cannot address the problem adequately and cannot fulfil all user needs or cover all concepts of data quality. In this study, we discuss some philosophical issues on data quality. We identify actual user needs on data quality, review existing standards and specifications on data quality, and propose an integrated model for data quality in the field of Earth observation (EO). We also propose a practical mechanism for applying the integrated quality information model to a large number of datasets through metadata inheritance. While our data quality management approach is in the domain of EO, we believe that the ideas and methodologies for data quality management can be applied to wider domains and disciplines to facilitate quality-enabled scientific research. PMID:23230156

An integrated view of data quality in Earth observation.

PubMed

Yang, X; Blower, J D; Bastin, L; Lush, V; Zabala, A; Masó, J; Cornford, D; Díaz, P; Lumsden, J

2013-01-28

Data quality is a difficult notion to define precisely, and different communities have different views and understandings of the subject. This causes confusion, a lack of harmonization of data across communities and omission of vital quality information. For some existing data infrastructures, data quality standards cannot address the problem adequately and cannot fulfil all user needs or cover all concepts of data quality. In this study, we discuss some philosophical issues on data quality. We identify actual user needs on data quality, review existing standards and specifications on data quality, and propose an integrated model for data quality in the field of Earth observation (EO). We also propose a practical mechanism for applying the integrated quality information model to a large number of datasets through metadata inheritance. While our data quality management approach is in the domain of EO, we believe that the ideas and methodologies for data quality management can be applied to wider domains and disciplines to facilitate quality-enabled scientific research.

Work stress among nursing home care attendants in Taiwan: a questionnaire survey.

PubMed

Hsu, Hui-Chuan; Kung, Yuan-Wei; Huang, Hsiao-Chien; Ho, Pei-Yu; Lin, Ya-Ying; Chen, Wen-Shin

2007-07-01

Care attendants constitute the main workforce in nursing homes, but their heavy workload, low autonomy, and indefinite responsibility result in high levels of stress and may affect quality of care. However, few studies have focused of this problem. The aim of this study was to examine work-related stress and associated factors that affect care attendants in nursing homes and to offer suggestions for how management can alleviate these problems in care facilities. We recruited participants from nine nursing homes with 50 or more beds located in middle Taiwan; 110 care attendants completed the questionnaire. The work stress scale for the care attendants was validated and achieved good reliability (Cronbach's alpha=0.93). We also conducted exploratory factor analysis. Six factors were extracted from the work stress scale: insufficient ability, stressful reactions, heavy workload, trouble in care work, poor management, and working time problems. The explained variance achieved 64.96%. Factors related to higher work stress included working in a hospital-based nursing home, having a fixed schedule, night work, feeling burden, inconvenient facility, less enthusiasm, and self-rated higher stress. Work stress for care attendants in nursing homes is related to human resource management and quality of care. We suggest potential management strategies to alleviate work stress for these workers.

Preferred providers and the credible commitment problem in health insurance: first experiences with the implementation of managed competition in the Dutch health care system.

PubMed

Boonen, Lieke H H M; Schut, Frederik T

2011-04-01

We investigate the impact of the transition towards managed competition in the Dutch health care system on health insurers' contracting behaviour. Specifically, we examine whether insurers have been able to take up their role as prudent buyers of care and examine consumers' attitudes towards insurers' new role. Health insurers' contracting behaviour is investigated by an extensive analysis of available information on purchasing practices by health insurers and by interviews with directors of health care purchasing of the four major health insurers, accounting for 90% of the market. Consumer attitudes towards insurers' new role are investigated by surveys among a representative sample of enrollees over the period 2005-2009. During the first four years of the reform, health insurers were very reluctant to engage in selective contracting and preferred to use 'soft' positive incentives to encourage preferred provider choice rather than engaging in restrictive managed care activities. Consumer attitudes towards channelling vary considerably by type of provider but generally became more negative in the first two years after the reform. Insurers' reluctance to use selective contracting can be at least partly explained by the presence of a credible-commitment problem. Consumers do not trust that insurers with restrictive networks are committed to provide good quality care. The credible-commitment problem seems to be particularly relevant to the Netherlands, since Dutch enrollees are not used to restrictions on provider choice. Since consumers are quite sensitive to differences in provider quality, more reliable information about provider quality is required to reduce the credible-commitment problem.

Perceived quality in a dementia unit: patients' caregivers as information providers.

PubMed

López-Picazo, J J; de Dios Cánovas-García, J; Antúnez, C; Marín, J; Antequera, M M; Vivancos, L; Martínez, B; Legaz, A; Navarro, D; Leal, M

2016-10-22

Dementia units (DU) provide comprehensive and specialised care to patients with dementia. However, assessment in these units normally focuses on patient management. The aim of this study was to determine satisfaction of the caregivers of patients managed in a DU and how they rated DU care. We created a self-administered questionnaire which was completed by 236 caregivers visiting the DU in 2015. The questionnaire included 6 dimensions (accessibility, organisation, professionalism, relationship with staff, information, and facilities); data were analysed using problem rates. A total of 53.4% caregivers completed the questionnaire; most were women, patients' spouses, or first-degree relatives. The overall problem rates was 15.0% (95% CI, 13.9-16.1), with sizeable differences between dimensions: from 0.1% (95% CI, 0.0-0.4) for 'relationship with staff' and 'professionalism' to 49.3% (95% CI, 45.4-53.2) for 'information'. Waiting times over 30minutes were perceived as excessive. Information problems were not directly related to patient management. Satisfaction was scored 8.29/10 (median 8; SD 1.45); 77.3% (95% CI, 69.8-74.8) of respondents were highly satisfied. Ninety-nine percent of the caregivers stated that they would recommend the DU. This questionnaire provides interesting data on care quality as perceived by patients' caregivers. Our results have allowed us to identify problems and implement corrective actions. Our questionnaire has proved to be a useful tool for evaluating and improving care quality in DUs. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Optimal implementation of best management practices to improve agricultural hydrology and water quality

NASA Astrophysics Data System (ADS)

Liu, Y.; Engel, B.; Collingsworth, P.; Pijanowski, B. C.

2017-12-01

Nutrient loading from the Maumee River watershed is a significant reason for the harmful algal blooms (HABs) problem in Lake Erie. Strategies to reduce nutrient loading from agricultural areas in the Maumee River watershed need to be explored. Best management practices (BMPs) are popular approaches for improving hydrology and water quality. Various scenarios of BMP implementation were simulated in the AXL watershed (an agricultural watershed in Maumee River watershed) using Soil and Water Assessment Tool (SWAT) and a new BMP cost tool to explore the cost-effectiveness of the practices. BMPs of interest included vegetative filter strips, grassed waterways, blind inlets, grade stabilization structures, wetlands, no-till, nutrient management, residue management, and cover crops. The following environmental concerns were considered: streamflow, Total Phosphorous (TP), Dissolved Reactive Phosphorus (DRP), Total Kjeldahl Nitrogen (TKN), and Nitrate+Nitrite (NOx). To obtain maximum hydrological and water quality benefits with minimum cost, an optimization tool was developed to optimally select and place BMPs by connecting SWAT, the BMP cost tool, and optimization algorithms. The optimization tool was then applied in AXL watershed to explore optimization focusing on critical areas (top 25% of areas with highest runoff volume/pollutant loads per area) vs. all areas of the watershed, optimization using weather data for spring (March to July, due to the goal of reducing spring phosphorus in watershed management plan) vs. full year, and optimization results of implementing BMPs to achieve the watershed management plan goal (reducing 2008 TP levels by 40%). The optimization tool and BMP optimization results can be used by watershed groups and communities to solve hydrology and water quality problems.

Cluster management.

PubMed

Katz, R

1992-11-01

Cluster management is a management model that fosters decentralization of management, develops leadership potential of staff, and creates ownership of unit-based goals. Unlike shared governance models, there is no formal structure created by committees and it is less threatening for managers. There are two parts to the cluster management model. One is the formation of cluster groups, consisting of all staff and facilitated by a cluster leader. The cluster groups function for communication and problem-solving. The second part of the cluster management model is the creation of task forces. These task forces are designed to work on short-term goals, usually in response to solving one of the unit's goals. Sometimes the task forces are used for quality improvement or system problems. Clusters are groups of not more than five or six staff members, facilitated by a cluster leader. A cluster is made up of individuals who work the same shift. For example, people with job titles who work days would be in a cluster. There would be registered nurses, licensed practical nurses, nursing assistants, and unit clerks in the cluster. The cluster leader is chosen by the manager based on certain criteria and is trained for this specialized role. The concept of cluster management, criteria for choosing leaders, training for leaders, using cluster groups to solve quality improvement issues, and the learning process necessary for manager support are described.

78 FR 3433 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-16

... and by educating the public, especially young people, about tobacco products and the dangers their use... identified. When FDA receives tobacco-specific adverse event and product problem information, it will use the... quality problem, or product use error occurs. This risk identification process is the first necessary step...

Informational system as an instrument for assessing the performance of the quality management system

NASA Astrophysics Data System (ADS)

Rohan, R.; Roşu, M. M.

2017-08-01

At present there is used a significant number of techniques and methods for diagnosis and management analysis which support the decision-making process. All these methods facilitate reaching the objectives for improving the results through efficiency, quality and customer satisfaction. By developing a methodology for analysing the problems identified in the macro-productive companies there can be brought outstanding benefits to the management and there are offered new perspectives on the critical influencing factors within a system. Through this paper we present an effective management strategy, applicable to an organization with productive profile in order to design an informational system aimed to manage one of its most important and complex systems, namely the coordination of the quality management system. The informational organisation of the quality management system on management principles, ensures an optimization of the informational energy consumption, allowing the management to deal with the following: to ascertain the current situation; to seize the opportunities, but also the potential risks afferent to the organisation policy; to observe the strengths and weaknesses; to take appropriate decisions and then to control the effects obtained. In this way, the decisional factors are able to better understand the available opportunities and to base more efficiently the process of choosing the alternatives.

Nursing students' experiences with refugees with mental health problems in Jordan: A qualitative content analysis.

PubMed

Dotevall, Camilla; Winberg, Elin; Rosengren, Kristina

2018-02-01

The aim of this study was to describe Jordanian nursing students' experience of caring for refugees with mental health problems. According to refugees' experiences of crisis, a well-educated staff is needed to provide high quality of care due to mental health problems. Therefore, health professionals play an important role in creating an environment that promotes human rights regardless of ethnic origin. The study comprised eight interviews and was analysed using content analysis, a qualitative method that involves an inductive approach, to increase our understanding of nursing students' perspective and thoughts regarding caring for refugees with mental health problems. The results formed one category: to be challenged by refugees' mental health issues and three subcategories: managing refugees' mental health needs, affected by refugees' mental health, and improve mental healthcare for refugees. Language problems could be managed by using interpreters to decrease cultural clashes to facilitate equal healthcare. In addition, well-educated (theoretical knowledge) and trained (practical knowledge) nursing students have potential to fulfil refugees' care needs regardless of ethnicity or background by using nursing interventions built on communication skills and cultural competences (theory, practice) to facilitate high quality of healthcare. Copyright © 2017 Elsevier Ltd. All rights reserved.

Quality Internships for School Leaders: Meeting the Challenge

ERIC Educational Resources Information Center

Gaudreau, Patricia A.; Kufel, Andrew P.; Parks, David J.

2006-01-01

An internship is essential for the development of competency-based leadership. Variation in the quality of time spent in clinical settings depends on the use of approaches that provide interns with opportunities to observe, participate in, and reflect on the problems of leadership and management found in schools. In essence, the internship is an…

The Quality Control Circle: Is It for Education?

ERIC Educational Resources Information Center

Land, Arthur J.

From its start in Japan after World War II, the Quality Control Circle (Q.C.) approach to management and organizational operation evolved into what it is today: people doing similar work meeting regularly to identify, objectively analyze, and develop solutions to problems. The Q.C. approach meets Maslow's theory of motivation by inviting…

Innovative Problems of Improving the Quality of Life of the Welfare State

ERIC Educational Resources Information Center

Panachev, Valery D.

2016-01-01

Improvement of the population quality of life should be based on promoting healthy lifestyle, active physical exercises and sports activities as one of its main priorities. In order to facilitate the achievement of this priority, the author proposes management technique of complicated coordination movements in space in the development of…

Leadership for the 21st Century

ERIC Educational Resources Information Center

Buck, Marilyn

2014-01-01

This article was presented as the 23rd Delphine Hanna Lecture and focused on reflections on leadership roles and qualities of excellent administrators. The three roles of administrators are to manage, solve problems, and develop a vision. Quality leaders know that it is not the message that is delivered, but how the message makes the recipient…

Information Technology Manager's Perspective on Experiences with Service Quality and Customer Satisfaction: A Phenomenology Study

ERIC Educational Resources Information Center

Porter, Sherry A.

2016-01-01

The general problem was that, in the competitive telecommunications industry, information technology service providers have to develop ways to improve on customer satisfaction and service quality during service disruptions to meet service level agreements. A descriptive phenomenological study was used to explore the lived experiences and…

Forest management in Northeast China: history, problems, and challenges.

PubMed

Yu, Dapao; Zhou, Li; Zhou, Wangming; Ding, Hong; Wang, Qingwei; Wang, Yue; Wu, Xiaoqing; Dai, Limin

2011-12-01

Studies of the history and current status of forest resources in Northeast China have become important in discussions of sustainable forest management in the region. Prior to 1998, excessive logging and neglected cultivation led to a series of problems that left exploitable forest reserves in the region almost exhausted. A substantial decrease in the area of natural forests was accompanied by severe disruption of stand structure and serious degradation of overall forest quality and function. In 1998, China shifted the primary focus of forest management in the country from wood production to ecological sustainability, adopting ecological restoration and protection as key foci of management. In the process, China launched the Natural Forest Conversion Program and implemented a new system of Classification-based Forest Management. Since then, timber harvesting levels in Northeast China have decreased, and forest area and stocking levels have slowly increased. At present, the large area of low quality secondary forest lands, along with high levels of timber production, present researchers and government agencies in China with major challenges in deciding on management models and strategies that will best protect, restore and manage so large an area of secondary forest lands. This paper synthesizes information from a number of sources on forest area, stand characteristics and stocking levels, and forest policy changes in Northeastern China. Following a brief historical overview of forest harvesting and ecological research in Northeast China, the paper discusses the current state of forest resources and related problems in forest management in the region, concluding with key challenges in need of attention in order to meet the demands for multi-purpose forest sustainability and management in the future.

Hydrology and water quality of Park Lake, south-central Wisconsin

USGS Publications Warehouse

Kammerer, P.A.

1996-01-01

Park Lake extends to the northeast from the village of Pardeeville in Columbia County (fig. 1). Local residents perceive water-quality problems in the lake that include excessive algae and aquatic plant growth. Algae and plant growth in a lake are controlled, in part, by the availability of phosphorus in the water. However, no measurements of phosphorus enter- ing the lake or of other factors that affect lake-water quality had been made, and available data on water quality were limited to 2 years of measurements at one site in the lake in 1986- 87. To obtain the data and in- formation needed to address the water-quality problems at Park Lake and to develop a management plan that would limit the input of phosphorus to the lake, the U.S. Geologi- cal Survey, in cooperation with the Park Lake Management District, studied the hydrology of the lake and collected data needed to determine sources and amount of phosphorus en- tering the lake. This Fact Sheet summarizes the results of that study. Data collected during the study were published in a separate report (Holmstrom and others, 1994, p. 70-85).

NASA Earth Resources Survey Symposium. Volume 1-A: Agriculture, environment

NASA Technical Reports Server (NTRS)

1975-01-01

A number of papers dealing with the practical application of imagery obtained from remote sensors on LANDSAT satellites, the Skylab Earth resources experiment package, and aircraft to problems in agriculture and the environment were presented. Some of the more important topics that were covered included: range management and resources, environmental monitoring and management, crop growth and inventory, land management, multispectral band scanners, forest management, mapping, marshlands, strip mining, water quality and pollution, ecology.

Knowledge Representation and Care Planning for Population Health Management.

PubMed

Merahn, Steven

2015-01-01

The traditional organizing principles of medical knowledge may be insufficient to allow for problem representations that are relevant to solution development in emerging models of care such as population health management. Operational classification and central management of clinical and quality objectives and associated strategies will allow for productive innovation in care design and better support goal-directed collaboration among patients and their health resource communities.

Improving Water Management Decision Support Tools Using NASA Satellite and Modeling Data

NASA Astrophysics Data System (ADS)

Toll, D. L.; Arsenault, K.; Nigro, J.; Pinheiro, A.; Engman, E. T.; Triggs, J.; Cosgrove, B.; Alonge, C.; Boyle, D.; Allen, R.; Townsend, P.; Ni-Meister, W.

2006-05-01

One of twelve Applications of National priority within NASA's Applied Science Program, the Water Management Program Element addresses concerns and decision making related to water availability, water forecast and water quality. The goal of the Water Management Program Element is to encourage water management organizations to use NASA Earth science data, models products, technology and other capabilities in their decision support tools for problem solving. The Water Management Program Element partners with Federal agencies, academia, private firms, and may include international organizations. This paper further describes the Water Management Program with the objective of informing the applications community of the potential opportunities for using NASA science products for problem solving. We will illustrate some ongoing and application Water Management projects evaluating and benchmarking NASA data with partnering federal agencies and their decision support tools: 1) Environmental Protection Agency for water quality; 2) Bureau of Reclamation for water supply, demand and forecast; and 3) NOAA National Weather Service for improved weather prediction. Examples of the types of NASA contributions to the these agency decision support tools include: 1) satellite observations within models assist to estimate water storage, i.e., snow water equivalent, soil moisture, aquifer volumes, or reservoir storages; 2) model derived products, i.e., evapotranspiration, precipitation, runoff, ground water recharge, and other 4-dimensional data assimilation products; 3) improve water quality, assessments by using improved inputs from NASA models (precipitation, evaporation) and satellite observations (e.g., temperature, turbidity, land cover) to nonpoint source models; and 4) water (i.e., precipitation) and temperature predictions from days to decades over local, regional and global scales.

Application of kaizen methodology to foster departmental engagement in quality improvement.

PubMed

Knechtges, Paul; Decker, Michael Christopher

2014-12-01

The Toyota Production System, also known as Lean, is a structured approach to continuous quality improvement that has been developed over the past 50 years to transform the automotive manufacturing process. In recent years, these techniques have been successfully applied to quality and safety improvement in the medical field. One of these techniques is kaizen, which is the Japanese word for "good change." The central tenant of kaizen is the quick analysis of the small, manageable components of a problem and the rapid implementation of a solution with ongoing, real-time reassessment. Kaizen adds an additional "human element" that all stakeholders, not just management, must be involved in such change. Because of the small size of the changes involved in a kaizen event and the inherent focus on human factors and change management, a kaizen event can serve as good introduction to continuous quality improvement for a radiology department. Copyright © 2014. Published by Elsevier Inc.

Quantification, Risk, and the Rhetoric of Higher Education Management

ERIC Educational Resources Information Center

Dale, Leigh

2012-01-01

This essay is a contribution to the literature of critique of higher education policy and management. It offers a general discussion of problems arising from the proliferation of mechanisms of audit and quality assurance within the context of concerns about dependence on quantitative measures of values. It argues that uncritical dependence on…

Environmental Resource Management Issues in Agronomy: A Lecture/Laboratory Course

ERIC Educational Resources Information Center

Munn, D. A.

2004-01-01

Environmental Sciences Technology T272 is a course with a laboratory addressing problems in soil and water quality and organic wastes utilization to serve students from associate degree programs in laboratory science and environmental resources management at a 2-year technical college. Goals are to build basic lab skills and understand the role…

American college of gastroenterology monograph on the management of irritable bowel syndrome.

PubMed

Camilleri, Michael

2015-04-01

This editorial reviews a recently published guideline on management of irritable bowel syndrome. The guideline illustrates problems arising from the quality of clinical trials used in systematic reviews and the potential impact of the inherent weaknesses of those trials on rating the strength of evidence and the resulting recommendations.

METRO-APEX Volume 9.1: Solid Waste Manager's Manual. Revised.

ERIC Educational Resources Information Center

University of Southern California, Los Angeles. COMEX Research Project.

The Solid Waste Manager's Manual is one of a set of twenty-one manuals used in METRO-APEX 1974, a computerized college and professional level, computer-supported, role-play, simulation exercise of a community with "normal" problems. Stress is placed on environmental quality considerations. APEX 1974 is an expansion of APEX--Air Pollution…

Dredging and Water Quality Problems in the Great Lakes. Volume 2. Appendices A1 to A19. Sampling Surveys with Separate Reports

DTIC Science & Technology

1969-01-01

Ii necessary and Identity by block number) Dredging Water Quality Water Pollution M0 AUOTR ACT e-ausamtoj m wesem. et itp omea d Identtfy by block...nmuibeA) The present report presents the results of a study conducted by the Corps Engineers with cooperation of the Federal Water Pollution Control...areas of the Great Lakes, as well as to develop the most practical methods for management of pollution problems that may be identified as resulting

HACCP-based quality risk management approach to udder health problems on dairy farms

PubMed Central

2009-01-01

Against the background of prevailing udder health problems on dairy farms, this paper discusses a new approach to mastitis control. Current udder health control programmes, such as the 'five-point plan', are highlighted and their drawbacks indicated. The concept and principles of hazard analysis critical control points (HACCP) are introduced. The eight core elements of this concept are dealt with by using the example of a dairy herd with a mastitis problem due to Staphylococcus aureus. The various steps to be taken in the development of a HACCP-based quality risk management programme are illustrated through the application of core elements. Finally, it is shown that the HACCP key words, structure, organisation, planning, communication and formalisation; which do not frequently appear in conventional herd health and production management programmes can contribute to better udder health. The role of the veterinarian can be paramount and of added value, if he/she is willing to invest in new knowledge and skills, such as the HACCP concept, farm economics, animal nutrition, and particularly the role of coach to the dairy farmer in the implementation of preventative measures in relation to udder health. PMID:22082372

HACCP-based quality risk management approach to udder health problems on dairy farms.

PubMed

Noordhuizen, Jptm; Cannas da Silva, J

2009-04-01

Against the background of prevailing udder health problems on dairy farms, this paper discusses a new approach to mastitis control. Current udder health control programmes, such as the 'five-point plan', are highlighted and their drawbacks indicated. The concept and principles of hazard analysis critical control points (HACCP) are introduced. The eight core elements of this concept are dealt with by using the example of a dairy herd with a mastitis problem due to Staphylococcus aureus. The various steps to be taken in the development of a HACCP-based quality risk management programme are illustrated through the application of core elements. Finally, it is shown that the HACCP key words, structure, organisation, planning, communication and formalisation; which do not frequently appear in conventional herd health and production management programmes can contribute to better udder health. The role of the veterinarian can be paramount and of added value, if he/she is willing to invest in new knowledge and skills, such as the HACCP concept, farm economics, animal nutrition, and particularly the role of coach to the dairy farmer in the implementation of preventative measures in relation to udder health.

Quality Requirements for Electronic Health Record Systems*. A Japanese-German Information Management Perspective.

PubMed

Winter, Alfred; Takabayashi, Katsuhiko; Jahn, Franziska; Kimura, Eizen; Engelbrecht, Rolf; Haux, Reinhold; Honda, Masayuki; Hübner, Ursula H; Inoue, Sozo; Kohl, Christian D; Matsumoto, Takehiro; Matsumura, Yasushi; Miyo, Kengo; Nakashima, Naoki; Prokosch, Hans-Ulrich; Staemmler, Martin

2017-08-07

For more than 30 years, there has been close cooperation between Japanese and German scientists with regard to information systems in health care. Collaboration has been formalized by an agreement between the respective scientific associations. Following this agreement, two joint workshops took place to explore the similarities and differences of electronic health record systems (EHRS) against the background of the two national healthcare systems that share many commonalities. To establish a framework and requirements for the quality of EHRS that may also serve as a basis for comparing different EHRS. Donabedian's three dimensions of quality of medical care were adapted to the outcome, process, and structural quality of EHRS and their management. These quality dimensions were proposed before the first workshop of EHRS experts and enriched during the discussions. The Quality Requirements Framework of EHRS (QRF-EHRS) was defined and complemented by requirements for high quality EHRS. The framework integrates three quality dimensions (outcome, process, and structural quality), three layers of information systems (processes and data, applications, and physical tools) and three dimensions of information management (strategic, tactical, and operational information management). Describing and comparing the quality of EHRS is in fact a multidimensional problem as given by the QRF-EHRS framework. This framework will be utilized to compare Japanese and German EHRS, notably those that were presented at the second workshop.

Using Quality Management Systems to Improve Test Development and Standards and to Promote Good Practice: A Case Study of Testing Italian as a Foreign Language

ERIC Educational Resources Information Center

Grego Bolli, Giuliana

2014-01-01

This article discusses the problem of quality in the production of language tests in the context of Italian language examinations. The concept of quality is closely related to the application of stated standards and related procedures. These standards, developed over the last thirty years, are mainly related to the concepts of the accountability…

A model for managing sources of groundwater pollution

USGS Publications Warehouse

Gorelick, Steven M.

1982-01-01

The waste disposal capacity of a groundwater system can be maximized while maintaining water quality at specified locations by using a groundwater pollutant source management model that is based upon linear programing and numerical simulation. The decision variables of the management model are solute waste disposal rates at various facilities distributed over space. A concentration response matrix is used in the management model to describe transient solute transport and is developed using the U.S. Geological Survey solute transport simulation model. The management model was applied to a complex hypothetical groundwater system. Large-scale management models were formulated as dual linear programing problems to reduce numerical difficulties and computation time. Linear programing problems were solved using a numerically stable, available code. Optimal solutions to problems with successively longer management time horizons indicated that disposal schedules at some sites are relatively independent of the number of disposal periods. Optimal waste disposal schedules exhibited pulsing rather than constant disposal rates. Sensitivity analysis using parametric linear programing showed that a sharp reduction in total waste disposal potential occurs if disposal rates at any site are increased beyond their optimal values.

A hybrid genetic-simulated annealing algorithm for the location-inventory-routing problem considering returns under e-supply chain environment.

PubMed

Li, Yanhui; Guo, Hao; Wang, Lin; Fu, Jing

2013-01-01

Facility location, inventory control, and vehicle routes scheduling are critical and highly related problems in the design of logistics system for e-business. Meanwhile, the return ratio in Internet sales was significantly higher than in the traditional business. Many of returned merchandise have no quality defects, which can reenter sales channels just after a simple repackaging process. Focusing on the existing problem in e-commerce logistics system, we formulate a location-inventory-routing problem model with no quality defects returns. To solve this NP-hard problem, an effective hybrid genetic simulated annealing algorithm (HGSAA) is proposed. Results of numerical examples show that HGSAA outperforms GA on computing time, optimal solution, and computing stability. The proposed model is very useful to help managers make the right decisions under e-supply chain environment.

A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard.

PubMed

Azadmanjir, Zahra; Torabi, Mashallah; Safdari, Reza; Bayat, Maryam; Golmahi, Fatemeh

2015-08-01

management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard. the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified. the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers. the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process.

Agriculture and stream water quality: A biological evaluation of erosion control practices

NASA Astrophysics Data System (ADS)

Lenat, David R.

1984-07-01

Agricultural runoff affects many streams in North Carolina. However, there is is little information about either its effect on stream biota or any potential mitigation by erosion control practices. In this study, benthic macroinvertebrates were sampled in three different geographic areas of North Carolina, comparing control watersheds with well-managed and poorly managed watersheds. Agricultural streams were characterized by lower taxa richness (especially for intolerant groups) and low stability. These effects were most evident at the poorly managed sites. Sedimentation was the apparent major problem, but some changes at agricultural sites implied water quality problems. The groups most intolerant of agricultural runoff were Ephemeroptera, Plecoptera and Trichoptera. Tolerant species were usually filter-feeders or algal grazers, suggesting a modification of the food web by addition of particulate organic matter and nutrients. This study clearly indicates that agricultural runoff can severely impact stream biota. However, this impact can be greatly mitigated by currently recommended erosion control practices.

Perceived quality of chronic illness care is associated with self-management: Results of a nationwide study in the Netherlands.

PubMed

van Houtum, L; Heijmans, M; Rijken, M; Groenewegen, P

2016-04-01

Healthcare providers are increasingly expected to help chronically ill patients understand their own central role in managing their illness. The aim of this study was to determine whether experiencing high-quality chronic illness care and having a nurse involved in their care relate to chronically ill people's self-management. Survey data from 699 people diagnosed with chronic diseases who participated in a nationwide Dutch panel-study were analysed using linear regression analysis, to estimate the association between chronic illness care and various aspects of patients' self-management, while controlling for their socio-demographic and illness characteristics. Chronically ill patients reported that the care they received was of high quality to some extent. Patients who had contact with a practise nurse or specialised nurse perceived the quality of the care they received as better than patients who only had contact with a GP or medical specialist. Patients' perceptions of the quality of care were positively related to all aspects of their self-management, whereas contact with a practise nurse or specialised nurse in itself was not. Chronically ill patients who have the experience to receive high-quality chronic illness care that focusses on patient activation, decision support, goal setting, problem solving, and coordination of care are better self-managers. Having a nurse involved in their care seems to be positively valued by chronically ill patients, but does not automatically imply better self-management. Copyright © 2016. Published by Elsevier Ireland Ltd.

Spawning Ideas--Moving from Ideas to Action: Quality Tools for Collective Problem-Solving and Continuous Learning.

ERIC Educational Resources Information Center

Flor, Richard F.; Troskey, Matthew D.

This paper explores the dynamics of managing collective problem solving and decision making, and the application of tools and strategies to deal with the emergent complexity of systems in which educators work. Schools and educational programs are complex adaptive systems that respond to changes in internal and external environments. Functioning…

Time's Up: Applying Teacher Management Skills to Solving Philadelphia's Problems

ERIC Educational Resources Information Center

Lax, Zach

2013-01-01

Teachers are natural problem solvers, and they should be using this quality to their advantage when it comes to solving the systemic issues that plague Philadelphia's education system. Many of the articles in this issue have already gone into great detail about what is happening in Philadelphia. Torch Lytle has provided a summary of the recent…

Management: A continuing literature survey with indexes, March 1976

NASA Technical Reports Server (NTRS)

1976-01-01

Management is a compilation of references to selected reports, journal articles, and other documents on the subject of management. This publication lists 368 documents originally announced in the 1975 issues of Scientific and Technical Aerospace Reports (STAR) or International Aerospace Abstracts (IAA). It includes references on the management of research and development, contracts, production, logistics, personnel, safety, reliability and quality control. It also includes references on: program, project and systems management; management policy, philosophy, tools, and techniques; decisionmaking processes for managers; technology assessment; management of urban problems; and information for managers on Federal resources, expenditures, financing, and budgeting.

Evaluating Quality Circles in a College of Further Education. Manchester Monographs 31.

ERIC Educational Resources Information Center

Atkinson, Tim

Quality circles (QCs) are small volunteer groups of workers who meet weekly with a trained leader operating to a strict code of conduct. They use techniques of brainstorming, cause and effect classification, pareto analysis, and presentation to consider work-related problems and recommend solutions to management. QCs have been tried in educational…

The Hazardous-Drums Project: A Multiweek Laboratory Exercise for General Chemistry Involving Environmental, Quality Control, and Cost Evaluation

ERIC Educational Resources Information Center

Hayes, David; Widanski, Bozena

2013-01-01

A laboratory experiment is described that introduces students to "real-world" hazardous waste management issues chemists face. The students are required to define an analytical problem, choose a laboratory analysis method, investigate cost factors, consider quality-control issues, interpret the meaning of results, and provide management…

Assessment of Runoff and Sediment Yields Using the AnnAGNPS Model from the Daning River Watershed in Three-Gorge Area of China

EPA Science Inventory

Soil erosion has been recognized as one of the major threats to our environment and water quality worldwide, especially in China. To mitigate nonpoint source water quality problems caused by soil erosion, best management practices (BMPs) and/or conservation programs have been ado...

Acceleration of aircraft-level Traffic Flow Management

NASA Astrophysics Data System (ADS)

Rios, Joseph Lucio

This dissertation describes novel approaches to solving large-scale, high fidelity, aircraft-level Traffic Flow Management scheduling problems. Depending on the methods employed, solving these problems to optimality can take longer than the length of the planning horizon in question. Research in this domain typically focuses on the quality of the modeling used to describe the problem and the benefits achieved from the optimized solution, often treating computational aspects as secondary or tertiary. The work presented here takes the complementary view and considers the computational aspect as the primary concern. To this end, a previously published model for solving this Traffic Flow Management scheduling problem is used as starting point for this study. The model proposed by Bertsimas and Stock-Patterson is a binary integer program taking into account all major resource capacities and the trajectories of each flight to decide which flights should be held in which resource for what amount of time in order to satisfy all capacity requirements. For large instances, the solve time using state-of-the-art solvers is prohibitive for use within a potential decision support tool. With this dissertation, however, it will be shown that solving can be achieved in reasonable time for instances of real-world size. Five other techniques developed and tested for this dissertation will be described in detail. These are heuristic methods that provide good results. Performance is measured in terms of runtime and "optimality gap." We then describe the most successful method presented in this dissertation: Dantzig-Wolfe Decomposition. Results indicate that a parallel implementation of Dantzig-Wolfe Decomposition optimally solves the original problem in much reduced time and with better integrality and smaller optimality gap than any of the heuristic methods or state-of-the-art, commercial solvers. The solution quality improves in every measureable way as the number of subproblems solved in parallel increases. A maximal decomposition provides the best results of any method tested. The convergence qualities of Dantzig-Wolfe Decomposition have been criticized in the past, so we examine what makes the Bertsimas-Stock Patterson model so amenable to use of this method. These mathematical qualities of the model are generalized to provide guidance on other problems that may benefit from massively parallel Dantzig-Wolfe Decomposition. This result, together with the development of the software, and the experimental results indicating the feasibility of real-time, nationwide Traffic Flow Management scheduling represent the major contributions of this dissertation.

Hoshin Kanri: a technique for strategic quality management.

PubMed

Tennant, C; Roberts, P A

2000-01-01

This paper describes a technique for Strategic Quality Management (SQM), known as Hoshin Kanri, which has been operated as a management system in many Japanese companies since the 1960s. It represents a core aspect of Japanese companies' management systems, and is stated as: the means by which the overall control system and Total Quality Management (TQM) are deployed. Hoshin Kanri is not particularly unique in its concept of establishing and tracking individual goals and objectives, but the manner in which the objectives and the means to achieve them are developed and deployed is. The problem with applying the concept of Strategic Quality Management (SQM) using Hoshin Kanri, is that it can tend to challenge the traditional authoritarian strategic planning models, which have become the paradigms of modern business. Yet Hoshin Kanri provides an appropriate tool for declaration of the strategic vision for the business while integrating goals and targets in a single holistic model. There have been various adaptations of Hoshin Kanri to align the technique to Western thinking and management approaches, yet outside Japan its significance has gone largely unreported. It is proposed that Hoshin Kanri is an effective methodology for SQM, which has a number of benefits over the more conventional planning techniques. The benefits of Hoshin Kanri as a tool for Strategic Quality Management (SQM) compared to conventional planning systems include: integration of strategic objectives with tactical daily management, the application of the plan-do-check-act cycle to business process management, parallel planning and execution methodology, company wide approach, improvements in communication, increased consensus and buy-in to goal setting, and cross-functional-management integration.

Management of a stage-structured insect pest: an application of approximate optimization.

PubMed

Hackett, Sean C; Bonsall, Michael B

2018-06-01

Ecological decision problems frequently require the optimization of a sequence of actions over time where actions may have both immediate and downstream effects. Dynamic programming can solve such problems only if the dimensionality is sufficiently low. Approximate dynamic programming (ADP) provides a suite of methods applicable to problems of arbitrary complexity at the expense of guaranteed optimality. The most easily generalized method is the look-ahead policy: a brute-force algorithm that identifies reasonable actions by constructing and solving a series of temporally truncated approximations of the full problem over a defined planning horizon. We develop and apply this approach to a pest management problem inspired by the Mediterranean fruit fly, Ceratitis capitata. The model aims to minimize the cumulative costs of management actions and medfly-induced losses over a single 16-week season. The medfly population is stage-structured and grows continuously while management decisions are made at discrete, weekly intervals. For each week, the model chooses between inaction, insecticide application, or one of six sterile insect release ratios. Look-ahead policy performance is evaluated over a range of planning horizons, two levels of crop susceptibility to medfly and three levels of pesticide persistence. In all cases, the actions proposed by the look-ahead policy are contrasted to those of a myopic policy that minimizes costs over only the current week. We find that look-ahead policies always out-performed a myopic policy and decision quality is sensitive to the temporal distribution of costs relative to the planning horizon: it is beneficial to extend the planning horizon when it excludes pertinent costs. However, longer planning horizons may reduce decision quality when major costs are resolved imminently. ADP methods such as the look-ahead-policy-based approach developed here render questions intractable to dynamic programming amenable to inference but should be applied carefully as their flexibility comes at the expense of guaranteed optimality. However, given the complexity of many ecological management problems, the capacity to propose a strategy that is "good enough" using a more representative problem formulation may be preferable to an optimal strategy derived from a simplified model. © 2018 by the Ecological Society of America.

Managing obesity in primary care.

PubMed

Goldie, Christine; Brown, Jenny

Obesity is a complex problem and often difficult to tackle in primary care. A year-long pilot of a practice nurse-led scheme that used a holistic approach towards self-care in obesity management was set up to reduce the cardiovascular risk of patients who were obese and improve their quality of life. This person-centred approach may offer an important tool in the management of these patients in the GP surgery.

Implementation of an Evidence-Based and Content Validated Standardized Ostomy Algorithm Tool in Home Care: A Quality Improvement Project.

PubMed

Bare, Kimberly; Drain, Jerri; Timko-Progar, Monica; Stallings, Bobbie; Smith, Kimberly; Ward, Naomi; Wright, Sandra

Many nurses have limited experience with ostomy management. We sought to provide a standardized approach to ostomy education and management to support nurses in early identification of stomal and peristomal complications, pouching problems, and provide standardized solutions for managing ostomy care in general while improving utilization of formulary products. This article describes development and testing of an ostomy algorithm tool.

A review and synthesis of recreation ecology research supporting carrying capacity and visitor use management decisionmaking

USGS Publications Warehouse

Marion, Jeff

2016-01-01

Resource and experiential impacts associated with visitation to wilderness and other similar backcountry settings have long been addressed by land managers under the context of “carrying capacity” decisionmaking. Determining a maximum level of allowable use, below which high-quality resource and experiential conditions would be sustained, was an early focus in the 1960s and 1970s. However, decades of recreation ecology research have shown that the severity and areal extent of visitor impact problems are influenced by an interrelated array of use-related, environmental, and managerial factors. This complexity, with similar findings from social science research, prompted scientists and managers to develop more comprehensive carrying capacity frameworks, including a new Visitor Use Management framework. These frameworks rely on a diverse array of management strategies and actions, often termed a “management toolbox,” for resolving visitor impact problems. This article reviews the most recent and relevant recreation ecology studies that have been applied in wildland settings to avoid or minimize resource impacts. The key findings and their management implications are highlighted to support the professional management of common trail, recreation site, and wildlife impact problems. These studies illustrate the need to select from a more diverse array of impact management strategies and actions based on an evaluation of problems to identify the most influential factors that can be manipulated.

OVERVIEW: CCL PATHOGENS RESEARCH AT NRMRL

EPA Science Inventory

The Microbial Contaminants Control Branch (MCCB), Water Supply and Water Resources Division, National Risk Management Research Laboratory, conducts research on microbiological problems associated with source water quality, treatment processes, distribution and storage of drin...

A comparison of quality and utilization problems in large and small group practices.

PubMed

Gleason, S C; Richards, M J; Quinnell, J E

1995-12-01

Physicians practicing in large, multispecialty medical groups share an organizational culture that differs from that of physicians in small or independent practices. Since 1980, there has been a sharp increase in the size of multispecialty group practice organizations, in part because of increased efficiencies of large group practices. The greater number of physicians and support personnel in a large group practice also requires a relatively more sophisticated management structure. The efficiencies, conveniences, and management structure of a large group practice provide an optimal environment to practice medicine. However, a search of the literature found no data linking a large group practice environment to practice outcomes. The purpose of the study reported in this article was to determine if physicians in large practices have fewer quality and utilization problems than physicians in small or independent practices.

Problems with provision: barriers to drinking water quality and public health in rural Tasmania, Australia.

PubMed

Whelan, Jessica J; Willis, Karen

2007-01-01

Access to safe drinking water is essential to human life and wellbeing, and is a key public health issue. However, many communities in rural and regional parts of Australia are unable to access drinking water that meets national standards for protecting human health. The aim of this research was to identify the key issues in and barriers to the provision and management of safe drinking water in rural Tasmania, Australia. Semi-structured interviews were conducted with key local government employees and public health officials responsible for management of drinking water in rural Tasmania. Participants were asked about their core public health duties, regulatory responsibilities, perceptions and management of risk, as well as the key barriers that may be affecting the provision of safe drinking water. This research highlights the effect of rural locality on management and safety of fresh water in protecting public health. The key issues contributing to problems with drinking water provision and quality identified by participants included: poor and inadequate water supply infrastructure; lack of resources and staffing; inadequate catchment monitoring; and the effect of competing land uses, such as forestry, on water supply quality. This research raises issues of inequity in the provision of safe drinking water in rural communities. It highlights not only the increasing need for greater funding by state and commonwealth government for basic services such as drinking water, but also the importance of an holistic and integrated approach to managing drinking water resources in rural Tasmania.

Intensive Quality Assurance of Therapist Adherence to Behavioral Interventions for Adolescent Substance Use Problems.

PubMed

Holth, Per; Torsheim, Torbjørn; Sheidow, Ashli J; Ogden, Terje; Henggeler, Scott W

2011-01-01

This study was a crosscultural replication of a study that investigated therapist adherence to behavioral interventions as a result of an intensive quality assurance system which was integrated into Multisystemic Therapy. Thirty-three therapists and eight supervisors participated in the study and were block randomized to either an Intensive Quality Assurance or a Workshop Only condition. Twenty-one of these therapists treated 41 cannabis-abusing adolescents and their families. Therapist adherence and youth drug screens were collected during a five-month baseline period prior to the workshop on contingency management and during 12 months post workshop. The results replicated the previous finding that therapist adherence to the cognitive-behavioral interventions, but not to contingency management, showed a strong positive difference in trend in favor of the intensive quality assurance condition. While the clinical impact of such quality assurance may be delayed and remains to be demonstrated, cannabis abstinence increased as a function of time in therapy, and was more likely with stronger therapy adherence to contingency management, but did not differ across quality assurance interventions.

METRO-APEX Volume 19.1: City Manager and County Administrative Officer's Manual. Revised.

ERIC Educational Resources Information Center

University of Southern California, Los Angeles. COMEX Research Project.

The City Manager and County Administrative Officer's Manual is one of a set of twenty-one manuals used in METRO-APEX 1974, a computerized college and professional level, computer-supported, role-play, simulation exercise of a community with "normal" problems. Stress is placed on environmental quality considerations. APEX 1974 is an…

Characteristics of a long-term forest soil productivity research site in Missouri

Treesearch

Felix, Jr. Ponder; Nancy M. Mikkelson

1995-01-01

Problems with soil quality and maintenance of soil productivity occur when management activities are improperly planned and carried out. To ensure that Forest Service management practices do not reduce long-term soil productivity (LTSP), a network of coordinated long-term experiments is being established across the United States. The first LTSP study in the Central...

Operations research in intensive care unit management: a literature review.

PubMed

Bai, Jie; Fügener, Andreas; Schoenfelder, Jan; Brunner, Jens O

2018-03-01

The intensive care unit (ICU) is a crucial and expensive resource largely affected by uncertainty and variability. Insufficient ICU capacity causes many negative effects not only in the ICU itself, but also in other connected departments along the patient care path. Operations research/management science (OR/MS) plays an important role in identifying ways to manage ICU capacities efficiently and in ensuring desired levels of service quality. As a consequence, numerous papers on the topic exist. The goal of this paper is to provide the first structured literature review on how OR/MS may support ICU management. We start our review by illustrating the important role the ICU plays in the hospital patient flow. Then we focus on the ICU management problem (single department management problem) and classify the literature from multiple angles, including decision horizons, problem settings, and modeling and solution techniques. Based on the classification logic, research gaps and opportunities are highlighted, e.g., combining bed capacity planning and personnel scheduling, modeling uncertainty with non-homogenous distribution functions, and exploring more efficient solution approaches.

Quality management: reduction of waiting time and efficiency enhancement in an ENT-university outpatients' department

PubMed Central

Helbig, Matthias; Helbig, Silke; Kahla-Witzsch, Heike A; May, Angelika

2009-01-01

Background Public health systems are confronted with constantly rising costs. Furthermore, diagnostic as well as treatment services become more and more specialized. These are the reasons for an interdisciplinary project on the one hand aiming at simplification of planning and scheduling patient appointments, on the other hand at fulfilling all requirements of efficiency and treatment quality. Methods As to understanding procedure and problem solving activities, the responsible project group strictly proceeded with four methodical steps: actual state analysis, analysis of causes, correcting measures, and examination of effectiveness. Various methods of quality management, as for instance opinion polls, data collections, and several procedures of problem identification as well as of solution proposals were applied. All activities were realized according to the requirements of the clinic's ISO 9001:2000 certified quality management system. The development of this project is described step by step from planning phase to inauguration into the daily routine of the clinic and subsequent control of effectiveness. Results Five significant problem fields could be identified. After an analysis of causes the major remedial measures were: installation of a patient telephone hotline, standardization of appointment arrangements for all patients, modification of the appointments book considering the reason for coming in planning defined working periods for certain symptoms and treatments, improvement of telephonic counselling, and transition to flexible time planning by daily updates of the appointments book. After implementation of these changes into the clinic's routine success could be demonstrated by significantly reduced waiting times and resulting increased patient satisfaction. Conclusion Systematic scrutiny of the existing organizational structures of the outpatients' department of our clinic by means of actual state analysis and analysis of causes revealed the necessity of improvement. According to rules of quality management correcting measures and subsequent examination of effectiveness were performed. These changes resulted in higher satisfaction of patients, referring colleagues and clinic staff the like. Additionally the clinic is able to cope with an increasing demand for appointments in outpatients' departments, and the clinic's human resources are employed more effectively. PMID:19183496

Implementation of ergonomics in the management of parking increasing the quality of living parking park in mall Robinson Denpasar city

NASA Astrophysics Data System (ADS)

Sutapa, I. K.; Sudiarsa, I. M.

2018-01-01

The problems that often arise in the area of Denpasar City mostly caused by parking problems at the centers of activities such as shopping centers. The problems that occur not only because of the large number of vehicles that parked but also the result of the condition of parking officers who have not received attention, there is no concern about the physical condition of parking attendants because doing night guard duty. To improve the quality of parking officer, ergonomic parking lot is improved through the application of appropriate technology with systemic, holistic, interdisciplinary and participatory approach. The general objective of the research is to know the implementation of ergonomics in parking management on the improvement of the quality of parking officer in Robinson shopping center. The indicator of the quality of the parking officer work is the decrease of musculoskeletal complaints, fatigue, workload, boredom and increasing work motivation. The study was conducted using the same subject design, involving 10 subjects as a simple random sample. Intervention is done by arrangement of ergonomic basement motorcycle parking. Measurements done before and after repair. Washing out (WO) for 14 days. The data obtained were analyzed descriptively, tested normality (shapirowilk) and homogeneity (Levene Test). For normal and homogeneous distribution data, different test with One Way Anova, different test between Period with Post Hoc. Normally distributed and non-homogeneous data, different test with Friedman Test, different test between periods using Wilcoxon test. Data were analyzed with significance level of 5%. The results showed that the implementation of ergonomic in the management of parking area of the court decreased musculoskeletal complaints by 15.10% (p <0.05), decreased fatigue rate by 22.06% (p <0.05), decreased workload by 21, 90 % (P <0,05), decrease boredom 15,85% (p <0,05) and motivation improvement 37, 68% (p <0,05). It is concluded that the implementation of ergonomics in parking management of the parking lot improves the quality of the parking officer work from: (1) decrease of musculoskeletal complaints, (2) decrease of melting rate, (3) decrease of parking workload, decreasing boredom and increasing work motivation.

Advanced Hysteroscopic Surgery: Quality Assurance in Teaching Hospitals.

PubMed

Erian, Mark M S; McLaren, Glenda R; Erian, Anna-Marie

2017-01-01

Advanced hysteroscopic surgery (AHS) is a vitally important technique in the armamentarium for the management of many day-to-day clinical problems, such as menorrhagia, surgical excision of uterine myomata and septa in the management of female infertility, hysteroscopic excision of chronically retained products of conception (placenta accreta), and surgical removal of intramural ectopic pregnancy. In today's climate of accountability, it is necessary that gynecologists take a more active role in assuring the quality of their work. In this article, we discuss the quality assurance system from the point of view of the surgical audit meetings in some of the major teaching hospitals affiliated with the University of Queensland (Brisbane, Queensland, Australia).

Advanced Hysteroscopic Surgery: Quality Assurance in Teaching Hospitals

PubMed Central

McLaren, Glenda R.; Erian, Anna-Marie

2017-01-01

Advanced hysteroscopic surgery (AHS) is a vitally important technique in the armamentarium for the management of many day-to-day clinical problems, such as menorrhagia, surgical excision of uterine myomata and septa in the management of female infertility, hysteroscopic excision of chronically retained products of conception (placenta accreta), and surgical removal of intramural ectopic pregnancy. In today's climate of accountability, it is necessary that gynecologists take a more active role in assuring the quality of their work. In this article, we discuss the quality assurance system from the point of view of the surgical audit meetings in some of the major teaching hospitals affiliated with the University of Queensland (Brisbane, Queensland, Australia). PMID:28729781

A guide to wound managment in palliative care.

PubMed

Naylor, Wayne A

2005-11-01

Wound management in palliative patients is often a very challenging area of care. There are many unique issues that can combine to produce complicated wound management scenarios, including the types of wounds and wound symptoms most commonly affecting palliative care patients, as well as the presence of concurrent disease and associated treatment. Problems exist with the availability of suitable dressings and balancing life expectancy with the goals of wound care. A significant, and possibly under-recognized, issue is the emotional and social distress experienced by these patients, which can be directly attributed to their wound. These problems must all be recognized and addressed in order to manage wounds effectively in this patient population. This article aims to explore these issues and offer advice on the management of wound-related symptoms, with the ultimate goal of improving patients' quality of life.

Towards an evaluation framework for information quality management (IQM) practices for health information systems--evaluation criteria for effective IQM practices.

PubMed

Mohammed, Siti Asma; Yusof, Maryati Mohd

2013-04-01

Poor information quality (IQ) must be understood as a business problem rather than systems problem. In health care organization, what is required is an effective quality management that continuously manages and reviews the factors influencing IQ in health information systems (HIS) so as to achieve the desired outcomes. Hence, in order to understand the issues of information quality management (IQM) practices in health care organizations, a more holistic evaluation study should be undertaken to investigate the IQM practices in health care organizations. It is the aim of this paper to identify the significant evaluation criteria that influence the production of good IQ in HIS. Six selected frameworks and best practices both from health informatics and information systems literature have been reviewed to identify the evaluation criteria from the perspective of human, organizational and technological factors. From the review, it was found that human and organization factors are of greater significance in influencing HIS IQ. Our review depicts that there is still shortage in finding a comprehensive IQM evaluation framework. Thus, the criteria from the frameworks reviewed can be used in combination for more comprehensive evaluation criteria. Integrated IQM evaluation criteria for HIS are then proposed in this study. Poor IQ is the result of complex interdependency within sociotechnical factors in health care organization and lack of formal and structured IQM practices. Thus, a feedback mechanism such as evaluation is needed to understand the issues in depth in the future. © 2012 Blackwell Publishing Ltd.

A Hybrid Genetic-Simulated Annealing Algorithm for the Location-Inventory-Routing Problem Considering Returns under E-Supply Chain Environment

PubMed Central

Guo, Hao; Fu, Jing

2013-01-01

Facility location, inventory control, and vehicle routes scheduling are critical and highly related problems in the design of logistics system for e-business. Meanwhile, the return ratio in Internet sales was significantly higher than in the traditional business. Many of returned merchandise have no quality defects, which can reenter sales channels just after a simple repackaging process. Focusing on the existing problem in e-commerce logistics system, we formulate a location-inventory-routing problem model with no quality defects returns. To solve this NP-hard problem, an effective hybrid genetic simulated annealing algorithm (HGSAA) is proposed. Results of numerical examples show that HGSAA outperforms GA on computing time, optimal solution, and computing stability. The proposed model is very useful to help managers make the right decisions under e-supply chain environment. PMID:24489489

A Guide to Job Enrichment and Redesign.

ERIC Educational Resources Information Center

Cunningham, J. Barton; Eberle, Ted

1990-01-01

Describes job design alternatives--job enrichment, the job characteristics model, Japanese style management, and quality-of-worklife approaches. Focuses on the problems that human resources professionals may encounter when attempting to implement these approaches. (Author/JOW)

Impact of environmental policies on the adoption of manure management practices in the Chesapeake Bay watershed.

PubMed

Savage, Jeff A; Ribaudo, Marc O

2013-11-15

Pollution in the Chesapeake Bay is a problem and has been a focus of federal and state initiatives to reduce nutrient pollution from agriculture and other sources since 1983. In 2010 EPA established a TMDL for the watershed. Producers may voluntarily respond to intense and focused policy scrutiny by adopting best management practices. A detailed analysis of water quality best management practices by animal feeding operations inside and outside the watershed yield insight into this relationship. Our findings support the hypothesis that farmers will adopt water quality measures if links are made clear and there is an expectation of future regulations. Published by Elsevier Ltd.

An evaluation of the total quality management implementation strategy for the advanced solid rocket motor project at NASA's Marshall Space Flight Center. M.S. Thesis - Tennessee Univ.

NASA Technical Reports Server (NTRS)

Schramm, Harry F.; Sullivan, Kenneth W.

1991-01-01

An evaluation of the NASA's Marshall Space Flight Center (MSFC) strategy to implement Total Quality Management (TQM) in the Advanced Solid Rocket Motor (ASRM) Project is presented. The evaluation of the implementation strategy reflected the Civil Service personnel perspective at the project level. The external and internal environments at MSFC were analyzed for their effects on the ASRM TQM strategy. Organizational forms, cultures, management systems, problem solving techniques, and training were assessed for their influence on the implementation strategy. The influence of ASRM's effort was assessed relative to its impact on mature projects as well as future projects at MSFC.

The influence of shade on northern red oak seedlings growth and carbon balance

Treesearch

Jennifer L. Jennings

1995-01-01

One management problem of the Southern Appalachian mixed hardwood forest is the lack of development of northern red oak (Quercus rubra L.) seedlings on high quality sites. Regeneration of red oak is not the problem. Following the removal of a stand, a combination of new seedlings, advanced reproduction and stump sprouts ensure red oak's initial...

[Effects of the ISO 15189 accreditation on Nagoya University Hospital].

PubMed

Yoshiko, Kenichi

2012-07-01

The Department of Clinical Laboratory, Nagoya University Hospital acquired ISO 15189 accreditation in November, 2009. The operation of our Quality Management System (QMS) was first surveyed in October, 2010. In this paper, we reported the activity for the preparation and operation of our QMS and the effects of ISO 15189 accreditation. We investigated the changes in the number and content on nonconformities, incident reports and complaints before and after accreditation as indicators to evaluate the effect of ISO 15189 accreditation. Post accreditation, the number of nonconformities and incident reports decreased, seeming to show an improvement of quality of the laboratory activity; however, the number of complaints increased. We identified the increase of complaints at the phlebotomy station. There had been some problems with blood sampling in the past, but it seemed that staff had a high level of concern regarding these problems at the phlebotomy station and took appropriate measures to resolve the complaints. We confirmed that the ISO 15189 accreditation was instrumental in the improvements of the safety and efficiency on laboratory works. However there was a problem that increase of overtime works to operate the QMS. We deal with development of a laboratory management system using IT recourses to solve the problem.

Automated platelet collection using the latest apheresis devices in an Indian setting.

PubMed

Agarwal, Prashant; Verma, Anupam

2009-10-01

In a developing nation like India where there is a scarcity of resources and voluntary donors, provision of safe and good quality blood and its components is a huge challenge. The demand for platelets is increasing constantly due to better management of various patient categories, specifically hemato-oncological cases, where there is an increased demand of platelet transfusion. The use of apheresis single donor platelets (SDPs) has been attributed to increased gap between demand and supply of whole blood derived random donor platelets (RDPs). Moreover, the other benefits of SDPs such as decreased donor exposure and simplification of inventory management cannot be overlooked. However, the increased costs and logistic problems, compounded by the lack of awareness, limit the donor recruitment and procedures for SDPs. In Indian scenario, there are no specific guidelines or standards available which can be followed, while simultaneously addressing the associated problems. In this review, we have tried to analyze the various problems of donor selection, donor safety and the quality issues regarding plateletpheresis. Based on this we have tried to give certain recommendations which might help the centers in resolving the problems related to plateletpheresis.

Applicability of market-based instruments for safeguarding water quality in coastal waterways: Case study for Darwin Harbour, Australia

NASA Astrophysics Data System (ADS)

Greiner, Romy

2014-02-01

Water pollution of coastal waterways is a complex problem due to the cocktail of pollutants and multiplicity of polluters involved and pollution characteristics. Pollution control therefore requires a combination of policy instruments. This paper examines the applicability of market-based instruments to achieve effective and efficient water quality management in Darwin Harbour, Northern Territory, Australia. Potential applicability of instruments is examined in the context of biophysical and economic pollution characteristics, and experience with instruments elsewhere. The paper concludes that there is potential for inclusion of market-based instruments as part of an instrument mix to safeguard water quality in Darwin Harbour. It recommends, in particular, expanding the existing licencing system to include quantitative pollution limits for all significant point polluters; comprehensive and independent pollution monitoring across Darwin Harbour; public disclosure of water quality and emissions data; positive incentives for landholders in the Darwin Harbour catchment to improve land management practices; a stormwater offset program for greenfield urban developments; adoption of performance bonds for developments and operations which pose a substantial risk to water quality, including port expansion and dredging; and detailed consideration of a bubble licensing scheme for nutrient pollution. The paper offers an analytical framework for policy makers and resource managers tasked with water quality management in coastal waterways elsewhere in Australia and globally, and helps to scan for MBIs suitable in any given environmental management situation.

The costs of caring: medical costs of Alzheimer's disease and the managed care environment.

PubMed

Murman, D L

2001-01-01

This review summarizes the medical costs associated with Alzheimer's disease (AD) and related dementias, as well as the payers responsible for these medical costs in the US health care system. It is clear from this review that AD and related dementias are associated with substantial medical costs. The payers responsible for a majority of these costs are families of patients with AD and the US government through the Medicare and Medicaid programs. In an attempt to control expenditures, Medicare and Medicaid have turned to managed care principles and managed care organizations. The increase in "managed" dementia care gives rise to several potential problems for patients with AD, along with many opportunities for systematic improvement in the quality of dementia care. Evidence-based disease management programs provide the greatest opportunities for improving managed dementia care but will require the development of dementia-specific quality of care measures to evaluate and continually improve them.

Management: A continuing literature survey with indexes

NASA Technical Reports Server (NTRS)

1978-01-01

This bibliography lists 782 reports, articles, and other documents introduced into the NASA scientific and technical information system in 1977. The citations, and abstracts when available, are reproduced exactly as they appeared originally in IAA and STAR, including the original accession numbers from the respective announcement journals. Topics cover the management of research and development contracts, production, logistics, personnel, safety, reliability and quality control citations. Includes references on: program, project and systems management; management policy, philosophy, tools, and techniques; decisionmaking processes for managers; technology assessment; management of urban problems; and information for managers on Federal resources, expenditures, financing, and budgeting.

Does Mobile Care ('mCare') Improve Quality of Life and Treatment Satisfaction Among Service Members Rehabilitating in the Community? Results from a 36-Wk, Randomized Controlled Trial.

PubMed

Little, Jeanette R; Pavliscsak, Holly H; Cooper, Mabel R; Goldstein, Lois A; Fonda, Stephanie J

2018-03-01

Research has shown that mobile phones can help with management of numerous health problems. As an adjunct to care management provided to injured service members rehabilitating in their communities, particularly those with mild traumatic brain injury (mTBI), post-traumatic stress (PTS), and/or behavioral health problems, the Army developed a mobile phone application called "mCare." This study examined whether service members who received mCare had higher well-being, were more satisfied with their care, and viewed mCare as a valuable part of their care management as compared with their counterparts who received standard care management alone, and whether those with mTBI, PTS, and/or behavioral health problems benefited differently from mCare. In-processing service members at four community-based warrior transition units were recruited for participation in a 36-wk, randomized, controlled trial and allocated to receive standard care management plus mCare (n = 95) or standard care management alone (n = 87). Participants in the mCare group received daily questionnaires, tips, and appointment reminders. All participants were asked to complete the General Well-being Schedule (GWS) at baseline, 12, 24, and 36 wk, and the Case Management Quality Questionnaire (CMQQ) at 12, 24, and 36 wk. All participants and care managers were approached to complete interviews about the usability/likeability of mCare or standard care management. The analyses tested for group differences in completion of the intervention, graphed means for the GWS and CMQQ by group/subgroup, and statistically compared the longitudinal trends in these outcomes using mixed models in which group, time, and group*time were included as regression variables. The analyses also tallied interview responses and identified thematic quotes. The study protocol was reviewed and approved by the Walter Reed National Military Medical Center's Institutional Review Board. Estimated rate of change in GWS scores was -2.2 (standard error = 1.0; t = -2.1; p = 0.0382). Estimated rate of change in CMQQ scores was -0.8 (standard error = 0.5; t = -1.52; p = 0.1299). Neither change was meaningful. Rates of change in the GWS and CMQQ scores did not differ by group or by behavioral health, mTBI, and PTS subgroups within the groups. The interviews found that 83% of mCare participants liked the communication with their care managers versus 73% of standard care management participants. Participants in both the mCare group and the care managers said that they liked the application's appointment tracking and reminders. Care managers thought mCare was particularly useful for people with mTBI, PTS, and cognitive problems. mCare did not result in differences in general well-being and satisfaction with care management among service members rehabilitating in their communities, some with mTBI, PTS, and/or behavioral health problems. But participants and care managers who used mCare said that they found it useful. Study limitations included the diversity of clinical issues of the participants, greater missing data among mCare participants, and the high baseline quality of care management in the settings observed. The fact that patients and care managers liked mCare, apart from no changes in outcomes, is important because health care is increasingly adopting mobile solutions.

Problem Video Gaming Among Children Enrolled in Tertiary Weight Management Programs.

PubMed

Stubblefield, Sam; Datto, George; Phan, Thao-Ly T; Werk, Lloyd N; Stackpole, Kristin; Siegel, Robert; Stratbucker, William; Tucker, Jared M; Christison, Amy L; Hossain, Jobayer; Gentile, Douglas A

2017-02-01

Prior studies show seven percent to nine percent of children demonstrate gaming behaviors that affect a child's ability to function (e.g., problem gaming), but none have examined the association between problem gaming and weight status. The objective of this study was to determine the prevalence of problem gaming among children enrolled in tertiary weight management programs. We administered a computer-based survey to a convenience sample of children aged 11-17 years enrolled in five geographically diverse pediatric weight management (PWM) programs in the COMPASS (Childhood Obesity Multi-Program Analysis and Study System) network. The survey included demographics, gaming characteristics, and a problem gaming assessment. The survey had 454 respondents representing a diverse cohort (53 percent females, 27 percent black, 24 percent Hispanic, 41 percent white) with mean age of 13.7 years. A total of 8.2 percent of respondents met criteria for problem gaming. Problem gamers were more likely to be white, male, play mature-rated games, and report daily play. Children in PWM programs reported problem gaming at the same rate as other pediatric populations. Screening for problem gaming provides an opportunity for pediatricians to address gaming behaviors that may affect the health of children with obesity who already are at risk for worsened health and quality of life.

Problem Video Gaming Among Children Enrolled in Tertiary Weight Management Programs

PubMed Central

Datto, George; Phan, Thao-Ly T.; Werk, Lloyd N.; Stackpole, Kristin; Siegel, Robert; Stratbucker, William; Tucker, Jared M.; Christison, Amy L.; Hossain, Jobayer; Gentile, Douglas A.

2017-01-01

Abstract Prior studies show seven percent to nine percent of children demonstrate gaming behaviors that affect a child's ability to function (e.g., problem gaming), but none have examined the association between problem gaming and weight status. The objective of this study was to determine the prevalence of problem gaming among children enrolled in tertiary weight management programs. We administered a computer-based survey to a convenience sample of children aged 11–17 years enrolled in five geographically diverse pediatric weight management (PWM) programs in the COMPASS (Childhood Obesity Multi-Program Analysis and Study System) network. The survey included demographics, gaming characteristics, and a problem gaming assessment. The survey had 454 respondents representing a diverse cohort (53 percent females, 27 percent black, 24 percent Hispanic, 41 percent white) with mean age of 13.7 years. A total of 8.2 percent of respondents met criteria for problem gaming. Problem gamers were more likely to be white, male, play mature-rated games, and report daily play. Children in PWM programs reported problem gaming at the same rate as other pediatric populations. Screening for problem gaming provides an opportunity for pediatricians to address gaming behaviors that may affect the health of children with obesity who already are at risk for worsened health and quality of life. PMID:28170312

Improving student satisfaction of Andalas University Dormitory through Service Quality and Importance Performance Analysis

NASA Astrophysics Data System (ADS)

Putri, Nilda Tri; Anggraini, Larisa

2018-03-01

Residential satisfaction of university dormitories serve as one of the significant aspects in the framework of sustainability in higher education. This research investigated the quality of dormitory services in Andalas University Dormitory based on student’s satisfaction. According to management residential, the enrollment of residential student has increased gradually in Andalas University. In 2016, capacity of residential student is 1686, but only 1081 students can stay at dormitory because some rooms in bad condition. There are a lot of problems and complaints regarding dormitory’s service quality i.e water problems, leaky rooms and bathrooms, cleanliness and inadequate facilities in residential college. In addition, there are 20% of last year student’s residential check out before the time of contract runs out. The aim of this research are understanding the level of GAP exists between expectation and perception students’ residential in the content of service quality and evaluating the improvement priority services using Importance Performance Analysis. This study is measuring service quality by using Responsiveness, Assurance, Empathy, Reliability and Tangible dimension. A negative GAP indicates that the actual services are than what was expected and the GAP is highlighted area for improvement. Based on IPA, management should improve this following dimension services : responsiveness, tangible and assurance dimension.

Techniques of fisheries management: water quality assessment with stream insects

Treesearch

A. Dennis Lemly

2000-01-01

Nutrient enrichment of streams is a long-standing problem that continues to have substantial local and regional consequences. For example, water quality of streams in the southern Appalachian Mountains of the U.S. can be seriously degraded by organic nutrients leached from animal wastes if cattle or other livestock are allowed to graze in the riparian zone. Local...

Fluvial sediment in the environment: a national challenge

USGS Publications Warehouse

Larsen, Matthew C.; Gellis, Allen C.; Glysson, G. Douglas; Gray, John R.; Horowitz, Arthur J.

2010-01-01

Sediment and sediment-associated constituents can contribute substantially to water-quality impairment. In the past, sediment was viewed mainly as an engineering problem that affected reservoir storage capacity, shipping channel maintenance, and bridge scour, as well as the loss of agricultural soil. Sediment is now recognized as a major cause of aquatic system degradation in many rivers and streams as a result of light attenuation, loss of spawning substrate due to fine-grained sediment infilling, reduction in primary productivity, decreases in biotic diversity, and effects from sediment-associated chemical constituents. Recent advances in sediment measurement, assessment, source-identification, and analytical protocols provide new capabilities to quantify sediment and solid-phase chemical fluxes in aquatic systems. Developing, maintaining, and augmenting current sediment- and water-quality-monitoring networks is essential for determining the health of U.S. waterways and for evaluating the effectiveness of management actions in reducing sediment-related problems. The application of new scientific capabilities that address the adverse effects of sediment and sediment- associated constituents represents a major step in managing the Nation’s water quality. A robust Federal, national-scale eff rt, in collaboration with vested stakeholders, is needed to address these sediment-related water-quality issues across the United States.

The utilization of six sigma and statistical process control techniques in surgical quality improvement.

PubMed

Sedlack, Jeffrey D

2010-01-01

Surgeons have been slow to incorporate industrial reliability techniques. Process control methods were applied to surgeon waiting time between cases, and to length of stay (LOS) after colon surgery. Waiting times between surgeries were evaluated by auditing the operating room records of a single hospital over a 1-month period. The medical records of 628 patients undergoing colon surgery over a 5-year period were reviewed. The average surgeon wait time between cases was 53 min, and the busiest surgeon spent 291/2 hr in 1 month waiting between surgeries. Process control charting demonstrated poor overall control of the room turnover process. Average LOS after colon resection also demonstrated very poor control. Mean LOS was 10 days. Weibull's conditional analysis revealed a conditional LOS of 9.83 days. Serious process management problems were identified in both analyses. These process issues are both expensive and adversely affect the quality of service offered by the institution. Process control mechanisms were suggested or implemented to improve these surgical processes. Industrial reliability and quality management tools can easily and effectively identify process control problems that occur on surgical services. © 2010 National Association for Healthcare Quality.

Integrated Management of Residential Indoor Air Quality: A Call for Stakeholders in a Changing Climate.

PubMed

Levasseur, Marie-Eve; Poulin, Patrick; Campagna, Céline; Leclerc, Jean-Marc

2017-11-25

A paradigm change in the management of environmental health issues has been observed in recent years: instead of managing specific risks individually, a holistic vision of environmental problems would assure sustainable solutions. However, concrete actions that could help translate these recommendations into interventions are lacking. This review presents the relevance of using an integrated indoor air quality management approach to ensure occupant health and comfort. At the nexus of three basic concepts (reducing contaminants at the source, improving ventilation, and, when relevant, purifying the indoor air), this approach can help maintain and improve indoor air quality and limit exposure to several contaminants. Its application is particularly relevant in a climate change context since the evolving outdoor conditions have to be taken into account during building construction and renovation. The measures presented through this approach target public health players, building managers, owners, occupants, and professionals involved in building design, construction, renovation, and maintenance. The findings of this review will help the various stakeholders initiate a strategic reflection on the importance of indoor air quality and climate change issues for existing and future buildings. Several new avenues and recommendations are presented to set the path for future research activities.

Integrated Management of Residential Indoor Air Quality: A Call for Stakeholders in a Changing Climate

PubMed Central

Levasseur, Marie-Eve; Poulin, Patrick; Campagna, Céline; Leclerc, Jean-Marc

2017-01-01

A paradigm change in the management of environmental health issues has been observed in recent years: instead of managing specific risks individually, a holistic vision of environmental problems would assure sustainable solutions. However, concrete actions that could help translate these recommendations into interventions are lacking. This review presents the relevance of using an integrated indoor air quality management approach to ensure occupant health and comfort. At the nexus of three basic concepts (reducing contaminants at the source, improving ventilation, and, when relevant, purifying the indoor air), this approach can help maintain and improve indoor air quality and limit exposure to several contaminants. Its application is particularly relevant in a climate change context since the evolving outdoor conditions have to be taken into account during building construction and renovation. The measures presented through this approach target public health players, building managers, owners, occupants, and professionals involved in building design, construction, renovation, and maintenance. The findings of this review will help the various stakeholders initiate a strategic reflection on the importance of indoor air quality and climate change issues for existing and future buildings. Several new avenues and recommendations are presented to set the path for future research activities. PMID:29186831

DCAA Audits: Widespread Problems with Audit Quality Require Significant Reform

DTIC Science & Technology

2009-09-01

is included in appendix III. DOD contract management continues to be a high- risk area for the government.17 With hundreds of billions of taxpayer...Defense Contract Management : DOD’s Lack of Adherence to Key Contracting Principles on Iraq Oil Contract Put Government Interests at Risk , GAO-07-839...in the Federal Government68 require federal agency managers to identify and assess relevant risks the agency faces from external and internal

Supplier Relationship Management at Army Life Cycle Management Commands: Gap Analysis of Best Practices

DTIC Science & Technology

2012-01-01

307–308) define kaizen as “continuous, incremental improvement of an activity to create more value with less muda.” They define muda as “any activity...approaches, kaizen events, Six Sigma, total quality management (TQM) for continuous improvement, kaikaku,6 process reengineering for discontinuous...them fix problems and develop capabilities. These efforts may include kaizen (i.e., continuous, incremental improvement) events, process mapping, work

Lymphoedema management: an international intersect between developed and developing countries. Similarities, differences and challenges.

PubMed

Stout, Nicole L; Brantus, Pierre; Moffatt, Christine

2012-01-01

Lymphoedema is a chronic swelling condition that contributes to disability, dysfunction and lost quality of life. Significant disparities exist worldwide regarding the availability of resources necessary to identify, treat and manage lymphoedema. This disparity transcends socio-economic status and is a common problem in both developed and developing countries. The overall impact of lymphoedema as a public health problem, however, is underestimated, principally due to the lack of epidemiologic data. These problems pose barriers to optimal identification and management of this disabling, lifelong condition. In 1997, the World Health Organization (50.29) resolved that lymphatic filariasis should be eliminated as a public health problem. A component of this strategy focuses on disability management for those suffering from lymphatic filariasis-related morbidity. This initiative has enhanced lymphoedema awareness in developing countries. However, significant deficits persist in health care providers' knowledge, educational initiatives and basic disease identification and treatment. In developed countries, lymphoedema continues to be an underrecognised condition and assumed to be only cancer-related. Health care resources allocated to treat and manage the disease are insufficient for basic and ongoing care, resulting in disease progression and disability. The International Lymphoedema Framework project, established in 2002, seeks to establish a consensus for best practices in the management of lymphoedema worldwide to reduce this disability burden. A basic global construct for lymphoedema management is needed to decrease morbidity and promote optimal disease management across all cultural and socio-economic boundaries. Many countries are unaware of the importance of lymphoedema management and have not defined a national strategy with respect to this problem. The objective of this article is to define similarities and differences in strategies for lymphoedema management between developed and developing countries and advocate for a cohesive and concerted approach to disease management.

The research and practice of spacecraft software engineering

NASA Astrophysics Data System (ADS)

Chen, Chengxin; Wang, Jinghua; Xu, Xiaoguang

2017-06-01

In order to ensure the safety and reliability of spacecraft software products, it is necessary to execute engineering management. Firstly, the paper introduces the problems of unsystematic planning, uncertain classified management and uncontinuous improved mechanism in domestic and foreign spacecraft software engineering management. Then, it proposes a solution for software engineering management based on system-integrated ideology in the perspective of spacecraft system. Finally, a application result of spacecraft is given as an example. The research can provides a reference for executing spacecraft software engineering management and improving software product quality.

Assessment of Indoor Air Quality Problems in Office-Like Environments: Role of Occupational Health Services.

PubMed

Carrer, Paolo; Wolkoff, Peder

2018-04-12

There is an increasing concern about indoor air quality (IAQ) and its impact on health, comfort, and work-performance in office-like environments and their workers, which account for most of the labor force. The Scientific Committee on Indoor Air Quality and Health of the ICOH (Int. Comm. Occup. Health) has discussed the assessment and management of IAQ problems and proposed a stepwise approach to be conducted by a multidisciplinary team. It is recommended to integrate the building assessment, inspection by walk-through of the office workplace, questionnaire survey, and environmental measurements, in that order. The survey should cover perceived IAQ, symptoms, and psychosocial working aspects. The outcome can be used for mapping the IAQ and to prioritize the order in which problems should be dealt with. Individual health surveillance in relation to IAQ is proposed only when periodical health surveillance is already performed for other risks (e.g., video display units) or when specific clinical examination of workers is required due to the occurrence of diseases that may be linked to IAQ (e.g., Legionnaire's disease), recurrent inflammation, infections of eyes, respiratory airway effects, and sensorial disturbances. Environmental and personal risk factors should also be compiled and assessed. Workplace health promotion should include programs for smoking cessation and stress and IAQ management.

Assessment of Indoor Air Quality Problems in Office-Like Environments: Role of Occupational Health Services

PubMed Central

2018-01-01

There is an increasing concern about indoor air quality (IAQ) and its impact on health, comfort, and work-performance in office-like environments and their workers, which account for most of the labor force. The Scientific Committee on Indoor Air Quality and Health of the ICOH (Int. Comm. Occup. Health) has discussed the assessment and management of IAQ problems and proposed a stepwise approach to be conducted by a multidisciplinary team. It is recommended to integrate the building assessment, inspection by walk-through of the office workplace, questionnaire survey, and environmental measurements, in that order. The survey should cover perceived IAQ, symptoms, and psychosocial working aspects. The outcome can be used for mapping the IAQ and to prioritize the order in which problems should be dealt with. Individual health surveillance in relation to IAQ is proposed only when periodical health surveillance is already performed for other risks (e.g., video display units) or when specific clinical examination of workers is required due to the occurrence of diseases that may be linked to IAQ (e.g., Legionnaire’s disease), recurrent inflammation, infections of eyes, respiratory airway effects, and sensorial disturbances. Environmental and personal risk factors should also be compiled and assessed. Workplace health promotion should include programs for smoking cessation and stress and IAQ management. PMID:29649167

Breaking down the communication barrier.

PubMed

Hawkins, R A

1991-01-01

Dr. Hawkins addresses the problem of how QA managers can best persuade physicians of the importance of QA programs. Since communication is the basis of educating clinicians, the author analyzes the diametrically opposite perspectives of QA managers and physicians even as they pursue the common goal of quality healthcare. While doctors are primarily loyal to patients and peers with an immediate care focus, process-oriented QA managers emphasize the institution and its longer-term goals. To overcome physician resistance to change, Dr. Hawkins offers an adult learner model that stresses understanding the medical staff's viewpoint, negotiation and respect. Physicians are enthusiastic about QA when it helps solve "the endemic daily system problems." The author concludes by recommending that QA managers join physicians on their clinical rounds to bridge the gap between their different approaches.

Quality management of medical education at the Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany.

PubMed

Dieter, Peter Erich

2008-12-01

The Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany, was founded in 1993 after the reunification of Germany. In 1999, a reform process of medical education was started together with Harvard Medical International. The traditional teacher and discipline-centred curriculum was replaced by a student-centred, interdisciplinary and integrative curriculum which has been named DIPOL (Dresden Integrative Patient/Problem- Oriented Learning). The reform process was accompanied and supported by a parallel-ongoing Faculty Development Program. In 2004, a Quality Management Program in medical education was implemented, and in 2005 medical education received DIN EN ISO 9001:2000 certification. Quality Management Program and DIN EN ISO 9001:2000 certification were/are unique for the 34 medical schools in Germany. The students played a very important strategic role in all processes. They were/are members in all committees like the Faculty Board, the Board of Study Affairs (with equal representation) and the ongoing audits in the Quality Management Program. Students are the only ones who experience all years of the curriculum and are capable of detecting, for example gaps, overlaps, inconsistencies of the curriculum and assessments. Therefore, the in-depth knowledge of students about the medical school's curriculum is a very helpful and essential tool in curriculum reform processes and Quality Management Programs of medical education. The reform in medical education, the establishment of the Quality Management program and the certification resulted in an improvement of quality and output of medical education and medical research.

Manage your human sigma.

PubMed

Fleming, John H; Coffman, Curt; Harter, James K

2005-01-01

If sales and service organizations are to improve, they must learn to measure and manage the quality of the employee-customer encounter. Quality improvement methodologies such as Six Sigma are extremely useful in manufacturing contexts, but they're less useful when it comes to human interactions. To address this problem, the authors have developed a quality improvement approach they refer to as Human Sigma. It weaves together a consistent method for assessing the employee-customer encounter and a disciplined process for managing and improving it. There are several core principles for measuring and managing the employee-customer encounter: It's important not to think like an economist or an engineer when assessing interactions because emotions inform both sides' judgments and behavior. The employee-customer encounter must be measured and managed locally, because there are enormous variations in quality at the work-group and individual levels. And to improve the quality of the employee-customer interaction, organizations must conduct both short-term, transactional interventions and long-term, transformational ones. Employee engagement and customer engagement are intimately connected--and, taken together, they have an outsized effect on financial performance. They therefore need to be managed holistically. That is, the responsibility for measuring and monitoring the health of employee-customer relationships must reside within a single organizational structure, with an executive champion who has the authority to initiate and manage change. Nevertheless, the local manager remains the single most important factor in local group performance. A local manager whose work group shows suboptimal performance should be encouraged to conduct interventions, such as targeted training, performance reviews, action learning, and individual coaching.

The economics of water reuse and implications for joint water quality-quantity management

NASA Astrophysics Data System (ADS)

Kuwayama, Y.

2015-12-01

Traditionally, economists have treated the management of water quality and water quantity as separate problems. However, there are some water management issues for which economic analysis requires the simultaneous consideration of water quality and quantity policies and outcomes. Water reuse, which has expanded significantly over the last several decades, is one of these issues. Analyzing the cost effectiveness and social welfare outcomes of adopting water reuse requires a joint water quality-quantity optimization framework because, at its most basic level, water reuse requires decision makers to consider (a) its potential for alleviating water scarcity, (b) the quality to which the water should be treated prior to reuse, and (c) the benefits of discharging less wastewater into the environment. In this project, we develop a theoretical model of water reuse management to illustrate how the availability of water reuse technologies and practices can lead to a departure from established rules in the water resource economics literature for the optimal allocation of freshwater and water pollution abatement. We also conduct an econometric analysis of a unique dataset of county-level water reuse from the state of Florida over the seventeen-year period between 1996 and 2012 in order to determine whether water quality or scarcity concerns drive greater adoption of water reuse practices.

Perceived Parent-Child Relations, Conduct Problems, and Clinical Improvement Following the Treatment of Oppositional Defiant Disorder.

PubMed

Booker, Jordan A; Ollendick, Thomas H; Dunsmore, Julie C; Greene, Ross W

2016-05-01

Our objective in this study was to examine the moderating influence of parent-child relationship quality (as viewed by the child) on associations between conduct problems and treatment responses for children with oppositional defiant disorder (ODD). To date, few studies have considered children's perceptions of relationship quality with parents in clinical contexts even though extant studies show the importance of this factor in children's behavioral adjustment in non-clinical settings. In this study, 123 children (ages 7 - 14 years, 61.8% male, 83.7% white) who fulfilled DSM-IV criteria for ODD received one of two psychosocial treatments: Parent Management Training or Collaborative & Proactive Solutions. In an earlier study, both treatments were found to be effective and equivalent in treatment outcomes (Ollendick et al., in press). In the current study, pre-treatment maternal reports of conduct problems and pre-treatment child reports of relations with parents were used to predict outcomes in ODD symptoms and their severity following treatment. Elevated reports of children's conduct problems were associated with attenuated reductions in both ODD symptoms and their severity. Perceived relationship quality with parents moderated the ties between conduct problems and outcomes in ODD severity but not the number of symptoms. Mother reports of elevated conduct problems predicted attenuated treatment response only when children viewed relationship quality with their parents as poorer. When children viewed the relationship as higher quality, they did not show an attenuated treatment response, regardless of reported conduct problems. The current findings underscore the importance of children's perspectives in treatment response and reductions in externalizing child behaviors.

Context-aware workflow management of mobile health applications.

PubMed

Salden, Alfons; Poortinga, Remco

2006-01-01

We propose a medical application management architecture that allows medical (IT) experts readily designing, developing and deploying context-aware mobile health (m-health) applications or services. In particular, we elaborate on how our application workflow management architecture enables chaining, coordinating, composing, and adapting context-sensitive medical application components such that critical Quality of Service (QoS) and Quality of Context (QoC) requirements typical for m-health applications or services can be met. This functional architectural support requires learning modules for distilling application-critical selection of attention and anticipation models. These models will help medical experts constructing and adjusting on-the-fly m-health application workflows and workflow strategies. We illustrate our context-aware workflow management paradigm for a m-health data delivery problem, in which optimal communication network configurations have to be determined.

Problems of systems dataware using optoelectronic measuring means of linear displacement

NASA Astrophysics Data System (ADS)

Bazykin, S. N.; Bazykina, N. A.; Samohina, K. S.

2017-10-01

Problems of the dataware of the systems with the use of optoelectronic means of the linear displacement are considered in the article. The classification of the known physical effects, realized by the means of information-measuring systems, is given. The organized analysis of information flows in technical systems from the standpoint of determination of inaccuracies of measurement and management was conducted. In spite of achieved successes in automation of machine-building and instruments-building equipment in the field of dataware of the technical systems, there are unresolved problems, concerning the qualitative aspect of the production process. It was shown that the given problem can be solved using optoelectronic lazer information-measuring systems. Such information-measuring systems are capable of not only executing the measuring functions, but also solving the problems of management and control during processing, thereby guaranteeing the quality of final products.

Training tomorrow's clinicians today--managed care essentials: a process for curriculum development.

PubMed

Colenda, C C; Wadland, W; Hayes, O; Anderson, W; Priester, F; Pearson, R; Keefe, C; Fleck, L

2000-05-01

To develop a managed care curriculum for primary care residents. This article outlines a 4-stage curriculum development process focusing on concepts of managed care organization and finance. The stages consist of: (1) identifying the curriculum development work group and framing the scope of the curriculum, (2) identifying stakeholder buy-in and expectations, (3) choosing curricular topics and delivery mechanisms, and (4) outlining the evaluation process. Key elements of building a curriculum development team, content objectives of the curriculum, the rationale for using problem-based learning, and finally, lessons learned from the partnership among the stakeholders are reviewed. The curriculum was delivered to an entering group of postgraduate-year 1 primary care residents. Attitudes among residents toward managed care remained relatively negative and stable over the yearlong curriculum, especially over issues relating to finance, quality of care, control and autonomy of practitioners, time spent with patients, and managed care's impact on the doctor-patient relationship. Residents' baseline knowledge of core concepts about managed care organization and finance improved during the year that the curriculum was delivered. Satisfaction with a problem-based learning approach was high. Problem-based learning, using real-life clinical examples, is a successful approach to resident instruction about managed care.

USGS California Water Science Center water programs in California

USGS Publications Warehouse

Shulters, Michael V.

2005-01-01

California is threatened by many natural hazards—fire, floods, landslides, earthquakes. The State is also threatened by longer-term problems, such as hydrologic effects of climate change, and human-induced problems, such as overuse of ground water and degradation of water quality. The threats and problems are intensified by increases in population, which has risen to nearly 36.8 million. For the USGS California Water Science Center, providing scientific information to help address hazards, threats, and hydrologic issues is a top priority. To meet the demands of a growing California, USGS scientific investigations are helping State and local governments improve emergency management, optimize resources, collect contaminant-source and -mobility information, and improve surface- and ground-water quality. USGS hydrologic studies and data collection throughout the State give water managers quantifiable and detailed scientific information that can be used to plan for development and to protect and more efficiently manage resources. The USGS, in cooperation with state, local, and tribal agencies, operates more than 500 instrument stations, which monitor streamflow, ground-water levels, and surface- and ground-water constituents to help protect water supplies and predict the threats of natural hazards. The following are some of the programs implemented by the USGS, in cooperation with other agencies, to obtain and analyze information needed to preserve California's environment and resources.

[Discussion on developing a data management plan and its key factors in clinical study based on electronic data capture system].

PubMed

Li, Qing-na; Huang, Xiu-ling; Gao, Rui; Lu, Fang

2012-08-01

Data management has significant impact on the quality control of clinical studies. Every clinical study should have a data management plan to provide overall work instructions and ensure that all of these tasks are completed according to the Good Clinical Data Management Practice (GCDMP). Meanwhile, the data management plan (DMP) is an auditable document requested by regulatory inspectors and must be written in a manner that is realistic and of high quality. The significance of DMP, the minimum standards and the best practices provided by GCDMP, the main contents of DMP based on electronic data capture (EDC) and some key factors of DMP influencing the quality of clinical study were elaborated in this paper. Specifically, DMP generally consists of 15 parts, namely, the approval page, the protocol summary, role and training, timelines, database design, creation, maintenance and security, data entry, data validation, quality control and quality assurance, the management of external data, serious adverse event data reconciliation, coding, database lock, data management reports, the communication plan and the abbreviated terms. Among them, the following three parts are regarded as the key factors: designing a standardized database of the clinical study, entering data in time and cleansing data efficiently. In the last part of this article, the authors also analyzed the problems in clinical research of traditional Chinese medicine using the EDC system and put forward some suggestions for improvement.

Sustainable Supplier Performance Evaluation and Selection with Neofuzzy TOPSIS Method

PubMed Central

Chaharsooghi, S. K.; Ashrafi, Mehdi

2014-01-01

Supplier selection plays an important role in the supply chain management and traditional criteria such as price, quality, and flexibility are considered for supplier performance evaluation in researches. In recent years sustainability has received more attention in the supply chain management literature with triple bottom line (TBL) describing the sustainability in supply chain management with social, environmental, and economic initiatives. This paper explores sustainability in supply chain management and examines the problem of identifying a new model for supplier selection based on extended model of TBL approach in supply chain by presenting fuzzy multicriteria method. Linguistic values of experts' subjective preferences are expressed with fuzzy numbers and Neofuzzy TOPSIS is proposed for finding the best solution of supplier selection problem. Numerical results show that the proposed model is efficient for integrating sustainability in supplier selection problem. The importance of using complimentary aspects of sustainability and Neofuzzy TOPSIS concept in sustainable supplier selection process is shown with sensitivity analysis. PMID:27379267

Sustainable Supplier Performance Evaluation and Selection with Neofuzzy TOPSIS Method.

PubMed

Chaharsooghi, S K; Ashrafi, Mehdi

2014-01-01

Supplier selection plays an important role in the supply chain management and traditional criteria such as price, quality, and flexibility are considered for supplier performance evaluation in researches. In recent years sustainability has received more attention in the supply chain management literature with triple bottom line (TBL) describing the sustainability in supply chain management with social, environmental, and economic initiatives. This paper explores sustainability in supply chain management and examines the problem of identifying a new model for supplier selection based on extended model of TBL approach in supply chain by presenting fuzzy multicriteria method. Linguistic values of experts' subjective preferences are expressed with fuzzy numbers and Neofuzzy TOPSIS is proposed for finding the best solution of supplier selection problem. Numerical results show that the proposed model is efficient for integrating sustainability in supplier selection problem. The importance of using complimentary aspects of sustainability and Neofuzzy TOPSIS concept in sustainable supplier selection process is shown with sensitivity analysis.

Integrated planning for regional development planning and water resources management under uncertainty: A case study of Xining, China

NASA Astrophysics Data System (ADS)

Fu, Z. H.; Zhao, H. J.; Wang, H.; Lu, W. T.; Wang, J.; Guo, H. C.

2017-11-01

Economic restructuring, water resources management, population planning and environmental protection are subjects to inner uncertainties of a compound system with objectives which are competitive alternatives. Optimization model and water quality model are usually used to solve problems in a certain aspect. To overcome the uncertainty and coupling in reginal planning management, an interval fuzzy program combined with water quality model for regional planning and management has been developed to obtain the absolutely ;optimal; solution in this study. The model is a hybrid methodology of interval parameter programming (IPP), fuzzy programing (FP), and a general one-dimensional water quality model. The method extends on the traditional interval parameter fuzzy programming method by integrating water quality model into the optimization framework. Meanwhile, as an abstract concept, water resources carrying capacity has been transformed into specific and calculable index. Besides, unlike many of the past studies about water resource management, population as a significant factor has been considered. The results suggested that the methodology was applicable for reflecting the complexities of the regional planning and management systems within the planning period. The government policy makers could establish effective industrial structure, water resources utilization patterns and population planning, and to better understand the tradeoffs among economic, water resources, population and environmental objectives.

Effects of regeneration on hydrology and water quality of a managed pine forest

Treesearch

Devendra M. Amatya; R. Wayne Skaggs; J. Wendell Gilliam; Jami E. Nettles

2004-01-01

Intensive forest management practices such as drainage, harvesting, site preparation, regeneration, and fertilization have been frequently blamed for problems related to excessive nitrogen, phosphorus, and sediment in receiving waters. Two 25 ha experimental watersheds (D1 ­ control; D2 ­ treatment) on a pine plantation in eastern North Carolina have been monitored...

The contribution of space observations to water resources management; Proceedings of the Symposium, Bangalore, India, May 29-June 9, 1979

NASA Technical Reports Server (NTRS)

Salomonson, V. V. (Editor); Bhavsar, P. D.

1980-01-01

The symposium focused on hydrology, soil moisture estimation and ground water exploration, wetlands monitoring and water quality estimation, hydrometeorology, snow and ice monitoring, and evapotranspiration estimation. Other problems discussed include surface water and flood mapping, watershed runoff estimation and prediction, and new space systems contributing to water resources management.

Contribution to systematic education of quality management in Slovak health care.

PubMed

Rusnakova, V; Bacharova, L

2001-01-01

Of the study was to contribute to quality improvement initiatives in Slovak health services through systematic approach to the education and training in quality management (QM). Consequently, the main objectives were to analyse the content of the education in QM abroad, to conduct an audit of perceived training needs in Slovakia, and to propose the design of QM training programme to be applied within CME scheme based on the study results. Triangular method in the design of the study was implemented. Review of relevant information, data from the questionnaire and semi-structured interview in the sample of 67 Slovak trainees from Health Management School and School of Public Health--were adopted in complementary fashion. Highlighted in the survey are positive attitudes to training in quality management documented by the median score higher than 6 in all tested areas, on scale 0-10. No significant differences in profession groups as physicians, nurses, HC managers or among training institutions involved were displayed. However, potential obstacles were identified in deeper study using interviews. The absence of knowledge and skills in management in general and in quality management approaches especially are observed. Typically, the role of strategic planning is undermined. The large scale of quality management approaches is converted to problems of accreditation. Barriers to participative culture, innovation, devolution of accountability, resistance to change and to team based management are authentic findings as well. Drawn from the study were related to: fostering managers--"transformational leaders" for locally driven decision making in health care policy and practice; need of training activities for the continuing education in quality with respect to specific target groups interests and their level of knowledge in management; content of training oriented towards combination of rational utilization of information, critical analytical skills and planning for quality with human resource development-interpersonal skills, team building (soft skills), not just reduction of quality management tools to hard techniques (statistics, ISO norms); methods of education, where the usage of experiential learning methods, participative training inclusive action learning is highlighted; team training complemented with individual professional development support inclusive a coaching and mentoring scheme. AS IMPLICATIONS: Four types of CME training: Basic Module QM, Training for QM teams, Training Trainers Scheme and Guiding through Accreditation and Quality Award were proposed. (Tab. 9, Ref. 38.)

QAIT: a quality assurance issue tracking tool to facilitate the improvement of clinical data quality.

PubMed

Zhang, Yonghong; Sun, Weihong; Gutchell, Emily M; Kvecher, Leonid; Kohr, Joni; Bekhash, Anthony; Shriver, Craig D; Liebman, Michael N; Mural, Richard J; Hu, Hai

2013-01-01

In clinical and translational research as well as clinical trial projects, clinical data collection is prone to errors such as missing data, and misinterpretation or inconsistency of the data. A good quality assurance (QA) program can resolve many such errors though this requires efficient communications between the QA staff and data collectors. Managing such communications is critical to resolving QA problems but imposes a major challenge for a project involving multiple clinical and data processing sites. We have developed a QA issue tracking (QAIT) system to support clinical data QA in the Clinical Breast Care Project (CBCP). This web-based application provides centralized management of QA issues with role-based access privileges. It has greatly facilitated the QA process and enhanced the overall quality of the CBCP clinical data. As a stand-alone system, QAIT can supplement any other clinical data management systems and can be adapted to support other projects. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Whistle Blowing: A Message to Leaders and Managers

PubMed Central

Schein, Edgar H.

2016-01-01

This comment argues that instead of worrying about the pros and cons of whistleblowing one should focus on the more general problem of the failure of upward communication around safety and quality problems and consider what leaders and managers must do to stimulate subordinates to communicate and reward such communication. The article analyzes why safety failures occur and introduces the concept of practical drift and adaptive moves as necessary for systemic safety to be understood and better handled. It emphasizes the key role of senior leadership in creating a climate in which critical upward communication will become more likely. PMID:27239866

Speed harmonization and peak-period shoulder use to manage urban freeway congestion.

DOT National Transportation Integrated Search

2009-10-01

Traffic congestion is an increasing problem in the nations urban areas, leading to personal inconvenience, : increased pollution, hampered economic productivity, and reduced quality of life. While traffic congestion tends : to continuously increas...

Livestock Waste Management in a Quality Environment. Circular 1074.

ERIC Educational Resources Information Center

Jedele, D. G., Ed.

This circular provides information to assist in assessing the pollution potential of livestock operations. It discusses a systematic approach to resolving problems through feedlot runoff control, liquid manure handling, hauling and lagooning, and ditching. (CS)

MANAGEMENT OF COMBINED SEWER OVERFLOW: RESEARCH PROGRAM CAPSTONE

EPA Science Inventory

Combined-sewer overflow (CSO) is a mixture of urban storm drainage, municipal-industrial wastewater, and subterranean infiltration. Untreated discharges of CSOs have caused substantial pollution impacts on the quality of receiving-water bodies. Problem constituents include visi...

MANAGEMENT OF COMBINED SEWER OVERFLOW RESEARCH PROGRAM CAPSTONE

EPA Science Inventory

Combined-sewer overflow (CSO) is a mixture of urban storm drainage, municipal-industrial wastewater, and subterranean infiltration. Untreated discharges of CSOs have caused substantial pollution impacts on the quality of receiving-water bodies. Problem constituents include ...

Impact of wastewater from the rural commune of Jmaa Moulblad on the physico-chemical quality of the waters of the Grou River (Rabat region, Morocco)

NASA Astrophysics Data System (ADS)

Arifi, Karim; Tahri, Latifa; El Abid, Abdallah; Hefiane, Fatima Zahra; Elblidi, Souad; Yahyaoui, Ahmed; Fekhaoui, Mohammed

2018-05-01

The Grou River is one of the main rivers that feed the reservoir of the Sidi Mohammed Ben Abdellah (SMBA) dam in Morocco. However, this river is particularly threatened by the pollution problem. It is in this context that this study aims to study the effect of wastewater from the rural commune of Jmaa Moulblad on the physicochemical quality of the waters of this river. We analyzed 11 physicochemical parameters (T° of area, T° of water, pH, EC, mV, Sal, TDS, BOD, COD, SS and TOC), with a monthly frequency since the month of December 2014 until November 2015. The results obtained show a worrying situation of the state of this watercourse. To remedy this problem, we recommend pre-treatment of wastewater before discharge and the implementation of a management plan and sustainable management of the Grou River watershed.

Innovation and construction management in Brazil: Challenges of companies in times of quality and productivity

NASA Astrophysics Data System (ADS)

Barbosa, A. A. R.; Vilnītis, M.

2017-10-01

Considering the efforts to optimize productivity and quality in the construction through the potential existing in the respective companies, this study presents an approach for identification, management and priorities of improvements actions at construction sites focusing status on productivity, added value and innovation in the socioeconomic context and scenario of construction industry in Brazil. Technological advances in recent years have made the Brazilian construction industry gradually incorporate technologies and forms of management, despite its traditionally conservative character. In current days, the innovations are pursued with the quest for greater quality, productivity, safety and customer satisfaction, which have been increasingly competitive and global. Construction in Brazil occupies an important role in the economy, directly contributing to GDP and acting on an extensive productive chain of suppliers, commercialization services and maintenance. The Brazilian construction sector has undergone major changes in recent years, facilitated by factors such as the resumption of public investments, the creation of laws that facilitate real estate, investments and funding of external resources, and the efforts of the Brazilian Quality and Productivity Program - PBQP H. However, the sector faces problems of a lack of skilled labour to meet the growth needs of the sector. There are still problems and challenges of quality and productivity that prevent full sector development. The aspects of nonconformity, low quality, high tax burden, outsourcing and informality of the workforce have not been adequately addressed and resolved. Through the use of indicators of productivity and growth, the challenges of the Brazilian construction industry are discussed and the possible paths for the sector that allow its full development and to reduce the distance between the Brazilian construction industry and that of the developed countries.

Endourologic management of malignant ureteral obstruction: indications, results, and quality-of-life issues.

PubMed

Sountoulides, Petros; Pardalidis, Nikolaos; Sofikitis, Nikolaos

2010-01-01

Obstruction of the upper urinary tract is a problem commonly faced by practicing urologists. The constant evolution in endourology has effectively facilitated minimally invasive management of upper-tract obstruction. In a case in which malignancy is the cause of obstruction, however, the situation significantly changes. Questions arise regarding the need for relieving the obstruction, the means to accomplish this, and the benefits and drawbacks of each technique regarding both their efficacy and their impact on the patients well-being and the crucial issue of quality of life in the face of malignancy.

What do nurse managers say about nurses' sickness absenteeism? A new perspective.

PubMed

Baydoun, Mohamed; Dumit, Nuhad; Daouk-Öyry, Lina

2016-01-01

To explore nurses' sickness absenteeism from the perspective of nurse managers. Sickness absenteeism among health-care providers, especially nurses, remains a significant problem in an era of challenges to provide high quality care with the required skill mix. This in turn compromises the quality of care and adds to the costs of an organisation. A qualitative descriptive design was used. Data were collected from a governmental academic hospital in Lebanon. In-depth tape-recorded interviews were conducted with a total of 20 nurse managers. Data were analysed through a content analysis approach. Data analysis yielded three domains as follows: work-related, individual and organisational factors that lead to nurses' sickness absenteeism. This study conceptualised nurses' absenteeism from the nurse managers' perspective, and it revealed absence antecedents that are rarely reported elsewhere in the literature. The findings from this study can be utilised to design reform initiatives concerned with nurses' absenteeism and to decrease its negative consequences in terms of quality and cost. © 2015 John Wiley & Sons Ltd.

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

PubMed

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

2015-04-15

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

Confronting Decision Cliffs: Diagnostic Assessment of Multi-Objective Evolutionary Algorithms' Performance for Addressing Uncertain Environmental Thresholds

NASA Astrophysics Data System (ADS)

Ward, V. L.; Singh, R.; Reed, P. M.; Keller, K.

2014-12-01

As water resources problems typically involve several stakeholders with conflicting objectives, multi-objective evolutionary algorithms (MOEAs) are now key tools for understanding management tradeoffs. Given the growing complexity of water planning problems, it is important to establish if an algorithm can consistently perform well on a given class of problems. This knowledge allows the decision analyst to focus on eliciting and evaluating appropriate problem formulations. This study proposes a multi-objective adaptation of the classic environmental economics "Lake Problem" as a computationally simple but mathematically challenging MOEA benchmarking problem. The lake problem abstracts a fictional town on a lake which hopes to maximize its economic benefit without degrading the lake's water quality to a eutrophic (polluted) state through excessive phosphorus loading. The problem poses the challenge of maintaining economic activity while confronting the uncertainty of potentially crossing a nonlinear and potentially irreversible pollution threshold beyond which the lake is eutrophic. Objectives for optimization are maximizing economic benefit from lake pollution, maximizing water quality, maximizing the reliability of remaining below the environmental threshold, and minimizing the probability that the town will have to drastically change pollution policies in any given year. The multi-objective formulation incorporates uncertainty with a stochastic phosphorus inflow abstracting non-point source pollution. We performed comprehensive diagnostics using 6 algorithms: Borg, MOEAD, eMOEA, eNSGAII, GDE3, and NSGAII to ascertain their controllability, reliability, efficiency, and effectiveness. The lake problem abstracts elements of many current water resources and climate related management applications where there is the potential for crossing irreversible, nonlinear thresholds. We show that many modern MOEAs can fail on this test problem, indicating its suitability as a useful and nontrivial benchmarking problem.

[Application of music therapy for managing agitated behavior in older people with dementia].

PubMed

Sung, Huei-Chuan; Chang, Anne M; Abbey, Jennifer

2006-10-01

Older people with dementia may display negative emotions, memory problems, sleep disturbance, and agitated behavior. Among these symptoms, agitated behavior has been identified by families and nursing staff as the care problem that presents the greatest challenge. Several studies have found that music therapy reduced agitated behaviors in those with dementia and recommended use of music as an effective strategy in managing this behavioral problem. Music therapy represents a lower cost, effective care approach that nursing staff can easily learn and apply to those with dementia. Furthermore, reductions in agitated behavior in dementia patients that result from music therapy can also alleviate caregiver stress and burden of care, leading to improvements in the health and quality of life of both dementia patients and their caregivers. This paper aims to introduce the principles and application of music therapy in the management of agitated behavior in those with dementia.

Financial management for nurse managers--the bottom line for renewal.

PubMed

Consolvo, C A; Peters, M

1991-01-01

Cost-effective health care has become the hospital motto for the 1990s. A great majority of costs can be controlled on individual nursing units, but many clinically expert nurse managers lack skills in financial management. Our goal was to teach such skills in a framework in which cost was balanced with quality. The three-day course emphasized leadership skills and management styles, change and renewal, solutions to problems of nurse turnover, and specific financial strategies. Evaluations of the course were positive and demonstrated one way in which valuable nurse managers can learn new skills to keep up with current needs.

Management of chronic spinal cord dysfunction.

PubMed

Abrams, Gary M; Ganguly, Karunesh

2015-02-01

Both acute and chronic spinal cord disorders present multisystem management problems to the clinician. This article highlights key issues associated with chronic spinal cord dysfunction. Advances in symptomatic management for chronic spinal cord dysfunction include use of botulinum toxin to manage detrusor hyperreflexia, pregabalin for management of neuropathic pain, and intensive locomotor training for improved walking ability in incomplete spinal cord injuries. The care of spinal cord dysfunction has advanced significantly over the past 2 decades. Management and treatment of neurologic and non-neurologic complications of chronic myelopathies ensure that each patient will be able to maximize their functional independence and quality of life.

A Faculty Development Program can result in an improvement of the quality and output in medical education, basic sciences and clinical research and patient care.

PubMed

Dieter, Peter Erich

2009-07-01

The Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany, was founded in 1993 after the reunification of Germany. In 1999, a reform process of medical education was started together with Harvard Medical International.The traditional teacher- and discipline-centred curriculum was displaced by a student-centred, interdisciplinary and integrative curriculum, which has been named Dresden Integrative Patient/Problem-Oriented Learning (DIPOL). The reform process was accompanied and supported by a parallel-ongoing Faculty Development Program. In 2004, a Quality Management Program in medical education was implemented, and in 2005 medical education received DIN EN ISO 9001:2000 certification. Quality Management Program and DIN EN ISO 9001:2000 certification were/are unique for the 34 medical schools in Germany.The students play a very important strategic role in all processes. They are members in all committees like the Faculty Board, the Board of Study Affairs (with equal representation) and the ongoing audits in the Quality Management Program. The Faculty Development program, including a reform in medical education, the establishment of the Quality Management program and the certification, resulted in an improvement of the quality and output of medical education and was accompanied in an improvement of the quality and output of basic sciences and clinical research and interdisciplinary patient care.

A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard

PubMed Central

Azadmanjir, Zahra; Torabi, Mashallah; Safdari, Reza; Bayat, Maryam; Golmahi, Fatemeh

2015-01-01

Introduction: management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard. Methods: the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified. Results: the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers. Conclusion: the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process. PMID:26483593

[Application of laboratory information system in the management of the key indicators of quality inspection].

PubMed

Guo, Ye; Chen, Qian; Wu, Wei; Cui, Wei

2015-03-31

To establish a system of monitoring the key indicator of quality for inspection (KIQI) on a laboratory information system (LIS), and to have a better management of KIQI. Clinical sample made in PUMCH were collected during the whole of 2014. Next, interactive input program were designed to accomplish data collecting of the disqualification rate of samples, the mistake rate of samples and the occasions of losing samples, etc. Then, a series moment of sample collection, laboratory sample arrived, sample test, sample check, response to critical value, namely, trajectory information left on LIS were recorded and the qualification rate of TAT, the notification rate of endangering result were calculated. Finally, the information about quality control were collected to build an internal quality control database and the KIQI, such as the out-of-control rate of quality control and the total error of test items were monitored. The inspection of the sample management shows the disqualification rates in 2014 were all below the target, but the rates in January and February were a little high and the rates of four wards were above 2%. The mistake rates of samples was 0.47 cases/10 000 cases, attaining the target (< 2 cases/10 000 cases). Also, there was no occasion of losing samples in 2014, attaining the target too. The inspection of laboratory reports shows the qualification rates of TAT was within the acceptable range (> 95%), however the rates of blood routine in November (94.75%) was out of range. We have solved the problem by optimizing the processes. The notification rate of endangering result attained the target (≥ 98%), while the rate of timely notification is needed to improve. Quality inspection shows the CV of APTT in August (5.02%) was rising significantly, beyond the accepted CV (5.0%). We have solved the problem by changing the reagent. The CV of TT in 2014 were all below the allowable CV, thus the allowable CV of the next year lower to 10%. It is an objective and effective method to manage KIQI with the powerful management mode of database and information process capability on LIS.

The interaction of fatigue, physical activity, and health-related quality of life in adults with multiple sclerosis (MS) and cardiovascular disease (CVD).

PubMed

Newland, Pamela K; Lunsford, Valerie; Flach, Alicia

2017-02-01

In addition to the underlying health problems and disability associated with multiple sclerosis (MS) and cardiovascular disease (CVD), adults with each of these chronic illnesses are independently known to experience fatigue. While fatigue's influence on physical activity and health related quality of life (HRQOL) with each of these illnesses has been discussed, what is lacking is information on how fatigue impacts physical activity and health related quality of life, and ultimately self-management for adults with these conditions. Additionally, individuals may be unaware of the significance of maintaining optimal physical activity in order to maintain everyday function and self-management. Thus, the purpose of this article is to discuss the complex effect of fatigue on physical activity and HRQOL among adults with MS and CVD, and to present potential self-management strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

A sequential factorial analysis approach to characterize the effects of uncertainties for supporting air quality management

NASA Astrophysics Data System (ADS)

Wang, S.; Huang, G. H.; Veawab, A.

2013-03-01

This study proposes a sequential factorial analysis (SFA) approach for supporting regional air quality management under uncertainty. SFA is capable not only of examining the interactive effects of input parameters, but also of analyzing the effects of constraints. When there are too many factors involved in practical applications, SFA has the advantage of conducting a sequence of factorial analyses for characterizing the effects of factors in a systematic manner. The factor-screening strategy employed in SFA is effective in greatly reducing the computational effort. The proposed SFA approach is applied to a regional air quality management problem for demonstrating its applicability. The results indicate that the effects of factors are evaluated quantitatively, which can help decision makers identify the key factors that have significant influence on system performance and explore the valuable information that may be veiled beneath their interrelationships.

Guidance and Control Software,

DTIC Science & Technology

1980-05-01

commitments of function, cost, and schedule . The phrase "software engineering" was intended to contrast with the phrase "computer science" the latter aims...the software problems of cost, delivery schedule , and quality were gradually being recognized at the highest management levels. Thus, in a project... schedule dates. Although the analysis of software problems indicated that the entire software development process (figure 1) needed new methods, only

An improved harmony search algorithm for emergency inspection scheduling

NASA Astrophysics Data System (ADS)

Kallioras, Nikos A.; Lagaros, Nikos D.; Karlaftis, Matthew G.

2014-11-01

The ability of nature-inspired search algorithms to efficiently handle combinatorial problems, and their successful implementation in many fields of engineering and applied sciences, have led to the development of new, improved algorithms. In this work, an improved harmony search (IHS) algorithm is presented, while a holistic approach for solving the problem of post-disaster infrastructure management is also proposed. The efficiency of IHS is compared with that of the algorithms of particle swarm optimization, differential evolution, basic harmony search and the pure random search procedure, when solving the districting problem that is the first part of post-disaster infrastructure management. The ant colony optimization algorithm is employed for solving the associated routing problem that constitutes the second part. The comparison is based on the quality of the results obtained, the computational demands and the sensitivity on the algorithmic parameters.

Why TQM does not work in Iranian healthcare organisations.

PubMed

Mosadeghrad, Ali Mohammad

2014-01-01

Despite the potential benefits of total quality management (TQM), many healthcare organisations encountered difficulties in its implementation. The purpose of this paper is to explore the barriers to successful implementation of TQM in healthcare organisations of Iran. This study involved a mixed research design. In-depth interviews were conducted with TQM practitioners to explore TQM implementation obstacles in Iranian healthcare organisations. In addition, this study involved survey-based research on the obstacles associated with successful TQM transformation. TQM implementation and its impact depend on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in Iranian healthcare organisations can be attributed to the non-holistic approach adopted in its implementation, inadequate knowledge of managers' about TQM implementation, frequent top management turnover, poor planning, vague and short-termed improvement goals, lack of consistent managers' and employees' commitment to and involvement in TQM implementation, lack of a corporate quality culture, lack of team orientation, lack of continuous education and training and lack of customer focus. Human resource problems, cultural and strategic problems were the most important obstacles to TQM successful implementation, respectively. Understanding the factors that are likely to obstruct TQM implementation would enable managers to develop more viable strategies for achieving business excellence. Understanding the factors that are likely to obstruct TQM implementation will help organisations in planning better TQM models.

Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol

PubMed Central

Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

2013-01-01

Introduction Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. Methods and analysis To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. Ethics and dissemination This protocol has been approved by the CSSS Alphonse–Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences. PMID:23633423

Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol.

PubMed

Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

2013-01-01

Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. This protocol has been approved by the CSSS Alphonse-Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences.

[Safety management in pathology laboratory: from specimen handling to confirmation of reports].

PubMed

Minato, Hiroshi; Nojima, Takayuki; Nakano, Mariko; Yamazaki, Michiko

2011-03-01

Medical errors in pathological diagnosis give a huge amount of physical and psychological damage to patients as well as medical staffs. We discussed here how to avoid medical errors in surgical pathology laboratory through our experience. Handling of surgical specimens and diagnosing process requires intensive labor and involves many steps. Each hospital reports many kinds of accidents or incidents, however, many laboratories share common problems and each process has its specific risk for the certain error. We analyzed the problems in each process and concentrated on avoiding misaccessioning, mislabeling, and misreporting. We have made several changes in our system, such as barcode labels, digital images of all specimens, putting specimens in embedding cassettes directly on the endoscopic biopsied specimens, and using a multitissue control block as controls in immunohistochemistry. Some problems are still left behind, but we have reduced the errors by decreasing the number of artificial operation as much as possible. A pathological system recognizing the status of read or unread the pathological reports by clinician are now underconstruction. We also discussed about quality assurance of diagnosis, cooperation with clinicians and other comedical staffs, and organization and method. In order to operate riskless work, it is important for all the medical staffs to have common awareness of the problems, keeping careful observations, and sharing all the information in common. Incorporation of an organizational management tool such as ISO 15189 and utilizing PDCA cycle is also helpful for safety management and quality improvement of the laboratory.

Mission operations and command assurance: Instilling quality into flight operations

NASA Technical Reports Server (NTRS)

Welz, Linda L.; Witkowski, Mona M.; Bruno, Kristin J.; Potts, Sherrill S.

1993-01-01

Mission Operations and Command Assurance (MO&CA) is a Total Quality Management (TQM) task on JPL projects to instill quality in flight mission operations. From a system engineering view, MO&CA facilitates communication and problem-solving among flight teams and provides continuous process improvement to reduce the probability of radiating incorrect commands to a spacecraft. The MO&CA task has evolved from participating as a member of the spacecraft team to an independent team reporting directly to flight project management and providing system level assurance. JPL flight projects have benefited significantly from MO&CA's effort to contain risk and prevent rather than rework errors. MO&CA's ability to provide direct transfer of knowledge allows new projects to benefit from previous and ongoing flight experience.

Algorithm for evaluating the effectiveness of a high-rise development project based on current yield

NASA Astrophysics Data System (ADS)

Soboleva, Elena

2018-03-01

The article is aimed at the issues of operational evaluation of development project efficiency in high-rise construction under the current economic conditions in Russia. The author touches the following issues: problems of implementing development projects, the influence of the operational evaluation quality of high-rise construction projects on general efficiency, assessing the influence of the project's external environment on the effectiveness of project activities under crisis conditions and the quality of project management. The article proposes the algorithm and the methodological approach to the quality management of the developer project efficiency based on operational evaluation of the current yield efficiency. The methodology for calculating the current efficiency of a development project for high-rise construction has been updated.

Towards Sustainable Ambon Bay: Evaluation of Solid Waste Management in Ambon City

NASA Astrophysics Data System (ADS)

Maryati, S.; Miharja, M.; Iscahyono, A. F.; Arsallia, S.; Humaira, AN S.

2017-07-01

Ambon Bay is a strategic area in the context of regional economic development, however it also faced environmental problems due to economic development and the growth of population. One of the environmental problems in the Ambon Bay is the growing solid waste which in turn lowers the quality of the water. The purpose of this study is to evaluate solid waste management in the Ambon City and propose recommendation in order to reduce solid waste in the Ambon Bay. The analytical method used is descriptive analysis by comparing a number of criteria based on the concept of solid waste management in coastal region with the current conditions of solid waste management in Ambon City. Criteria for waste management are divided into generation, storage, collection, transport, transfer and disposal. From the results of analysis, it can be concluded that the components of solid waste management at transport, transfer, and disposal level are generally still adequate, but solid waste management at source, storage and collection level have to be improved.

Calculation of intercepted runoff depth based on stormwater quality and environmental capacity of receiving waters for initial stormwater pollution management.

PubMed

Peng, Hai-Qin; Liu, Yan; Gao, Xue-Long; Wang, Hong-Wu; Chen, Yi; Cai, Hui-Yi

2017-11-01

While point source pollutions have gradually been controlled in recent years, the non-point source pollution problem has become increasingly prominent. The receiving waters are frequently polluted by the initial stormwater from the separate stormwater system and the wastewater from sewage pipes through stormwater pipes. Consequently, calculating the intercepted runoff depth has become a problem that must be resolved immediately for initial stormwater pollution management. The accurate calculation of intercepted runoff depth provides a solid foundation for selecting the appropriate size of intercepting facilities in drainage and interception projects. This study establishes a separate stormwater system for the Yishan Building watershed of Fuzhou City using the InfoWorks Integrated Catchment Management (InfoWorks ICM), which can predict the stormwater flow velocity and the flow of discharge outlet after each rainfall. The intercepted runoff depth is calculated from the stormwater quality and environmental capacity of the receiving waters. The average intercepted runoff depth from six rainfall events is calculated as 4.1 mm based on stormwater quality. The average intercepted runoff depth from six rainfall events is calculated as 4.4 mm based on the environmental capacity of the receiving waters. The intercepted runoff depth differs when calculated from various aspects. The selection of the intercepted runoff depth depends on the goal of water quality control, the self-purification capacity of the water bodies, and other factors of the region.

COLLABORATIVE RESEARCH ON URBAN BEST MANAGEMENT PRACTICES

EPA Science Inventory

Storm driven wet weather flow (WWF) which includes combined sewer and sanitary sewer overflows and stormwater discharges are a leading cause of water-quality impairment. Problem constituents in WWF include pathogens, solids, nutrients, and toxicants. New technologies to control...

Synergistic Knowledge Development in Interdisciplinary Teams

ERIC Educational Resources Information Center

Broussard, Shorna R.; La Lopa, Joseph Mick; Ross-Davis, Amy

2007-01-01

Problem solving, interpersonal skills, information literacy, and critical and independent thinking are essential qualities that employers seek, yet many undergraduates lack. We structured an interdisciplinary classroom and experiential learning environment where students from three undergraduate courses (Hospitality and Tourism Management,…

Quality assessment of urban environment

NASA Astrophysics Data System (ADS)

Ovsiannikova, T. Y.; Nikolaenko, M. N.

2015-01-01

This paper is dedicated to the research applicability of quality management problems of construction products. It is offered to expand quality management borders in construction, transferring its principles to urban systems as economic systems of higher level, which qualitative characteristics are substantially defined by quality of construction product. Buildings and structures form spatial-material basis of cities and the most important component of life sphere - urban environment. Authors justify the need for the assessment of urban environment quality as an important factor of social welfare and life quality in urban areas. The authors suggest definition of a term "urban environment". The methodology of quality assessment of urban environment is based on integrated approach which includes the system analysis of all factors and application of both quantitative methods of assessment (calculation of particular and integrated indicators) and qualitative methods (expert estimates and surveys). The authors propose the system of indicators, characterizing quality of the urban environment. This indicators fall into four classes. The authors show the methodology of their definition. The paper presents results of quality assessment of urban environment for several Siberian regions and comparative analysis of these results.

[Theoretical grounds of a structural and functional model for quality assurance of radiation diagnostics under conditions of development of the modern health care system in Ukraine].

PubMed

Korop, Oleg A; Lenskykh, Sergiy V

2018-01-01

Introduction: Modern changes in the health care system of Ukraine are focused on financial support in providing medical and diagnostic care to the population and are based on deep and consistent structural and functional transformations. They are aimed at providing adequate quality care, which is the main target function and a principal criterion for operation of health care system. The urgency of this problem is increasing in the context of reforming the health care system and global changes in the governmental financial guarantees for the provision of medical services to the population. The aim of the work is to provide theoretical grounds for a structural and functional model of quality assurance of radiation diagnostics at all levels of medical care given to the population under the current health care reform in Ukraine. Materials and methods: The object of the study is organizing the operation of the radiation diagnostic service; the information is based on the actual data on the characteristics of radiation diagnosis at different levels of medical care provision. Methods of systematic approach, system analysis and structural and functional analysis of the operating system of radiation diagnostics are used. Review: The basis of the quality assurance model is the cyclical process, which includes the stages of the problem identifition, planning of its solution, organization of the system for implementation of decisions, monitoring the quality management process of the radiation diagnostics, and factors influencing the quality of the radiation diagnostics service. These factors include the quality of the structure, process, results, organization of management and control of current processes and the results of radiation diagnostics management. Conclusions: The advantages of the proposed model for ensuring the quality of the radiation diagnostics service are its systemacy and complexity, elimination of identified defects and deficiencies, and achievement of profitability through modern redistribution and use of existing resources of the health care system. The results of adequate service quality management activities in radiation diagnostics are the improvement of organizational and economic principles along with legislative regulation, the implementation of a modern system of radiation diagnostics in the state health care at the national and regional levels, the increase of the accessibility, quality and efficiency of the radiation diagnostics service.

Participative management in health care services.

PubMed

Muller, M

1995-03-01

The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalization of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management. A continuum of interactive decision-making and problem-solving is described, the different role-players involved, as well as the levels of interactive decision-making and problem-solving. The most appropriate decision-making strategy should be employed in pro-active and reactive decision-making. Applicable principles and assumptions in each element of participative management is described. It is recommended that this proposed model for participative management be refined by means of a literature control, interactive dialogue with experts and a model case description or participative management, to ensure the trustworthiness of this research.

Conceptual basis for an integrated system for the management of a protected area. Examples from its application in a mediterranean area.

PubMed

Cornejo, E; Fungairiño, S G; Barandica, J M; Serrano, J M; Zorrilla, J M; Gómez, T; Zapata, F J; Acosta, F J

2016-01-15

Improving the efficiency of management in protected areas is imperative in a generalized context of limited conservation budgets. However, this is overlooked due to flaws in problem definition, general disregard for cost information, and a lack of suitable tools for measuring costs and management quality. This study describes an innovative methodological framework, implemented in the web application SIGEIN, focused on maximizing the quality of management against its costs, establishing an explicit justification for any decision. The tool integrates, with this aim, a procedure for prioritizing management objects according to a conservation value, modified by a functional criterion; a project management module; and a module for management of continuous assessment. This appraisal associates the relevance of the conservation targets, the efficacy of the methods employed, both resource and personnel investments, and the resulting costs. Preliminary results of a prototypical SIGEIN application on the Site of Community Importance Chafarinas Islands are included. Copyright © 2015 Elsevier Ltd. All rights reserved.

Environmental management strategy: four forces analysis.

PubMed

Doyle, Martin W; Von Windheim, Jesko

2015-01-01

We develop an analytical approach for more systematically analyzing environmental management problems in order to develop strategic plans. This approach can be deployed by agencies, non-profit organizations, corporations, or other organizations and institutions tasked with improving environmental quality. The analysis relies on assessing the underlying natural processes followed by articulation of the relevant societal forces causing environmental change: (1) science and technology, (2) governance, (3) markets and the economy, and (4) public behavior. The four forces analysis is then used to strategize which types of actions might be most effective at influencing environmental quality. Such strategy has been under-used and under-valued in environmental management outside of the corporate sector, and we suggest that this four forces analysis is a useful analytic to begin developing such strategy.

Environmental Management Strategy: Four Forces Analysis

NASA Astrophysics Data System (ADS)

Doyle, Martin W.; Von Windheim, Jesko

2015-01-01

We develop an analytical approach for more systematically analyzing environmental management problems in order to develop strategic plans. This approach can be deployed by agencies, non-profit organizations, corporations, or other organizations and institutions tasked with improving environmental quality. The analysis relies on assessing the underlying natural processes followed by articulation of the relevant societal forces causing environmental change: (1) science and technology, (2) governance, (3) markets and the economy, and (4) public behavior. The four forces analysis is then used to strategize which types of actions might be most effective at influencing environmental quality. Such strategy has been under-used and under-valued in environmental management outside of the corporate sector, and we suggest that this four forces analysis is a useful analytic to begin developing such strategy.

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts.

PubMed

Suh, Siri; Moreira, Philippe; Ly, Moussa

2007-11-29

In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. The most notable improvement across regions was in infection prevention.Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts

PubMed Central

Suh, Siri; Moreira, Philippe; Ly, Moussa

2007-01-01

Background In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. Methods This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. Results The most notable improvement across regions was in infection prevention. Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Conclusion Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality. PMID:18047678

Chronically ill patients' self-management abilities to maintain overall well-being: what is needed to take the next step in the primary care setting?

PubMed

Cramm, Jane Murray; Nieboer, Anna Petra

2015-09-15

Although widespread problems in patient-professional interaction and insufficient support of patients' self-management abilities have been recognized, research investigating the relationships among care quality, productive interaction, and self-management abilities to maintain overall well-being is lacking. Furthermore, studies have revealed differences in these characteristics among certain groups (e.g., less-educated and older patients). This longitudinal study thus aimed to identify relationships among background characteristics, quality of care, productivity of patient-professional interaction, and self-management abilities to maintain overall well-being in chronically ill patients participating in 18 Dutch disease management programs. This longitudinal study included patients participating in 18 Dutch disease management programs. Surveys were administered in 2011 (T1; n = 2191 (out of 4693), 47 % response rate) and 2012 (T2: n = 1722 (out of 4350), 40 % response rate). A total of 1279 patients completed questionnaires at both timepoints (T1 and T2) (27 % response rate). Self-management abilities to maintain well-being were measured using the short (18-item) version of the Self-Management Ability Scale (SMAS-S), patients' perceptions of the productivity of interactions with health care professionals were assessed with the relational coordination instrument and the short (11-item) version of the Patient Assessment of Chronic Illness Care (PACIC-S) was used to assess patients' perceptions of the quality of chronic care delivery. Perceived and objective quality of care and the productivity of patient-professional interaction were found to be related to patients' self-management abilities to maintain overall well-being. These abilities were related negatively to and significantly predicted by low educational level, single status, and older age, despite the mediating role of productive interaction in their relationship with patients' perceptions of care quality. These findings suggest that patient-professional interaction is not yet sufficiently productive to successfully protect against the deterioration of self-management abilities in some groups of chronically ill patients, although such interaction and high-quality care are important factors in such protection. Improvement of the quality of chronic care delivery should thus always be accompanied by investment in high-quality communication and patient-professional relationships.

TAC management in North Sea flatfish fisheries

NASA Astrophysics Data System (ADS)

Daan, Niels

1997-11-01

The Common Fisheries Policy of the European Union adopted in 1983 is primarily focused on a science-based TAC management system with fixed national quota shares. The quality of the assessments of plaice and sole, the consistency of the scientific advice, the congruency of the management decisions, and the enforcement of the regulations are reviewed over a 15-year period. The conclusion is that there have been problems at each level, with the ultimate effect that the policy has not been able to restrict fishing mortality and that the level of overexploitation has only increased. It is argued that the present TAC system has created more problems than it has resolved. Attention is drawn to the autonomic economic developments within the fishery and to the potential for managing the fishery more effectively from the cost side rather than the profit side.

Living With Diabetes in Appalachia: A Focus Group Study.

PubMed

Carpenter, Roger; Smith, Mary Jane

This article presents an innovative holistic practice application based on evidence from a focus group study on managing diabetes. The purpose of this study addressed the research question: How do persons with type 2 diabetes describe ways of managing the challenge of living with diabetes? A second purpose was to link the findings on ways to manage diabetes to holistic nursing practice through story theory. Nine adults with type 2 diabetes living in rural West Virginia participated in 3 focus groups. Using content analysis, the study findings integrated themes with core qualities, and are as follows: living life as an evolving process is awakening to the present and doing it your way, being on guard is a vigilant ongoing responsibility, attending to bodily experience is awareness of body and facing life stress, and knowing the consequences is awareness of potential problems and taking charge. Merging the study findings with the concepts of story theory led to the development of an innovative practice application for managing diabetes. Managing diabetes in this practice application goes beyond problem-centeredness to a patient-centered approach, offering attention to individual preferences. Since managing diabetes is a major problem in Appalachia, there a need for innovative approaches. This study adds to the body of knowledge on how persons from Appalachia manage diabetes. In addition, it offers a story practice approach for managing diabetes-replacing a problem focus to a more holistic approach to practice leading to more meaningful and fulfilling outcomes.

Resolving and avoiding conflict with the professional staff.

PubMed

Scher, S

1991-01-01

The professional staff perspective radically diverges from that of management. Whereas the professional staff sees the hospital in terms of its providing quality health care to each individual patient, hospital executives see the hospital in terms of its financial and systemwide performance. Unless these divergent perspectives are effectively integrated to solve problems and formulate hospital policies, chronic conflict between hospital management and the professional staff is inevitable.

Smoke Management: Toward a Data Base to Validate PB-Piedmont - Numerical Simulation of Smoke on the Ground at Night

Treesearch

Gary L. Achtemeier

1999-01-01

The use of fire for controlled burning to meet objectives for silviculture or for ecosystem management carries the risk of liability for smoke. Near-ground smoke can degrade air quality, reduce visibility, aggravate health problems, and create a general nuisance. At night, smoke can locally limit visibility over roadways creating serious hazards to transportation. PB-...

Management-focused approach to investigating coastal water-quality drivers and impacts in the Baltic Sea

NASA Astrophysics Data System (ADS)

Vigouroux, G.; Destouni, G.; Chen, Y.; Bring, A.; Jönsson, A.; Cvetkovic, V.

2017-12-01

Coastal areas link human-driven conditions on land with open sea conditions, and include crucial and vulnerable ecosystems that provide a variety of ecosystem services. Eutrophication is a common problem that is not least observed in the Baltic Sea, where coastal water quality is influenced both by land-based nutrient loading and by partly eutrophic open sea conditions. Robust and adaptive management of coastal systems is essential and necessitates integration of large scale catchment-coastal-marine systems as well as consideration of anthropogenic drivers and impacts, and climate change. To address this coastal challenge, relevant methodological approaches are required for characterization of coupled land, local coastal, and open sea conditions under an adaptive management framework for water quality. In this paper we present a new general and scalable dynamic characterization approach, developed for and applied to the Baltic Sea and its coastal areas. A simple carbon-based water quality model is implemented, dividing the Baltic Sea into main management basins that are linked to corresponding hydrological catchments on land, as well as to each other though aggregated three-dimensional marine hydrodynamics. Relevant hydrodynamic variables and associated water quality results have been validated on the Baltic Sea scale and show good accordance with available observation data and other modelling approaches. Based on its scalability, this methodology is further used on coastal zone scale to investigate the effects of hydrodynamic, hydro-climatic and nutrient load drivers on water quality and management implications for coastal areas in the Baltic Sea.

Challenges and opportunities of health care supply chain management in the United States.

PubMed

Elmuti, Dean; Khoury, Grace; Omran, Omar; Abou-Zaid, Ahmed S

2013-01-01

This article explores current supply chain management challenges and initiatives and identifies problems that affect supply chain management success in the U.S. health-care industry. In addition, it investigates the impact of health care supply chain management (SCM) initiatives on the overall organizational effectiveness. The attitudinal results, as well as the performance results presented in this study support the claim of health care proponents that the SCM allows organizations to reduce cost, improve quality, and reduce cycle time, and leads to high performance.

Self-management support programs for persons with Parkinson's disease: An integrative review.

PubMed

Kessler, Dorothy; Liddy, Clare

2017-10-01

To identify the characteristics of self-management programs for persons with Parkinson's disease and the evidence for their effectiveness. An integrative literature review was conducted. Studies describing the provision or outcomes of self-management interventions for persons with Parkinson's disease and published in English were included. Two reviewers independently screened and evaluated articles. Interventions were described and compared, and evidence was presented using The Traffic Lighting system. Eighteen interventions were identified, representing a variety of group- and individual-based interventions that differed in structure, components, and outcomes. Notably, 89% were designed specifically for persons with Parkinson's disease and 39% combined self-management support with other therapies. Evidence to support specific self-management programs for persons with Parkinson's disease was limited. However, a moderate quality systematic review and a good quality RCT supported self-management for improving specific domains of quality of life. A variety of interventions have been designed to support self-management by persons with Parkinson's disease. More research is needed to identify key active ingredients and determine which programs are most effective. Self-management programs embedded within rehabilitation are promising. Clinicians should ensure programs include goal setting and problem solving and consider the inclusion of caregivers and peer support. Copyright © 2017 Elsevier B.V. All rights reserved.

The Role of Reliability, Vulnerability and Resilience in the Management of Water Quality Systems

NASA Astrophysics Data System (ADS)

Lence, B. J.; Maier, H. R.

2001-05-01

The risk based performance indicators reliability, vulnerability and resilience provide measures of the frequency, magnitude and duration of the failure of water resources systems, respectively. They have been applied primarily to water supply problems, including the assessment of the performance of reservoirs and water distribution systems. Applications to water quality case studies have been limited, although the need to consider the length and magnitude of violations of a particular water quality standard has been recognized for some time. In this research, the role of reliability, vulnerability and resilience in water quality management applications is investigated by examining their significance as performance measures for water quality systems and assessing their potential for assisting in decision making processes. The importance of each performance indicator is discussed and a framework for classifying such systems, based on the relative significance of each of these indicators, is introduced and illustrated qualitatively with various case studies. Quantitative examples drawn from both lake and river water quality modeling exercises are then provided.

Quality of life in stoma patients.

PubMed

Nugent, K P; Daniels, P; Stewart, B; Patankar, R; Johnson, C D

1999-12-01

Patients with stomas face many difficulties both physical and psychological. Little is known about the long-term problems and the impact on patient lifestyle of a permanent stoma. This study was designed to address the problems faced by patients with stomas. Patients were identified from the Stoma Care Department records for the years 1985 to 1992 and were contacted by mail. A questionnaire was designed to assess postoperative care, quality of life issues, and equipment problems. Responses were recorded on either a visual analog scale, a choice of yes-or-no alternatives, or by selection from a list of responses. A total of 542 eligible patients were contacted, and 391 replies were received. Major stomal problems included rashes (51 percent), leakage (36 percent), and ballooning (90 percent of patients with ileostomy). The majority of patients experienced some change in lifestyle (80 percent), and more than 40 percent of patients had problems with their sex lives. Many patients cope extremely well with a stoma; however, some patients experience considerable difficulty and distress. Improved preoperative assessment and counseling with longer follow-up by the stoma department would be helpful in the management of these patients and probably would contribute to improvement in the quality of their lives.

Holistic Management of Schizophrenia Symptoms Using Pharmacological and Non-pharmacological Treatment.

PubMed

Ganguly, Pronab; Soliman, Abdrabo; Moustafa, Ahmed A

2018-01-01

Individuals with schizophrenia lead a poor quality of life, due to poor medical attention, homelessness, unemployment, financial constraints, lack of education, and poor social skills. Thus, a review of factors associated with the holistic management of schizophrenia is of paramount importance. The objective of this review is to improve the quality of life of individuals with schizophrenia, by addressing the factors related to the needs of the patients and present them in a unified manner. Although medications play a role, other factors that lead to a successful holistic management of schizophrenia include addressing the following: financial management, independent community living, independent living skill, relationship, friendship, entertainment, regular exercise for weight gained due to medication administration, co-morbid health issues, and day-care programmes for independent living. This review discusses the relationship between different symptoms and problems individuals with schizophrenia face (e.g., homelessness and unemployment), and how these can be managed using pharmacological and non-pharmacological methods. Thus, the target of this review is the carers of individuals with schizophrenia, public health managers, counselors, case workers, psychiatrists, and clinical psychologists aiming to enhance the quality of life of individuals with schizophrenia.

Evaluation of spatial and temporal water quality in the Akkaya dam watershed (Niğde, Turkey) and management implications

NASA Astrophysics Data System (ADS)

Yaşar Korkanç, Selma; Kayıkçı, Sedef; Korkanç, Mustafa

2017-05-01

The aim of this study is to investigate the water pollution in the Akkaya Dam watershed spatially and temporally and put forward management suggestions in a watershed scale. For this purpose, monthly water sampling was performed from 11 sampling stations on streams that fed the dam. According to land surveys they have a potential to inflict pollution to the dam. Thus the physical and chemical parameters (i.e. pH, dissolved oxygen, electrical conductivity, temperature, chemical oxygen demand, turbidity and suspended solids) were monitored monthly for 1-year period. Chloride, sulfate, total nitrogen, ammonium, nitrite, nitrate were monitored for a 6-month period, and the results were evaluated in accordance with the Turkish Regulation of Surface Water Quality Management. Results of the study show that the most important reasons for the pollution in the dam are caused by domestic and industrial wastewaters, which were released to the system without being treated, or without being sufficiently treated, and also of agricultural activities. It was determined that electrical conductivity, dissolved oxygen, turbidity, chemical oxygen demand, suspended solids, nitrite, nitrate, total nitrogen, sulfate, and chloride parameters which were high at the sampling stations where domestic and industrial wastewaters discharge were present. pH and temperature demonstrate a difference at a significant level by seasons. As a result of the study, it was determined that the water was of IVth quality in terms of nitrate, chemical oxygen demand, and total nitrogen, and it was of IIIrd quality water with respect to ammonium, electrical conductivity, and dissolved oxygen. It was observed that the dam outflow water was of IVth quality with respect to nitrate, chemical oxygen demand, and total nitrogen, and of IIIrd quality with respect to dissolved oxygen and electrical conductivity. It is considered that the pollution problem in the Akkaya Dam can only be resolved with prevention studies on a watershed scale. Therefore, coordination between the institutions is necessary. The preparation for the integrated water management plan of the watershed will provide a significant contribution to the solution of the water quality problem.

[Quality Management in Medicine: What the Surgeon Needs to Know].

PubMed

Holtel, M; Roßmüller, T; Frommhold, K

2016-10-01

Quality management (QM) is a method used in the field of economics that was adopted late by the medical sector. The coincidence of quality management and what is referred to as economisation in medicine frequently leads to QM being - incorrectly - perceived as part of the economisation problem rather than as part of its solution. Quality assurance defines and observes key performance indicators for the achievement of quality objectives. QM is a form of active management that intends to systematically exclude the effects of chance. It is supposed to enable those in charge of an institution to deal with complex processes, to influence them and achieve quality even under unfavourable circumstances. Clearly defined written standards are an important aspect of QM and allow for 80 % of patients to be treated faster and less labour-intensively and thus to create more capacity for the individual treatment of the 20 % of patients requiring other than routine care. Standards provide a framework to rely on for department heads and other staff alike. They reduce complexity, support processes in stress situations and prevent inconsistent decisions in the course of treatment. Document management ensures transparent and up-to-date in-house standards and creates continuity. Good documents are short, easy to use, and, at the same time, comply with requirements. Specifications describe in-house standards; validation documents provide a forensically sound documentation. Quality management has a broad impact on an institution. It helps staff reflect on their daily work, and it initiates a reporting and auditing system as well as the systematic management of responses to surveys and complaints. Risk management is another aspect of QM; it provides structures to identify, analyse, assess and modify risks and subject them to risk controlling. Quality management is not necessarily associated with certification. However, if certification is intended, it serves to define requirements, increase motivation for the implementation of measures to be taken, and provide long-term continuity in newly adopted processes. Specialist certificates issued by medical associations frequently emphasise an interdisciplinary treatment approach; however, their certification processes are often of poor quality. The effectiveness and efficiency is evident for individual QM instruments in medicine. It is very likely that quality management improves effectiveness in the whole field of medicine, but this has yet to be proved. Georg Thieme Verlag KG Stuttgart · New York.

RECENT PUBLICATIONS - ISOTOPE HYDROLOGY LABORATORY (WATER QUALITY MANAGEMENT BRANCH, WSWRD, NRMRL)

EPA Science Inventory

NRMRL's Water Supply and Water Resouces Division's Isotope Hydrology Laboratory (IHL) produces and publishes highly specialized technical and scientific documents relating to IHL's research. The mission of IHL is to resolve environmental hydrology problems through research and ap...

Sprayer technology: reduce spray drift

USDA-ARS?s Scientific Manuscript database

Enhancing environmental quality and sustaining the economic viability of food production are keys to sustainable agriculture. Modern vegetable production uses a variety of materials to manage pest problems. Selecting the proper spray nozzle for the application of liquid products is critical to red...

Data: The Common Thread & Tie That Binds Exposure Science

EPA Science Inventory

While a number of ongoing efforts exist aimed at empirically measuring or modeling exposure data, problems persist regarding availability and access to this data. Innovations in managing proprietary data, establishing data quality, standardization of data sets, and sharing of exi...

Measurement and Diagnosis of Student Attitudes Toward a Career in Advertising. Working Paper Series, Center for Marketing Studies Paper No. 19.

ERIC Educational Resources Information Center

Lutz, Richard J.

A problem currently facing many advertising agencies is the recruitment of top quality business school graduates as potential account managers. Viewing the problem from a marketing perspective, a career in advertising is seen as a product competing with other careers for the market of new graduates. Then it is possible to use one of the…

Trust Management in Swarm-Based Autonomic Computing Systems

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

Maiden, Wendy M.; Haack, Jereme N.; Fink, Glenn A.

2009-07-07

Reputation-based trust management techniques can address issues such as insider threat as well as quality of service issues that may be malicious in nature. However, trust management techniques must be adapted to the unique needs of the architectures and problem domains to which they are applied. Certain characteristics of swarms such as their lightweight ephemeral nature and indirect communication make this adaptation especially challenging. In this paper we look at the trust issues and opportunities in mobile agent swarm-based autonomic systems and find that by monitoring the trustworthiness of the autonomic managers rather than the swarming sensors, the trust managementmore » problem becomes much more scalable and still serves to protect the swarms. We also analyze the applicability of trust management research as it has been applied to architectures with similar characteristics. Finally, we specify required characteristics for trust management mechanisms to be used to monitor the trustworthiness of the entities in a swarm-based autonomic computing system.« less

Parental Problem-Solving Abilities and the Association of Sickle Cell Disease Complications with Health-related Quality of Life for School-age Children

PubMed Central

Barakat, Lamia P.; Daniel, Lauren C.; Smith, Kelsey; Robinson, M. Renée; Patterson, Chavis A.

2013-01-01

Children with sickle cell disease (SCD) are at risk for poor health-related quality of life (HRQOL). The current analysis sought to explore parent problem-solving abilities/skills as a moderator between SCD complications and HRQOL to evaluate applicability to pediatric SCD. At baseline, 83 children ages 6–12 years and their primary caregiver completed measures of the child HRQOL. Primary caregivers also completed a measure of social problem-solving. A SCD complications score was computed from medical record review. Parent problem-solving abilities significantly moderated the association of SCD complications with child self-report psychosocial HRQOL (p = .006). SCD complications had a direct effect on parent proxy physical and psychosocial child HRQOL. Enhancing parent problem-solving abilities may be one approach to improve HRQOL for children with high SCD complications; however, modification of parent perceptions of HRQOL may require direct intervention to improve knowledge and skills involved in disease management. PMID:24222378

Parental problem-solving abilities and the association of sickle cell disease complications with health-related quality of life for school-age children.

PubMed

Barakat, Lamia P; Daniel, Lauren C; Smith, Kelsey; Renée Robinson, M; Patterson, Chavis A

2014-03-01

Children with sickle cell disease (SCD) are at risk for poor health-related quality of life (HRQOL). The current analysis sought to explore parent problem-solving abilities/skills as a moderator between SCD complications and HRQOL to evaluate applicability to pediatric SCD. At baseline, 83 children ages 6-12 years and their primary caregiver completed measures of child HRQOL. Primary caregivers also completed a measure of social problem-solving. A SCD complications score was computed from medical record review. Parent problem-solving abilities significantly moderated the association of SCD complications with child self-report psychosocial HRQOL (p = .006). SCD complications had a direct effect on parent proxy physical and psychosocial child HRQOL. Enhancing parent problem-solving abilities may be one approach to improve HRQOL for children with high SCD complications; however, modification of parent perceptions of HRQOL may require direct intervention to improve knowledge and skills involved in disease management.

Using machine-learning methods to analyze economic loss function of quality management processes

NASA Astrophysics Data System (ADS)

Dzedik, V. A.; Lontsikh, P. A.

2018-05-01

During analysis of quality management systems, their economic component is often analyzed insufficiently. To overcome this issue, it is necessary to withdraw the concept of economic loss functions from tolerance thinking and address it. Input data about economic losses in processes have a complex form, thus, using standard tools to solve this problem is complicated. Use of machine learning techniques allows one to obtain precise models of the economic loss function based on even the most complex input data. Results of such analysis contain data about the true efficiency of a process and can be used to make investment decisions.

Cornell University remote sensing program. [application to waste disposal site selection, study of drainage patterns, and water quality management.

NASA Technical Reports Server (NTRS)

Liang, T.; Mcnair, A. J.; Philipson, W. R.

1977-01-01

Aircraft and satellite remote sensing technology were applied in the following areas: (1) evaluation of proposed fly ash disposal sites; (2) development of priorities for drainage improvements; (3) state park analysis for rehabilitation and development; (4) watershed study for water quality planning; and (5) assistance project-landfill site selection. Results are briefly summarized. Other projects conducted include: (1) assessment of vineyard-related problems; (2) LANDSAT analysis for pheasant range management; (3) photo-historic evaluation of Revolutionary War sites; and (4) thermal analysis of building insulation. The objectives, expected benefits and actions, and status of these projects are described.

[Quality control in anesthesiology].

PubMed

Muñoz-Ramón, J M

1995-03-01

The process of quality control and auditing of anesthesiology allows us to evaluate care given by a service and solve problems that are detected. Quality control is a basic element of care giving and is only secondarily an area of academic research; it is therefore a meaningless effort if the information does not serve to improve departmental procedures. Quality assurance procedures assume certain infrastructural requirements and an initial period of implementation and adjustment. The main objectives of quality control are the reduction of morbidity and mortality due to anesthesia, assurance of the availability and proper management of resources and, finally, the well-being and safety of the patient.

Water pollution in Pakistan and its impact on public health--a review.

PubMed

Azizullah, Azizullah; Khattak, Muhammad Nasir Khan; Richter, Peter; Häder, Donat-Peter

2011-02-01

Water pollution is one of the major threats to public health in Pakistan. Drinking water quality is poorly managed and monitored. Pakistan ranks at number 80 among 122 nations regarding drinking water quality. Drinking water sources, both surface and groundwater are contaminated with coliforms, toxic metals and pesticides throughout the country. Various drinking water quality parameters set by WHO are frequently violated. Human activities like improper disposal of municipal and industrial effluents and indiscriminate applications of agrochemicals in agriculture are the main factors contributing to the deterioration of water quality. Microbial and chemical pollutants are the main factors responsible exclusively or in combination for various public health problems. This review discusses a detailed layout of drinking water quality in Pakistan with special emphasis on major pollutants, sources of pollution and the consequent health problems. The data presented in this review are extracted from various studies published in national and international journals. Also reports released by the government and non-governmental organizations are included. Copyright © 2010 Elsevier Ltd. All rights reserved.

Medication Reconciliation and Therapy Management in Dialysis-Dependent Patients: Need for a Systematic Approach

PubMed Central

Cardone, Katie E.; Manley, Harold J.; St. Peter, Wendy L.; Shaffer, Rachel; Somers, Michael; Mehrotra, Rajnish

2013-01-01

Summary Patients with ESRD undergoing dialysis have highly complex medication regimens and disproportionately higher total cost of care compared with the general Medicare population. As shown by several studies, dialysis-dependent patients are at especially high risk for medication-related problems. Providing medication reconciliation and therapy management services is critically important to avoid costs associated with medication-related problems, such as adverse drug events and hospitalizations in the ESRD population. The Medicare Modernization Act of 2003 included an unfunded mandate stipulating that medication therapy management be offered to high-risk patients enrolled in Medicare Part D. Medication management services are distinct from the dispensing of medications and involve a complete medication review for all disease states. The dialysis facility is a logical coordination center for medication management services, like medication therapy management, and it is likely the first health care facility that a patient will present to after a care transition. A dedicated and adequately trained clinician, such as a pharmacist, is needed to provide consistent, high-quality medication management services. Medication reconciliation and medication management services that could consistently and systematically identify and resolve medication-related problems would be likely to improve ESRD patient outcomes and reduce total cost of care. Herein, this work provides a review of available evidence and recommendations for optimal delivery of medication management services to ESRD patients in a dialysis facility-centered model. PMID:23990162

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

PubMed

Miller, Robert H; Bovbjerg, Randall R

2002-06-01

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

[Effectiveness of incorporating a quality management system].

PubMed

Seki, Akira; Hankins, Raleigh W; Miya, Tetsumasa

2010-01-01

In 2003, the ISO 15189 international standardization program on the quality and competence of the clinical reference laboratory was introduced. To date, 46 facilities have committed themselves to providing a higher level of medical service by incorporating a quality management system (QMS) and acquiring accreditation. QMS is defined as "setting up a policy and goals pertaining to quality, and adopting an appropriate system," and is a scheme that includes all managerial and technical factors that can affect test results. Regarding the Health Sciences Research Institute Group, 4 facilities have previously received the accreditation described above, but in the process of implementing the QMS, a number of problems have been identified. Here, we report on the effectiveness of adopting such a QMS based on the results of employee questionnaires, internal audits, customer complaint analyses, and external audits by the Japan Accreditation Board for Conformity Assessment (JAB), the official inspection body for accreditation.

The Challenge: Overcoming the Pitfalls.

ERIC Educational Resources Information Center

Lozier, G. Gregory; Teeter, Deborah J.

1993-01-01

Some organizations are having difficulty with the Total Quality Management (TQM) approach. Problems appear to come from reliance on prepackaged TQM programs, large-scale, diffuse implementation, mass training programs, measurement paralysis, overemphasis on tools, process selection, outmoded reward structures, and simplistic views of change and…

PROVIDING SAFE WATER TO RURAL NEPAL: A NOVEL WATER FILTRATION SYSTEM

EPA Science Inventory

The quality of Nepalese water sources is often compromised by pathogen contamination resulting from inadequate wastewater management, and arsenic contamination from natural and anthropogenic sources. The primary source of Nepal’s arsenic problem is suspected to arise fro...

Mission operations and command assurance: Flight operations quality improvements

NASA Technical Reports Server (NTRS)

Welz, Linda L.; Bruno, Kristin J.; Kazz, Sheri L.; Potts, Sherrill S.; Witkowski, Mona M.

1994-01-01

Mission Operations and Command Assurance (MO&CA) is a Total Quality Management (TQM) task on JPL projects to instill quality in flight mission operations. From a system engineering view, MO&CA facilitates communication and problem-solving among flight teams and provides continuous solving among flight teams and provides continuous process improvement to reduce risk in mission operations by addressing human factors. The MO&CA task has evolved from participating as a member of the spacecraft team, to an independent team reporting directly to flight project management and providing system level assurance. JPL flight projects have benefited significantly from MO&CA's effort to contain risk and prevent rather than rework errors. MO&CA's ability to provide direct transfer of knowledge allows new projects to benefit from previous and ongoing flight experience.

A problem analysis and program for watershed-management research in the White Mountains of New Hampshire

Treesearch

George R., Jr. Trimble

1959-01-01

The U. S. Forest Service was authorized by Congress in late summer of 1954 to conduct watershed management research in New Hampshire. The purpose of this work is to determine the effect of forest cover on streamflow: the influence of forest cover type, forest condition, and forest treatment practices on water yield, rate of delivery, and on water quality. This is the...

Analysis of Station Quality Issues from EarthScope's Transportable Array

NASA Astrophysics Data System (ADS)

Pfeifer, C.; Barstow, N.; Busby, R.; Hafner, K.

2008-12-01

160 of the first 400 Earthscope USARRY transportable array (TA) stations have completed their first two-year deployment and are being moved to their next locations. Over the past 4 years the majority of stations have run with few interruptions in the transfer of real time data to the Array Network Facility (ANF) at the Univ of CA San Diego and near real time data to the IRIS Data Management System (DMS). The combination of telemetered data and dedicated people reviewing the waveforms and state of health data have revealed several conditions that can affect the data quality or cause loss of data. The data problems fall into three broad categories; station power, equipment malfunction, and communication failures. Station power issues have been implicated in several types of noise seen in the seismic data (as well as causing station failures and resultant data gaps). The most common type of equipment problem that has been found to degrade data quality is caused by sensor problems, and has affected all 3 types of sensors used in the TA to varying degrees. While communication problems can cause real time data loss, they do not cause a degradation of the quality of the data, and any gaps in the real time data due solely to communications problems are filled in later with the continuous data recorded to disk at each TA station. Over the past 4 years the TA team has recognized a number of noise sources and have made several design changes to minimize the effects on data quality. Design/procedural changes include: stopping water incursion into the stations, power conditioning, changing mass re-center voltage thresholds. Figures that demonstrate examples are provided. Changes have created better data quality and improved the station performance. Vigilance and deployment of service teams to reestablish communications, replace noisy sensors, and troubleshoot problems is also key to maintaining the high-quality TA network.

The Quality Assurance Project assists the vitamin A capsule program in Antique Province, Philippines.

PubMed

Blumenfeld, S

1994-01-01

Vitamin A deficiency remains an important problem in some parts of the Philippines. The Department of Health, with assistance from the Helen Keller Institute (HKI), established a vitamin A supplementation program in Antique Province providing for the administration of vitamin A capsules to malnourished children. Although the HKI cut off its assistance in 1992, continuation of the capsule supplementation program was an element of the National Nutrition Plan for 1992-96, and remains an element of the Antique Provincial health services program under the Philippines' devolved health services scheme. The Quality Assurance Program (QAP) in May 1993 began helping the Provincial Health Office improve the quality of the vitamin A program. A systems analysis was first undertaken to identify significant deviations from provider performance standards which had been adapted by the province from Nutrition Service guidelines. Many problems were observed, including lack of knowledge of the high-priority categories of children, incomplete counseling, and frequent mistakes in determining children's nutritional status. The provincial health office staff recommended that six of the province's seventeen municipalities participate in the quality improvement effort. The intent of the QAP staff was not only to help the provincial staff improve the quality of its vitamin A program by resolving some immediate operational problems, but to provide the health care workers with a quality improvement experience that they would intuitively transfer to other programs for which they were responsible. The coaching/facilitating approach of modern quality management allowed health workers to explore their own approaches to solving the problems chosen.

Level of Adoption of Quality Management Systems Into the Mexican Pork Industry

NASA Astrophysics Data System (ADS)

Maldonado-Siman, Em; Ruíz-Flores, Agustín; Núñez-Domínguez, Rafael; González-Alcorta, Mariano; Hernández-Rodríguez, Bertha Alicia

This research studies the characteristics of the Mexican pork sector; adoption status of quality management systems, and product destinations. Ninety six percent of fifty enterprises have fully answered a questionnaire. Ninety percent are small and medium-sized, the rest are large-sized firms. Nineteen percent of them have totally adopted HACCP, sixty three percent are implementing or planning to do it, the rest have no plans to adopt it. Thirteen percent of the enterprises had ISO 9000. Thirty four percent of their sales go to supermarkets, 57% to other retail chains and 9% to exportation. Product destinations are mainly Central America, United States of America, Asia and Mexico. To improve efficiency and the quality of process it is necessary to implement HACCP. Besides, customers and legal requirements are the external factors, which result in this adoption. In the process of implementing, there are some problems, such as staff motivation and training. The results suggest that HACCP system operating is important for the Mexican pork industry. It also has relevant implications in domestic trade. It is necessary to encourage adoption of quality management systems in the sector.

Doctors and managers: poor relationships may be damaging patients—what can be done?

PubMed Central

Edwards, N

2003-01-01

The problem of poor relationships between doctors and managers is a common feature of many healthcare systems. This problem needs to be explicitly addressed and there are a number of positive steps that could be taken. Firstly, there would be value in working to improve the quality of relationships and better mutual understanding of the necessarily different positions of doctors and managers. Finding a common approach to managing resources, accountability, autonomy, and the creation of more systematic ways of working seems to be important. The use of costed clinical pathways may be one approach. Rather than seeing guidelines and accountability systems as a threat to autonomy there is an argument that they are an essential adjunct to it. Redefining autonomy in order to preserve it and to ensure that it encompasses accountability and responsibility will be an important step. A key step is the development of clinical leadership. PMID:14645744

The practical problem of improving quality in multicenter dialysis facilities.

PubMed

Balter, Paul

2003-01-01

Multifacility dialysis groups are frequently interested in improving overall quality and find that there are major differences between individual units. Upper management must consider what strategy is needed for the whole company and what strategy must be formulated by individual facilities. To make substantive changes, management must decide to adopt a new culture of true teamwork, drive out fear, and emphasize leadership and education both at the management level and in the individual unit. Both at the corporate and unit levels, leaders must be chosen who are able to recognize people who have the ability, the educational background, the enthusiasm, and the time to direct change. Empowering the individual units and individual employees to make changes and be enthusiastic about improvement is the key to success.

The association between chronic care management and the quality of thrombosis care

PubMed Central

Drewes, H.W.; Baan, C.A.; Westert, G.P.; Meijboom, B.R.; Lambooij, M.

2010-01-01

Introduction The oral anticoagulant therapy (OAT), used to prevent thrombosis, is associated with substantial avoidable hospitalization. Aim Identify the associations between chronic care management and the quality of OAT as suggested by the chronic care model (CCM) of Wagner. Methods Regression analysis with data of 61 thrombosis clinics and inductive analysis with 63 interviews with health care professionals of 23 thrombosis clinics. Results Results show substantial differences between regions in the quality of thrombosis care and the CCM activities. However, the variation in quality of care was not associated with the differences in CCM activities. The inductive analysis indicates that there are problems in the cooperation between caregivers. Several preferred CCM activities (e.g., multidisciplinary protocol) as well as the barriers to implement these activities (e.g., conflicting interests) were put forward by the health care professionals. Conclusion It can be concluded that there is variation in quality of thrombosis care between regions. This variation could not be explained by the observed differences in CCM activities. However, fragmentation is a major source of inefficiency according to health care professionals. The paper concludes with suggestions to improve chronic care management for thrombosis.

Workplace mental health: An international review of guidelines.

PubMed

Memish, Kate; Martin, Angela; Bartlett, Larissa; Dawkins, Sarah; Sanderson, Kristy

2017-08-01

The aim of this systematic review was to determine the quality and comprehensiveness of guidelines developed for employers to detect, prevent, and manage mental health problems in the workplace. An integrated approach that combined expertise from medicine, psychology, public health, management, and occupational health and safety was identified as a best practice framework to assess guideline comprehensiveness. An iterative search strategy of the grey literature was used plus consultation with experts in psychology, public health, and mental health promotion. Inclusion criteria were documents published in English and developed specifically for employers to detect, prevent, and manage mental health problems in the workplace. A total of 20 guidelines met these criteria and were reviewed. Development documents were included to inform quality assessment. This was performed using the AGREE II rating system. Our results indicated that low scores were often due to a lack of focus on prevention and rather a focus on the detection and treatment of mental health problems in the workplace. When prevention recommendations were included they were often individually focused and did not include practical tools or advice to implement. An inconsistency in language, lack of consultation with relevant population groups in the development process and a failure to outline and differentiate between the legal/minimum requirements of a region were also observed. The findings from this systematic review will inform translation of scientific evidence into practical recommendations to prevent mental health problems within the workplace. It will also direct employers, clinicians, and policy-makers towards examples of best-practice guidelines. Copyright © 2017 Elsevier Inc. All rights reserved.

An initial approach towards quality of service based Spectrum Trading

NASA Astrophysics Data System (ADS)

Bastidas, Carlos E. Caicedo; Vanhoy, Garret; Volos, Haris I.; Bose, Tamal

Spectrum scarcity has become an important issue as demands for higher data rates increase in diverse wireless applications and aerospace communication scenarios. To address this problem, it becomes necessary to manage radio spectrum assignment in a way that optimizes the distribution of spectrum resources among several users while taking into account the quality of service (QoS) characteristics desired by the users of spectrum. In this paper, a novel approach to managing spectrum assignment based on Spectrum Trading (ST) will be presented. Market based spectrum assignment mechanisms such as spectrum trading are of growing interest to many spectrum management agencies that are planning to increase the use of these mechanisms for spectrum management and reduce their emphasis on command and control methods. This paper presents some of our initial work into incorporating quality of service information into the mechanisms that determine how spectrum should be traded when using a spectrum exchange. Through simulations and a testbed implementation of a QoS aware spectrum exchange our results show the viability of using QoS based mechanisms in spectrum trading and in the enhancement of dynamic spectrum assignment systems.

Associations among everyday stress, critical life events, and sexual problems.

PubMed

Bodenmann, Guy; Ledermann, Thomas; Blattner, Denise; Galluzzo, Claudia

2006-07-01

This study addresses the question of how stress is linked to sexual problems among women and men in close relationships. Psychological symptoms, relationship quality, internal daily stress (i.e., originating within the couple such as conflicts, worry for the partner), external daily stress (i.e., stress arising outside the couple such as job stress, stressful relatives, and so forth), and critical life events were examined with regard to their association with different sexual problems. The results support the hypotheses that (1) there is an incremental effect of stress on sexual problems after controlling for psychological symptoms and relationship quality, and that (2) it is primarily internal daily stress and in some cases critical life events rather than external daily stress that are related to sexual problems, particularly hypoactive sexual desire in women and men, sexual aversion in women, vaginismus in women, and premature ejaculation in men. Our findings indicate that the treatment of these sexual problems should address relationship issues and include a focus on helping individuals improve their stress management skills within their couple relationship.

Quality Control of the Print with the Application of Statistical Methods

NASA Astrophysics Data System (ADS)

Simonenko, K. V.; Bulatova, G. S.; Antropova, L. B.; Varepo, L. G.

2018-04-01

The basis for standardizing the process of offset printing is the control of print quality indicators. The solution of this problem has various approaches, among which the most important are statistical methods. Practical implementation of them for managing the quality of the printing process is very relevant and is reflected in this paper. The possibility of using the method of constructing a Control Card to identify the reasons for the deviation of the optical density for a triad of inks in offset printing is shown.

Organized DFM

NASA Astrophysics Data System (ADS)

Sato, Takashi; Honma, Michio; Itoh, Hiroyuki; Iriki, Nobuyuki; Kobayashi, Sachiko; Miyazaki, Norihiko; Onodera, Toshio; Suzuki, Hiroyuki; Yoshioka, Nobuyuki; Arima, Sumika; Kadota, Kazuya

2009-04-01

The category and objective of DFM production management are shown. DFM is not limited to an activity within a particular unit process in design and process. A new framework for DFM is required. DFM should be a total solution for the common problems of all processes. Each of them must be linked to one another organically. After passing through the whole of each process on the manufacturing platform, quality of final products is guaranteed and products are shipped to the market. The information platform is layered with DFM, APC, and AEC. Advanced DFM is not DFM for partial optimization of the lithography process and the design, etc. and it should be Organized DFM. They are managed with high-level organizational IQ. The interim quality between each step of the flow should be visualized. DFM will be quality engineering if it is Organized DFM and common metrics of the quality are provided. DFM becomes quality engineering through effective implementation of common industrial metrics and standardized technology. DFM is differential technology, but can leverage standards for efficient development.

Modelling raw water quality: development of a drinking water management tool.

PubMed

Kübeck, Ch; van Berk, W; Bergmann, A

2009-01-01

Ensuring future drinking water supply requires a tough management of groundwater resources. However, recent practices of economic resource control often does not involve aspects of the hydrogeochemical and geohydraulical groundwater system. In respect of analysing the available quantity and quality of future raw water, an effective resource management requires a full understanding of the hydrogeochemical and geohydraulical processes within the aquifer. For example, the knowledge of raw water quality development within the time helps to work out strategies of water treatment as well as planning finance resources. On the other hand, the effectiveness of planed measurements reducing the infiltration of harmful substances such as nitrate can be checked and optimized by using hydrogeochemical modelling. Thus, within the framework of the InnoNet program funded by Federal Ministry of Economics and Technology, a network of research institutes and water suppliers work in close cooperation developing a planning and management tool particularly oriented on water management problems. The tool involves an innovative material flux model that calculates the hydrogeochemical processes under consideration of the dynamics in agricultural land use. The program integrated graphical data evaluation is aligned on the needs of water suppliers.

Valuing preferences over stormwater management outcomes including improved hydrologic function

NASA Astrophysics Data System (ADS)

LondoñO Cadavid, Catalina; Ando, Amy W.

2013-07-01

Stormwater runoff causes environmental problems such as flooding, soil erosion, and water pollution. Conventional stormwater management has focused primarily on flood reduction, while a new generation of decentralized stormwater solutions yields ancillary benefits such as healthier aquatic habitat, improved surface water quality, and increased water table recharge. Previous research has estimated values for flood reduction from stormwater management, but no estimates exist for the willingness to pay (WTP) for some of the other environmental benefits of alternative approaches to stormwater control. This paper uses a choice experiment survey of households in Champaign-Urbana, Illinois, to estimate the values of several attributes of stormwater management outcomes. We analyzed data from 131 surveyed households in randomly selected neighborhoods. We find that people value reduced basement flooding more than reductions in yard or street flooding, but WTP for basement flood reduction in the area only exists if individuals are currently experiencing significant flooding themselves. Citizens value both improved water quality and improved hydrologic function and aquatic habitat from runoff reduction. Thus, widespread investment in low impact development stormwater solutions could have very large total benefits, and stormwater managers should be wary of policies and infrastructure plans that reduce flooding at the expense of water quality and aquatic habitat.

Four Sides to Every Story: Creating Effective Multimedia Business Simulations.

ERIC Educational Resources Information Center

Graham, William; Legere, Sylvie M.

1998-01-01

Discusses the goal-based design concepts used to build a CD-ROM-based course for senior executives at Andersen Consulting. Topics include quality management; continuous improvement; problem-centered learning; video storytelling; feedback; multimedia learning environments; course organization; and possible future applications. (Author/LRW)

WATERSHED CENTRAL: AN INTEGRATED WATERSHED ASSESSMENT AND MANAGEMENT WEBSITE

EPA Science Inventory

The Clean Water Act (CWA) requires that States develop pollution reduction targets for impaired or threatened waters often referred to as total maximum daily loads (TMDLs). These are waters that do not meet state water quality standards or will have impending problems meeting th...

Space transportation system flight 2 OSTA-1 scientific payload data management plan: Addendum

NASA Technical Reports Server (NTRS)

1982-01-01

Flight events for the OSTA-1 scientific payload on the second flight of the Space Shuttle, STS-2 are described. Data acquisition is summarized. A discussion of problems encountered and a preliminary evaluation of data quality is also provided.

A novel symbiotic organisms search algorithm for congestion management in deregulated environment

NASA Astrophysics Data System (ADS)

Verma, Sumit; Saha, Subhodip; Mukherjee, V.

2017-01-01

In today's competitive electricity market, managing transmission congestion in deregulated power system has created challenges for independent system operators to operate the transmission lines reliably within the limits. This paper proposes a new meta-heuristic algorithm, called as symbiotic organisms search (SOS) algorithm, for congestion management (CM) problem in pool based electricity market by real power rescheduling of generators. Inspired by interactions among organisms in ecosystem, SOS algorithm is a recent population based algorithm which does not require any algorithm specific control parameters unlike other algorithms. Various security constraints such as load bus voltage and line loading are taken into account while dealing with the CM problem. In this paper, the proposed SOS algorithm is applied on modified IEEE 30- and 57-bus test power system for the solution of CM problem. The results, thus, obtained are compared to those reported in the recent state-of-the-art literature. The efficacy of the proposed SOS algorithm for obtaining the higher quality solution is also established.

A novel symbiotic organisms search algorithm for congestion management in deregulated environment

NASA Astrophysics Data System (ADS)

Verma, Sumit; Saha, Subhodip; Mukherjee, V.

2017-01-01

In today's competitive electricity market, managing transmission congestion in deregulated power system has created challenges for independent system operators to operate the transmission lines reliably within the limits. This paper proposes a new meta-heuristic algorithm, called as symbiotic organisms search (SOS) algorithm, for congestion management (CM) problem in pool-based electricity market by real power rescheduling of generators. Inspired by interactions among organisms in ecosystem, SOS algorithm is a recent population-based algorithm which does not require any algorithm specific control parameters unlike other algorithms. Various security constraints such as load bus voltage and line loading are taken into account while dealing with the CM problem. In this paper, the proposed SOS algorithm is applied on modified IEEE 30- and 57-bus test power system for the solution of CM problem. The results, thus, obtained are compared to those reported in the recent state-of-the-art literature. The efficacy of the proposed SOS algorithm for obtaining the higher quality solution is also established.

An environmental approach for used oil management in Asian cities: a Bangkok' s experience.

PubMed

Leong, Shing Tet; Laortanakul, Preecha

2003-11-01

This paper addresses increasing concern about the pollution threat of used oil being illegally dumped and the impact of oil on air pollution and freshwater ecosystems in Asian countries. Used oil is a very serious waste management problem. These results call for management action such as maximising the collection and recovery of used oil. The Thai government recognizes the need to recycle used oil and has been active in encouraging programs to accomplish this goal. Thus unless new approaches and incentives are developed, used oil generation may become an increasing serious problem to our environment. The purpose of this study is to examine the technical and economic feasibility, of recycling used oils. In addition, this paper briefly discusses the problems to be overcome and outlines potential mechanisms for providing the necessary disposal controls in order to maximize the protection to public health and environmental quality from potential hazards posed by used lube oil disposal.

Reflective action assessment with a prospective clinical problem solving tool in the context of rehabilitation medicine: an illustrative case study.

PubMed

Kellett, David; Mpofu, Elias; Madden, Richard

2013-06-01

This study describes a case formulation approach applying a prospective ICF derived clinical tool to assess rehabilitation needs for a community dwelling stroke survivor with care from an outpatient rehabilitation medicine clinic. Case history data on the person were assessed for rehabilitation management planning using a prospective tool to interlink current with projected future functional status in everyday settings. Implicit assessment with reflective action informed decision points at each stage of the rehabilitation process. As a result of reflective action using the prospective tool, rehabilitation management led to significant changes in client participation after limitations to mobility and self care were mapped to the living conditions of the stroke survivor. The context sensitive rehabilitative plan resulted in higher subjective health-related quality of life in the stroke survivor and significant other and enhanced their capacity for participation. Reflective action informed assessment applying ICF concepts to clinical problem solving resulted in positive gains in health-related quality of life in a stroke survivor.

Bowel function and quality of life after colostomy in individuals with spinal cord injury.

PubMed

Bølling Hansen, Rikke; Staun, Michael; Kalhauge, Anna; Langholz, Ebbe; Biering-Sørensen, Fin

2016-05-01

To evaluate the effect of colostomy on bowel function and quality of life (QoL) in individuals with spinal cord injury (SCI). Cross-sectional descriptive study. Department for Spinal Cord Injuries and Departments of Gastroenterology and Radiology, Rigshospitalet. Eighteen individuals with SCI and a colostomy performed post injury, 12 males, 6 females, 8 with tetraplegia and 10 with paraplegia. Median age at time of study was 49.9 years, years since lesion was 3-56 years, and time since colostomy was performed 0.5 to 20 years. Questionnaires and measurement of gastrointestinal transit time (GITT). Retrospective data collection from patient records, a questionnaire on bowel management pre and post colostomy, quality of life (QoL) by SF-36, and GITT. Seventy-two percent significantly reduced their use of time on bowel emptying after the colostomy. All but one reported being content with the colostomy. Thirty-nine percent reported one or more problems related to the colostomy. Seventy-five percent had a GITT within normal range for able-bodied populations. When disregarding the physical component, QoL was not significantly lower in the total study group compared to a Danish norm group, but significantly lower when compared the subgroup of persons with tetraplegia. A colostomy reduces the time necessary for bowel management. The majority of individuals with SCI and a colostomy did not perceive bowel management as being a problem. The results indicate that colostomy is a favourable option for individuals with SCI, who spend long hours on bowel management and for whom non-invasive procedures did not improve the situation enough.

Evaluating health service quality: using importance performance analysis.

PubMed

Izadi, Azar; Jahani, Younes; Rafiei, Sima; Masoud, Ali; Vali, Leila

2017-08-14

Purpose Measuring healthcare service quality provides an objective guide for managers and policy makers to improve their services and patient satisfaction. Consequently, the purpose of this paper is to measure service quality provided to surgical and medical inpatients at Kerman Medical Sciences University (KUMS) in 2015. Design/methodology/approach A descriptive-analytic study, using a cross-sectional method in the KUMS training hospitals, was implemented between October 2 and March 15, 2015. Using stratified random sampling, 268 patients were selected. Data were collected using an importance-performance analysis (IPA) questionnaire, which measures current performance and determines each item's importance from the patients' perspectives. These data indicate overall satisfaction and appropriate practical strategies for managers to plan accordingly. Findings Findings revealed a significant gap between service importance and performance. From the patients' viewpoint, tangibility was the highest priority (mean=3.54), while reliability was given the highest performance (mean=3.02). The least important and lowest performance level was social accountability (mean=1.91 and 1.98, respectively). Practical implications Healthcare managers should focus on patient viewpoints and apply patient comments to solve problems, improve service quality and patient satisfaction. Originality/value The authors applied an IPA questionnaire to measure service quality provided to surgical and medical ward patients. This method identifies and corrects service quality shortcomings and improving service recipient perceptions.

An innovative time-cost-quality tradeoff modeling of building construction project based on resource allocation.

PubMed

Hu, Wenfa; He, Xinhua

2014-01-01

The time, quality, and cost are three important but contradictive objectives in a building construction project. It is a tough challenge for project managers to optimize them since they are different parameters. This paper presents a time-cost-quality optimization model that enables managers to optimize multiobjectives. The model is from the project breakdown structure method where task resources in a construction project are divided into a series of activities and further into construction labors, materials, equipment, and administration. The resources utilized in a construction activity would eventually determine its construction time, cost, and quality, and a complex time-cost-quality trade-off model is finally generated based on correlations between construction activities. A genetic algorithm tool is applied in the model to solve the comprehensive nonlinear time-cost-quality problems. Building of a three-storey house is an example to illustrate the implementation of the model, demonstrate its advantages in optimizing trade-off of construction time, cost, and quality, and help make a winning decision in construction practices. The computational time-cost-quality curves in visual graphics from the case study prove traditional cost-time assumptions reasonable and also prove this time-cost-quality trade-off model sophisticated.

The Effectiveness of self management program on quality of life in patients with sickle cell disease

PubMed Central

Ahmadi, M; Jahani, S; Poormansouri, S; Shariati, A; Tabesh, H

2015-01-01

Background Sickle cell patients suffer from many physical, psychological, and social problems that can affect their quality of life. To deal with this chronic condition and manage their disease and prevent complications associated with the disease, they must learn skills and behaviours. The aim of this study was to determine the effectiveness of self-management programs on quality of life in these patients. Material and Methods Samples of this quasi-experimental study, which included 69 patients with sickle cell disease referring to the Thalassemia Clinic of Shafa Hospital, were entered into the study by census method. Patients received a self-management program using the 5A model for 12 weeks, while their quality of life before the intervention were assessed at the twelfth week and thirty-sixth week using SF-36 questionnaire. Data were analyzed by descriptive statistics, paired t-test, Wilcoxon test, Hotelling's T2, and repeated measures test. Results The eight dimensions and the total QoL score after intervention were significantly increased compared to those before the intervention (P<0.001). Repeated measures test showed that the mean score of eight QoL dimensions and the total QoL score decreased in the thirty-sixth week, compared to twelfth week. However, it was significantly enhanced in comparison with the intervention baseline (P<0.05). Conclusions Current study revealed the efficacy of self-management interventions on the quality of life in patients with sickle cell disease. Therefore, application of this supportive method could be useful to empower the patients and help them to manage the disease. PMID:25914799

Managed care strategy for mental health services.

PubMed

Jones, A

In the UK, managed care is beginning to be recognized as a cost effective, quality-driven system which can be used to structure patient care. This article examines the potential use of managed care pathways in mental health services, focusing on clients with schizophrenia. The strengths of managed care include the effective coordination of healthcare resources, the clear accountable audit of mental health practice and the re-engineering of mental health practice to improve patient outcomes. Problems in designing representative care pathways and encouraging healthcare providers to implement care pathways are some of the disadvantages of this system.

Internet of Things technology-based management methods for environmental specimen banks.

PubMed

Peng, Lihong; Wang, Qian; Yu, Ang

2015-02-01

The establishment and management of environmental specimen banks (ESBs) has long been a problem worldwide. The complexity of specimen environment has made the management of ESB likewise complex. Through an analysis of the development and management of ESBs worldwide and in light of the sophisticated Internet of Things (IOT) technology, this paper presents IOT technology-based ESB management methods. An IOT technology-based ESB management system can significantly facilitate ESB ingress and egress management as well as long-term storage management under quality control. This paper elaborates on the design of IOT technology-based modules, which can be used in ESB management to achieve standardized, smart, information-based ESB management. ESB management has far-reaching implications for environmental management and for research in environmental science.

Recommendations for managing cutaneous disorders associated with advancing age

PubMed Central

Humbert, Philippe; Dréno, Brigitte; Krutmann, Jean; Luger, Thomas Anton; Triller, Raoul; Meaume, Sylvie; Seité, Sophie

2016-01-01

The increasingly aged population worldwide means more people are living with chronic diseases, reduced autonomy, and taking various medications. Health professionals should take these into consideration when managing dermatological problems in elderly patients. Accordingly, current research is investigating the dermatological problems associated with the loss of cutaneous function with age. As cell renewal slows, the physical and chemical barrier function declines, cutaneous permeability increases, and the skin becomes increasingly vulnerable to external factors. In geriatric dermatology, the consequences of cutaneous aging lead to xerosis, skin folding, moisture-associated skin damage, and impaired wound healing. These problems pose significant challenges for both the elderly and their carers. Most often, nurses manage skin care in the elderly. However, until recently, little attention has been paid to developing appropriate, evidence-based, skincare protocols. The objective of this paper is to highlight common clinical problems with aging skin and provide some appropriate advice on cosmetic protocols for managing them. A review of the literature from 2004 to 2014 using PubMed was performed by a working group of six European dermatologists with clinical and research experience in dermatology. Basic topical therapy can restore and protect skin barrier function, which relieves problems associated with xerosis, prevents aggravating moisture-associated skin damage, and enhances quality of life. In conclusion, the authors provide physicians with practical recommendations to assist them in implementing basic skin care for the elderly in an integrated care approach. PMID:26929610

Teaching organization theory for healthcare management: three applied learning methods.

PubMed

Olden, Peter C

2006-01-01

Organization theory (OT) provides a way of seeing, describing, analyzing, understanding, and improving organizations based on patterns of organizational design and behavior (Daft 2004). It gives managers models, principles, and methods with which to diagnose and fix organization structure, design, and process problems. Health care organizations (HCOs) face serious problems such as fatal medical errors, harmful treatment delays, misuse of scarce nurses, costly inefficiency, and service failures. Some of health care managers' most critical work involves designing and structuring their organizations so their missions, visions, and goals can be achieved-and in some cases so their organizations can survive. Thus, it is imperative that graduate healthcare management programs develop effective approaches for teaching OT to students who will manage HCOs. Guided by principles of education, three applied teaching/learning activities/assignments were created to teach OT in a graduate healthcare management program. These educationalmethods develop students' competency with OT applied to HCOs. The teaching techniques in this article may be useful to faculty teaching graduate courses in organization theory and related subjects such as leadership, quality, and operation management.

Water quality and management of private drinking water wells in Pennsylvania.

PubMed

Swistock, Bryan R; Clemens, Stephanie; Sharpe, William E; Rummel, Shawn

2013-01-01

Pennsylvania has over three million rural residents using private water wells for drinking water supplies but is one of the few states that lack statewide water well construction or management standards. The study described in this article aimed to determine the prevalence and causes of common health-based pollutants in water wells and evaluate the need for regulatory management along with voluntary educational programs. Water samples were collected throughout Pennsylvania by Master Well Owner Network volunteers trained by Penn State Extension. Approximately 40% of the 701 water wells sampled failed at least one health-based drinking water standard. The prevalence of most water quality problems was similar to past studies although both lead and nitrate-N were reduced over the last 20 years. The authors' study suggests that statewide water well construction standards along with routine water testing and educational programs to assist water well owners would result in improved drinking water quality for private well owners in Pennsylvania.

Creating a testing field where delta technology and water innovations are tested and demonstrated with the help of citizen science methods

NASA Astrophysics Data System (ADS)

de Vries, Sandra; Rutten, Martine; de Vries, Liselotte; Anema, Kim; Klop, Tanja; Kaspersma, Judith

2017-04-01

In highly populated deltas, much work is to be done. Complex problems ask for new and knowledge driven solutions. Innovations in delta technology and water can bring relief to managing the water rich urban areas. Testing fields form a fundamental part of the knowledge valorisation for such innovations. In such testing fields, product development by start-ups is coupled with researchers, thus supplying new scientific insights. With the help of tests, demonstrations and large-scale applications by the end-users, these innovations find their way to the daily practices of delta management. More and more cities embrace the concept of Smart Cities to tackle the ongoing complexity of urban problems and to manage the city's assets - such as its water supply networks and other water management infrastructure. Through the use of new technologies and innovative systems, data are collected from and with citizens and devices - then processed and analysed. The information and knowledge gathered are keys to enabling a better quality of life. By testing water innovations together with citizens in order to find solutions for water management problems, not only highly spatial amounts of data are provided by and/or about these innovations, they are also improved and demonstrated to the public. A consortium consisting of a water authority, a science centre, a valorisation program and two universities have joined forces to create a testing field for delta technology and water innovations using citizen science methods. In this testing field, the use of citizen science for water technologies is researched and validated by facilitating pilot projects. In these projects, researchers, start-ups and citizens work together to find the answer to present-day water management problems. The above mentioned testing field tests the use of crowd-sourcing data as for example hydrological model inputs, or to validate remote sensing applications, or improve water management decisions. Currently the testing field starts two pilot projects concerning (1) the validation of green measures used for water storage in order to better quantify their worth, and (2) the collection of water quality data in a polder polluted by horticulture in such manner that water management and awareness are improved.

Managing Nonpoint Source Pollution in Western Washington: Landowner Learning Methods and Motivations

NASA Astrophysics Data System (ADS)

Ryan, Clare M.

2009-06-01

States, territories, and tribes identify nonpoint source pollution as responsible for more than half of the Nation’s existing and threatened water quality impairments, making it the principal remaining cause of water quality problems across the United States. Combinations of education, technical and financial assistance, and regulatory measures are used to inform landowners about nonpoint source pollution issues, and to stimulate the use of best management practices. A mail survey of non-commercial riparian landowners investigated how they learn about best management practices, the efficacy of different educational techniques, and what motivates them to implement land management activities. Landowners experience a variety of educational techniques, and rank those that include direct personal contact as more effective than brochures, advertisements, radio, internet, or television. The most important motivations for implementing best management practices were linked with elements of a personal stewardship ethic, accountability, personal commitment, and feasibility. Nonpoint source education and social marketing campaigns should include direct interpersonal contacts, and appeal to landowner motivations of caring, responsibility, and personal commitment.

A case study in the practical use of LANDSAT data

NASA Technical Reports Server (NTRS)

Cox, S.

1982-01-01

The use of computer aided classification of LANDSAT data in developing water quality plans for New Jersey watersheds is used to exemplify how a state natural resource management program benefits from satellite imagery. The transition of a research and development system into an operational remote sensing system to help decision makers is demonstrated. Nontechnial issues that can assist (or hinder) an agency in adopting a new technology are examined. The progress of LANDSAT use by state government from the earliest stage of curiosity through to incorporation in actual state planning methods is charted. Potential applications of LANDSAT data to real information needs and solutions to management problems are examined. The problems and mistakes that occurred in using LANDSAT data in the past are discussed as well as the ways by which these problems were overcome.

Socio-Technical Systems Analysis in Health Care: A Research Agenda

PubMed Central

Bass, Ellen; Bellandi, Tommaso; Gurses, Ayse; Hallbeck, Susan; Mollo, Vanina

2012-01-01

Given the complexity of health care and the ‘people’ nature of healthcare work and delivery, STSA (Sociotechnical Systems Analysis) research is needed to address the numerous quality of care problems observed across the world. This paper describes open STSA research areas, including workload management, physical, cognitive and macroergonomic issues of medical devices and health information technologies, STSA in transitions of care, STSA of patient-centered care, risk management and patient safety management, resilience, and feedback loops between event detection, reporting and analysis and system redesign. PMID:22611480

Getting the most from outsourcing.

PubMed

Mak, C

1996-04-01

Outsourcing is common in the business world for its cost saving benefits. This article examines outsourcing as it is used in the Hong Kong healthcare setting for security services and assesses its outcomes in terms of cost, quality, performance, and control. The author reports on several management problems, and makes suggestions for effective outsourcing practices. Hospitals are advised to prepare and manage their contracts as if they were run in-house. Administrators who manage hospitals must examine their operations and try to add value to services where applicable, including outsourced services.

An overview of the management of patients with chronic pancreatitis.

PubMed

Johnstone, Carolyn C

2016-11-23

Chronic pancreatitis is a complex inflammatory condition characterised by irreversible damage to the pancreas. This article explores the pathophysiology of this condition and its effects on pancreatic function. It outlines the causes and presenting features of chronic pancreatitis, as well as its effect on patients' quality of life and the changes to their lifestyle that are likely to be required. Chronic pancreatitis cannot be cured; therefore, treatment aims to control pain, manage problems associated with malabsorption, and assess and manage long-term complications that may develop, such as insulin dependence.

Small business, cash budgets and general practice.

PubMed

Jackson, A R

1991-01-01

In practice management, general practice falls into the category of small business with all its attendant generic problems. Disciplined planning and good financial management are not often seen in small business. These are required if general practitioners are to continue (or return to) the provision of high quality medical services. An effective budget process, especially cash-flow budgeting, is the key to successful planning and financial management. Budgeting will bring Control, Co-ordination, and Credibility to your practice. It will enable you to set goals and to achieve them.

Hanford Site Composite Analysis Technical Approach Description: Automated Quality Assurance Process Design.

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

Dockter, Randy E.

2017-07-31

The U.S. Department of Energy (DOE) in DOE O 435.1 Chg. 1, Radioactive Waste Management, requires the preparation and maintenance of a composite analysis (CA). The primary purpose of the CA is to provide a reasonable expectation that the primary public dose limit is not likely to be exceeded by multiple source terms that may significantly interact with plumes originating at a low-level waste disposal facility. The CA is used to facilitate planning and land use decisions that help assure disposal facility authorization will not result in long-term compliance problems; or, to determine management alternatives, corrective actions, or assessment needsmore » if potential problems are identified.« less

The application of remote sensing to resource management and environmental quality programs in Kansas

NASA Technical Reports Server (NTRS)

Barr, B. G.

1975-01-01

Specific assistance to state agencies and public bodies on over 15 remote sensing projects concerned with (1) urban and regional analysis, (2) rural development, and (3) habitat management and environmental analysis is discussed. Specific problems of officials are considered and a basis for communication by demonstration is provided. In addition to data products in support of specific agency projects; consultation and training in use of satellite and aircraft imagery is provided to personnel from several state, regional, and county agencies. Effective communication and confidence is established through these efforts and users now routinely seek information and advice about the application of remote sensing technology to solution of their agency problems.

Adopting Extensible Business Reporting Language (XBRL): A Grounded Theory

ERIC Educational Resources Information Center

Cruz, Marivic

2010-01-01

In 2007 and 2008, government challenges consisted of error prone, manually intensive, and inefficient environments for financial reporting. Banking regulators worldwide faced issues with respect to transparency, timeliness, quality, and managing risks associated with accounting opacity. The general problem was the existing reporting standards and…

Public Libraries: Responding to Demand.

ERIC Educational Resources Information Center

Annichiarico, Mark; And Others

1993-01-01

Discussion of problems library wholesalers/distributors face trying to fulfill public libraries' needs while adjusting to a changing industry is based on responses by librarians to a survey on library jobbers. Increased services to libraries, electronic ordering, timeliness, stock management, and quality control are addressed; and a chart of…

USING STATISTICAL METHODS FOR WATER QUALITY MANAGEMENT: ISSUES, PROBLEMS AND SOLUTIONS

EPA Science Inventory

This book is readable, comprehensible and I anticipate, usable. The author has an enthusiasm which comes out in the text. Statistics is presented as a living breathing subject, still being debated, defined, and refined. This statistics book actually has examples in the field...

SWMM 5 - A Case Study of Model Re-Development

EPA Science Inventory

By the turn of the 21st century the U.S. Environmental Protection Agency’s (EPA) Storm Water Management Model (SWMM) already had a 30-year history of extensive use throughout the world for analyzing complex hydrologic, hydraulic, and water quality problems related to urban draina...

Watershed Central: An Integrated Watershed Assessment and Management Website - St. Louis

EPA Science Inventory

The Clean Water Act (CWA) requires that States develop pollution reduction targets for impaired or threatened waters often referred to as total maximum daily loads (TMDLs). These are waters that do not meet state water quality standards or will have impending problems meeting th...

WATERSHED CENTRAL: AN INTEGRATED WATERSHED ASSESSMENT AND MANAGEMENT WEBSITE (PRESENTATION)

EPA Science Inventory

The Clean Water Act (CWA) requires that States develop pollution reduction targets for impaired or threatened waters often referred to as total maximum daily loads (TMDLs). These are waters that do not meet state water quality standards or will have impending problems meeting th...

WATERSHED CENTRAL: AN INTEGRATED WATERSHED ASSESSMENT AND MANAGEMENT WEBSITE (2)

EPA Science Inventory

The Clean Water Act (CWA) requires that States develop pollution reduction targets for impaired or threatened waters often referred to as total maximum daily loads (TMDLs). These are waters that do not meet state water quality standards or will have impending problems meeting th...

Key Performance Indicators in Radiology: You Can't Manage What You Can't Measure.

PubMed

Harvey, H Benjamin; Hassanzadeh, Elmira; Aran, Shima; Rosenthal, Daniel I; Thrall, James H; Abujudeh, Hani H

2016-01-01

Quality assurance (QA) is a fundamental component of every successful radiology operation. A radiology QA program must be able to efficiently and effectively monitor and respond to quality problems. However, as radiology QA has expanded into the depths of radiology operations, the task of defining and measuring quality has become more difficult. Key performance indicators (KPIs) are highly valuable data points and measurement tools that can be used to monitor and evaluate the quality of services provided by a radiology operation. As such, KPIs empower a radiology QA program to bridge normative understandings of health care quality with on-the-ground quality management. This review introduces the importance of KPIs in health care QA, a framework for structuring KPIs, a method to identify and tailor KPIs, and strategies to analyze and communicate KPI data that would drive process improvement. Adopting a KPI-driven QA program is both good for patient care and allows a radiology operation to demonstrate measurable value to other health care stakeholders. Copyright © 2015 Mosby, Inc. All rights reserved.

Clean Watersheds Needs Survey (CWNS) 2008 Report to Congress

EPA Pesticide Factsheets

The Environmental Protection Agency's CWNS is required by Sections 205(a) and 516(b)(1) of the CWA. The CWNS is a summary of the estimated capital costs for water quality projects and other activities eligible for SRF support as authorized by the 1987 CWA Amendments. The Clean Watersheds Needs Survey (CWNS) 2008 Report to Congress summarizes the results of EPA's 15th national survey of capital costs to address water quality or water quality related public health problems. The total wastewater and stormwater management needs for the nation are $298.1 billion as of January 1, 2008. This amount includes $192.2 billion for wastewater treatment plants, pipe repairs, and buying and installing new pipes; $63.6 billion for combined sewer overflow correction; and $42.3 billion for stormwater management. Small communities have documented needs of $22.7 billion.

Precipitation data in a mountainous catchment in Honduras: quality assessment and spatiotemporal characteristics

NASA Astrophysics Data System (ADS)

Westerberg, I.; Walther, A.; Guerrero, J.-L.; Coello, Z.; Halldin, S.; Xu, C.-Y.; Chen, D.; Lundin, L.-C.

2010-08-01

An accurate description of temporal and spatial precipitation variability in Central America is important for local farming, water supply and flood management. Data quality problems and lack of consistent precipitation data impede hydrometeorological analysis in the 7,500 km2 Choluteca River basin in central Honduras, encompassing the capital Tegucigalpa. We used precipitation data from 60 daily and 13 monthly stations in 1913-2006 from five local authorities and NOAA's Global Historical Climatology Network. Quality control routines were developed to tackle the specific data quality problems. The quality-controlled data were characterised spatially and temporally, and compared with regional and larger-scale studies. Two gap-filling methods for daily data and three interpolation methods for monthly and mean annual precipitation were compared. The coefficient-of-correlation-weighting method provided the best results for gap-filling and the universal kriging method for spatial interpolation. In-homogeneity in the time series was the main quality problem, and 22% of the daily precipitation data were too poor to be used. Spatial autocorrelation for monthly precipitation was low during the dry season, and correlation increased markedly when data were temporally aggregated from a daily time scale to 4-5 days. The analysis manifested the high spatial and temporal variability caused by the diverse precipitation-generating mechanisms and the need for an improved monitoring network.

Patient safety is not enough: targeting quality improvements to optimize the health of the population.

PubMed

Woolf, Steven H

2004-01-06

Ensuring patient safety is essential for better health care, but preoccupation with niches of medicine, such as patient safety, can inadvertently compromise outcomes if it distracts from other problems that pose a greater threat to health. The greatest benefit for the population comes from a comprehensive view of population needs and making improvements in proportion with their potential effect on public health; anything less subjects an excess of people to morbidity and death. Patient safety, in context, is a subset of health problems affecting Americans. Safety is a subcategory of medical errors, which also includes mistakes in health promotion and chronic disease management that cost lives but do not affect "safety." These errors are a subset of lapses in quality, which result not only from errors but also from systemic problems, such as lack of access, inequity, and flawed system designs. Lapses in quality are a subset of deficient caring, which encompasses gaps in therapeutics, respect, and compassion that are undetected by normative quality indicators. These larger problems arguably cost hundreds of thousands more lives than do lapses in safety, and the system redesigns to correct them should receive proportionately greater emphasis. Ensuring such rational prioritization requires policy and medical leaders to eschew parochialism and take a global perspective in gauging health problems. The public's well-being requires policymakers to view the system as a whole and consider the potential effect on overall population health when prioritizing care improvements and system redesigns.

Understanding enabling capacities for managing the 'wicked problem' of nonpoint source water pollution in catchments: a conceptual framework.

PubMed

Patterson, James J; Smith, Carl; Bellamy, Jennifer

2013-10-15

Nonpoint source (NPS) water pollution in catchments is a 'wicked' problem that threatens water quality, water security, ecosystem health and biodiversity, and thus the provision of ecosystem services that support human livelihoods and wellbeing from local to global scales. However, it is a difficult problem to manage because water catchments are linked human and natural systems that are complex, dynamic, multi-actor, and multi-scalar in nature. This in turn raises questions about understanding and influencing change across multiple levels of planning, decision-making and action. A key challenge in practice is enabling implementation of local management action, which can be influenced by a range of factors across multiple levels. This paper reviews and synthesises important 'enabling' capacities that can influence implementation of local management action, and develops a conceptual framework for understanding and analysing these in practice. Important enabling capacities identified include: history and contingency; institutional arrangements; collaboration; engagement; vision and strategy; knowledge building and brokerage; resourcing; entrepreneurship and leadership; and reflection and adaptation. Furthermore, local action is embedded within multi-scalar contexts and therefore, is highly contextual. The findings highlight the need for: (1) a systemic and integrative perspective for understanding and influencing change for managing the wicked problem of NPS water pollution; and (2) 'enabling' social and institutional arenas that support emergent and adaptive management structures, processes and innovations for addressing NPS water pollution in practice. These findings also have wider relevance to other 'wicked' natural resource management issues facing similar implementation challenges. Copyright © 2013 Elsevier Ltd. All rights reserved.

Dry mouth: Xerostomia and salivary gland hypofunction.

PubMed

Frydrych, Agnieszka M

2016-07-01

Mouth dryness may present as salivary gland hypofunction (SGH), xerostomia or both. It is considered one of the most underappreciated, underdiagnosed and undermanaged oral health conditions. Despite its common presentation and adverse impact on life quality, it is also generally poorly understood. Increased awareness of the condition is important in addressing these problems. This article discusses SGH and xerostomia, and the associated intra-oral and extra-oral implications. It also summarises currently available management approaches and the evidence behind them. SGH and xerostomia are complex problems. None of the currently available management approaches are entirely satisfactory. Addressing the causative or contributing factors is therefore paramount. While oral health complaints are generally left up to the dental professional to manage, the nature of mouth dryness necessitates increased dialogue between the dental and 
medical professions to ensure optimal patient care.

Status of surface-water modeling in the U.S. Geological Survey

USGS Publications Warehouse

Jennings, Marshall E.; Yotsukura, Nobuhiro

1979-01-01

The U.S. Geological Survey is active in the development and use of models for the analysis of various types of surface-water problems. Types of problems for which models have been, or are being developed, include categories such as the following: (1)specialized hydraulics, (2)flow routing in streams, estuaries, lakes, and reservoirs, (3) sedimentation, (4) transport of physical, chemical, and biological constituents, (5) surface exchange of heat and mass, (6) coupled stream-aquifer flow systems, (7) physical hydrology for rainfall-runoff relations, stream-system simulations, channel geometry, and water quality, (8) statistical hydrology for synthetic streamflows, floods, droughts, storage, and water quality, (9) management and operation problems, and (10) miscellaneous hydrologic problems. Following a brief review of activities prior to 1970, the current status of surface-water modeling is given as being in a developmental, verification, operational, or continued improvement phase. A list of recently published selected references, provides useful details on the characteristics of models.

Improving Histopathology Laboratory Productivity: Process Consultancy and A3 Problem Solving.

PubMed

Yörükoğlu, Kutsal; Özer, Erdener; Alptekin, Birsen; Öcal, Cem

2017-01-01

The ISO 17020 quality program has been run in our pathology laboratory for four years to establish an action plan for correction and prevention of identified errors. In this study, we aimed to evaluate the errors that we could not identify through ISO 17020 and/or solve by means of process consulting. Process consulting is carefully intervening in a group or team to help it to accomplish its goals. The A3 problem solving process was run under the leadership of a 'workflow, IT and consultancy manager'. An action team was established consisting of technical staff. A root cause analysis was applied for target conditions, and the 6-S method was implemented for solution proposals. Applicable proposals were activated and the results were rated by six-sigma analysis. Non-applicable proposals were reported to the laboratory administrator. A mislabelling error was the most complained issue triggering all pre-analytical errors. There were 21 non-value added steps grouped in 8 main targets on the fish bone graphic (transporting, recording, moving, individual, waiting, over-processing, over-transaction and errors). Unnecessary redundant requests, missing slides, archiving issues, redundant activities, and mislabelling errors were proposed to be solved by improving visibility and fixing spaghetti problems. Spatial re-organization, organizational marking, re-defining some operations, and labeling activities raised the six sigma score from 24% to 68% for all phases. Operational transactions such as implementation of a pathology laboratory system was suggested for long-term improvement. Laboratory management is a complex process. Quality control is an effective method to improve productivity. Systematic checking in a quality program may not always find and/or solve the problems. External observation may reveal crucial indicators about the system failures providing very simple solutions.

Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know-Part II: Catheter Care and Management of Common Systemic Post-procedural Complications.

PubMed

Taslakian, Bedros; Sridhar, Divya

2017-09-01

Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant comprehensive patient care responsibilities. Providing excellent and thorough clinical care is as essential to the practice of IR as achieving technical success in procedures. Basic clinical skills that every interventional radiologist should learn include routine management of percutaneously inserted drainage and vascular catheters and rapid effective management of common systemic post-procedural complications. A structured approach to post-procedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety. The aim of this second part, in conjunction with part 1, is to complete the comprehensive review of post-procedural care in patients undergoing interventional radiology procedures. We discuss common problems encountered after insertion of drainage and vascular catheters and describe effective methods of troubleshooting these problems. Commonly encountered systemic complications in IR are described, and ways for immediate identification and management of these complications are provided.

Temporal and spatial changes of water quality and management strategies of Dianchi Lake in southwest China

NASA Astrophysics Data System (ADS)

Zhang, T.; Zeng, W. H.; Wang, S. R.; Ni, Z. K.

2013-12-01

Temporal and spatial changes to the water quality of Dianchi Lake in Southwest China were investigated using monthly monitoring data from 2005 to 2012. Based on the analysis of total phosphorus (TP), total nitrogen (TN), and chlorophyll a (Chl a) concentrations, it was determined that, in Caohai Lake, the annual concentrations of these variables ranged from 0.19-1.46, 6.11-16.79, 0.06-0.14 mg L-1, respectively. In addition, the annual concentrations of TP, TN and Chl a in Waihai Lake ranged between 0.13-0.20, 1.82-3.01, 0.04-0.09 mg L-1, respectively. Cluster Analysis (CA) classified the 10 monitoring sites into two groups (group A and group B) based on similarities of water quality characteristics. Our data revealed that the current status of water quality within Caohai Lake was much worse than that of Waihai Lake. Water quality was seriously degraded during the economic boom near the period of the "Eleventh Five-Year Plan" (2005-2010), and gradually improved from 2010 to 2012 because of the "standard emission directive to industry". The main factors that influenced the spatial and temporal changes to water quality were natural factors including lake evolution and regional characteristic as well as human factors such as pollution load into the lake and management strategies that were already adopted. Some activities and regulations were implemented to enhance the lake environment by controlling wastewater emissions and establishing regulations to protect the lakes in the Yunnan Province. However, problems with institutional fragmentation (horizontal and vertical), simple treatment methods, low-intensity investment in pollution control, and lack of meaningful endogenous pollution control strategies were still present in the lake management strategy. To solve these problems, suitable control measures are needed, especially considering the current old-age status of Dianchi Lake. The fundamental improvement of the water quality within Caohai Lake was dependent on the measures taken in the upper reaches of the Caohai Watershed, including further recovery of submerged plants, resource utilization by floating plants and the reinforcement of sediment disposal. Management strategies for endogenous pollution in Waihai Lake were mainly dependent on restocking algae-eating fish and the ecological restoration of macrophytes. In this way, the swamping trend and the ageing process that is occurring in Dianchi Lake can be stunted.

Evaluation of agricultural best-management practices in the Conestoga River headwaters, Pennsylvania; effects of nutrient management on water quality in the Little Conestoga Creek headwaters, 1983-89

USGS Publications Warehouse

Koerkle, E.H.; Fishel, D.K.; Brown, M.J.; Kostelnik, K.M.

1996-01-01

Water quality in the headwaters of the Little Conestoga Creek, Lancaster County, Pa., was investigated from April 1986 through September 1989 to determine possible effects of agricultural nutrient management on water quality. Nutrient management, an agricultural Best-Management Practice, was promoted in the 5.8-square-mile watershed by the U.S. Department of Agriculture Rural Clean Water Program. Nonpoint-source- agricultural contamination was evident in surface water and ground water in the watershed; the greatest contamination was in areas underlain by carbonate rock and with intensive row-crop and animal production. Initial implementation of nutrient management covered about 30 percent of applicable land and was concentrated in the Nutrient-Management Subbasin. By 1989, nutrient management covered about 45 percent of the entire Small Watershed, about 85 percent of the Nutrient- Management Subbasin, and less than 10 percent of the Nonnutrient-Management Subbasin. The number of farms implementing nutrient management increased from 14 in 1986 to 25 by 1989. Nutrient applications to cropland in the Nutrient- Management Subbasin decreased by an average of 35 percent after implementation. Comparison of base- flow surface-water quality from before and after implementation suggests that nutrient management was effective in slowing or reversing increases in concentrations of dissolved nitrate plus nitrite in the Nutrient-Management Subbasin. Although not statistically significant, the Mann-Whitney step-trend coefficient for the Nutrient-Management Subbasin was 0.8 milligram per liter, whereas trend coefficients for the Nonnutrient-Management Subbasin and the Small Watershed were 0.4 and 1.4 milligrams per liter, respectively, for the period of study. Analysis of covariance comparison of concurrent concentrations from the two sub- basins showed a significant decrease in concen- trations from the Nutrient-Management Subbasin compared to the Nonnutrient-Management Subbasin. The small, positive effect of nutrient management on base-flow water quality should be interpreted with caution. Lack of statistical significance for most tests, short-term variation in climate and agricultural activities, unknown ground-water flow rates, and insufficient agricultural-activity data for farms outside of the Nutrient-Management Subbasin were potential problems. A regression model relating nutrient applications to concen- trations of dissolved nitrate plus nitrite showed no significant explanatory relation.

Decision Support Model for Optimal Management of Coastal Gate

NASA Astrophysics Data System (ADS)

Ditthakit, Pakorn; Chittaladakorn, Suwatana

2010-05-01

The coastal areas are intensely settled by human beings owing to their fertility of natural resources. However, at present those areas are facing with water scarcity problems: inadequate water and poor water quality as a result of saltwater intrusion and inappropriate land-use management. To solve these problems, several measures have been exploited. The coastal gate construction is a structural measure widely performed in several countries. This manner requires the plan for suitably operating coastal gates. Coastal gate operation is a complicated task and usually concerns with the management of multiple purposes, which are generally conflicted one another. This paper delineates the methodology and used theories for developing decision support modeling for coastal gate operation scheduling. The developed model was based on coupling simulation and optimization model. The weighting optimization technique based on Differential Evolution (DE) was selected herein for solving multiple objective problems. The hydrodynamic and water quality models were repeatedly invoked during searching the optimal gate operations. In addition, two forecasting models:- Auto Regressive model (AR model) and Harmonic Analysis model (HA model) were applied for forecasting water levels and tide levels, respectively. To demonstrate the applicability of the developed model, it was applied to plan the operations for hypothetical system of Pak Phanang coastal gate system, located in Nakhon Si Thammarat province, southern part of Thailand. It was found that the proposed model could satisfyingly assist decision-makers for operating coastal gates under various environmental, ecological and hydraulic conditions.

How to Begin a Quality Improvement Project.

PubMed

Silver, Samuel A; Harel, Ziv; McQuillan, Rory; Weizman, Adam V; Thomas, Alison; Chertow, Glenn M; Nesrallah, Gihad; Bell, Chaim M; Chan, Christopher T

2016-05-06

Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects. Copyright © 2016 by the American Society of Nephrology.

How to Begin a Quality Improvement Project

PubMed Central

Harel, Ziv; McQuillan, Rory; Weizman, Adam V.; Thomas, Alison; Chertow, Glenn M.; Nesrallah, Gihad; Bell, Chaim M.; Chan, Christopher T.

2016-01-01

Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects. PMID:27016497

Satellite water quality monitoring in coastal and estuarine waters: a look at SeaWiFS, MODIS, MERIS, and HICO

EPA Science Inventory

The United States Environmental Protection Agency’s charge to protect human health and the environment requires a long-term commitment to creating sustainable solutions to environmental problems. The most direct way to ensure that management practices are achieving sustainability...

MULTI-OBJECTIVE OPTIMAL DESIGN OF GROUNDWATER REMEDIATION SYSTEMS: APPLICATION OF THE NICHED PARETO GENETIC ALGORITHM (NPGA). (R826614)

EPA Science Inventory

A multiobjective optimization algorithm is applied to a groundwater quality management problem involving remediation by pump-and-treat (PAT). The multiobjective optimization framework uses the niched Pareto genetic algorithm (NPGA) and is applied to simultaneously minimize the...

Another level of leadership: nurses on boards.

PubMed

Bleich, Michael R

2014-12-01

The movement to place nurses on boards of directors is growing, enriching boards with individuals possessing knowledge of clinical quality tied to care delivery models, human resource competencies and management, finance, and organizational change. Professional development educators are poised to advance a board's capacity to address complex health care problems.

Advisory on Relocatable and Renovated Classrooms. IAQ Info Sheet.

ERIC Educational Resources Information Center

California State Dept. of Health Services, Berkeley.

Many California school districts, in complying with the Class Size Reduction Program, will obtain relocatable classrooms directly from manufacturers who are under no specific guidelines or codes relative to indoor air quality (IAQ). This document, designed to aid school facility managers in minimizing potential IAQ problems, summarizes the indoor…

Behavioral kernels and brief interventions: teaching parents effective behavior management strategies.

PubMed

Shapiro, Cheri J

2013-01-01

Reducing the high prevalence of emotional and behavioral problems among youth requires that parents be given access to high-quality, effective parenting supports and interventions. Recently developed brief parenting interventions can be delivered without stigma in primary health care and other settings by a range of professionals.

Assuring Integrity of Information Utility in Cyber-Learning Formats.

ERIC Educational Resources Information Center

Morrison, James L.; Stein, Linda L.

1999-01-01

Describes a cyber-learning project for the World Wide Web developed by faculty and librarians at the University of Delaware that combined discovery learning with problem-based learning to develop critical thinking and quality management for information. Undergraduates were to find, evaluate, and use information to generate an Internet marketing…

Colleges Turn to Private Companies To Build and Run Student Housing.

ERIC Educational Resources Information Center

van der Werf, Martin

1999-01-01

Increasingly, colleges and universities are privatizing housing, attracted to the limited financial outlay and involvement in management. Critics fear that institutions' financial positions will be compromised if the private developers have problems, and that institutions will lose control of financial aspects and quality of residence-hall life,…

Asian Educational Discourse: Construction of Ontological Security

ERIC Educational Resources Information Center

Khalina, Natalya V.; Kovaleva, Alla V.; Voronin, Maksim S.; Anikin, Denis V.; Valyulina, Ekaterina V.

2018-01-01

This article considers the problem of ontology security through Asian educational discourse, which is structurally determined by the process of moral self-improvement. Considered are trends in improving the management of educational system by developing the culture of quality, which is considered as the next stage of the Asian education systems…

Decision Support System (DSS) for MSMA Integrated Stormwater Management Ecohydrology for Sustainable Green Infrastructure

NASA Astrophysics Data System (ADS)

Sidek, L. M.; Mohiyaden, H. A.; Haris, H.; Basri, H.; Muda, Z. C.; Roseli, Z. A.; Norlida, M. D.

2016-03-01

Rapid urbanization has known to have several adverse impacts towards hydrological cycle due to increasing impervious surface and degradation of water quality in stormwater runoff. In the past, urban waterways have been confined to narrow river corridors with the channels canalised and concrete and other synthetic materials forming the bed and banks of the river. Apart from that, stormwater pollutants such as litter, debris and sediments in drainage system are common problems that can lead to flooding and the degradation of water quality. To solve this problem, implementing stormwater Best Management Practices (BMPs) proves very promising due to its near natural characteristics and multiple effects on the drainage of stormwater runoff in urban areas. This judgment of using BMPs depends on not only relevant theoretical considerations, but also a large amount of practical experience and the availability of relevant data, as well. To fulfil this task, the so-called Decision Support System (DSS) in MSMA Design Aid and Database system are able to assist engineers and developers in management and improvement of water quantity and quality entering urban rivers from urban regions. This system is also helpful when an expert level judgment procure some repetitive and large amount of cases, like in the planning of stormwater BMPs systems for an entire city catchment. One of the advantages of an expert system is that it provides automation of expert-level judgement using availability of checking tools system.

Service quality in community pharmacy: an exploration of determinants.

PubMed

White, Lesley; Klinner, Christiane

2012-01-01

Although various instruments have been developed to measure customer satisfaction with community pharmacy services, there is limited research regarding pharmacy staffs' understanding of service quality and its determinants. This study aimed to explore the perceptions of pharmacy staff regarding the factors that constitute a high level of service quality using the service quality determinants proposed by the Conceptual Model of Service Quality. Structured interviews were conducted with 27 pharmacy assistants and 6 pharmacists in 3 community pharmacies in Sydney. The interview questions focused on the participants' perceptions of consumer expectations, the translation of these perceptions into service quality specifications, the actual service delivery, and the communication to customers. From the pharmacy staff perspective, service quality is significantly limited by insufficient internal communication and control processes that impede role clarity and the resolution of conflicting role expectations among customer service personnel. Participants indicated that these problems could be alleviated through the implementation of more transparent, realistic, measurable, and accepted quality specifications by pharmacy management. The study indicates that the extent to which pharmacy management sets, maintains, and communicates service quality specifications to staff directly affects role clarity, role conflict, and organizational commitment among customer service staff, which in turn directly influence the level of service quality provided to the customers. Copyright © 2012 Elsevier Inc. All rights reserved.

Deviation Management: Key Management Subsystem Driver of Knowledge-Based Continuous Improvement in the Henry Ford Production System.

PubMed

Zarbo, Richard J; Copeland, Jacqueline R; Varney, Ruan C

2017-10-01

To develop a business subsystem fulfilling International Organization for Standardization 15189 nonconformance management regulatory standard, facilitating employee engagement in problem identification and resolution to effect quality improvement and risk mitigation. From 2012 to 2016, the integrated laboratories of the Henry Ford Health System used a quality technical team to develop and improve a management subsystem designed to identify, track, trend, and summarize nonconformances based on frequency, risk, and root cause for elimination at the level of the work. Programmatic improvements and training resulted in markedly increased documentation culminating in 71,641 deviations in 2016 classified by a taxonomy of 281 defect types into preanalytic (74.8%), analytic (23.6%), and postanalytic (1.6%) testing phases. The top 10 deviations accounted for 55,843 (78%) of the total. Deviation management is a key subsystem of managers' standard work whereby knowledge of nonconformities assists in directing corrective actions and continuous improvements that promote consistent execution and higher levels of performance. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The measurement of quality of care in the Veterans Health Administration.

PubMed

Halpern, J

1996-03-01

The Veterans Health Administration (VHA) is committed to continual refinement of its system of quality measurement. The VHA organizational structure for quality measurement has three levels. At the national level, the Associate Chief Medical Director for Quality Management provides leadership, sets policy, furnishes measurement tools, develops and distributes measures of quality, and delivers educational programs. At the intermediate level, VHA has four regional offices with staff responsible for reviewing risk management data, investigating quality problems, and ensuring compliance with accreditation requirements. At the hospital level, staff reporting directly to the chief of staff or the hospital director are responsible for implementing VHA quality management policy. The Veterans Health Administration's philosophy of quality measurement recognizes the agency's moral imperative to provide America's veterans with care that meets accepted standards. Because the repair of faulty systems is more efficient than the identification of poor performers, VHA has integrated the techniques of total quality into a multifaceted improvement program that also includes the accreditation program and traditional quality assurance activities. VHA monitors its performance by maintaining adverse incident databases, conducting patient satisfaction surveys, contracting for external peer review of 50,000 records per year, and comparing process and outcome rates internally and when possible with external benchmarks. The near-term objectives of VHA include providing medical centers with a quality matrix that will permit local development of quality indicators, construction of a report card for VHA's customers, and implementing the Malcolm W. Baldrige system for quality improvement as the road map for systemwide continuous improvement. Other goals include providing greater access to data, creating a patient-centered database, providing real-time clinical decision support, and expanding the databases.

Overview of the Management of Cough

PubMed Central

French, Cynthia T.; Lewis, Sandra Zelman; Diekemper, Rebecca L.; Gold, Philip M.; Adams, Todd M.; Altman, Kenneth W.; Barker, Alan F.; Birring, Surinder S.; Bolser, Donald C.; Boulet, Louis-Philippe; Braman, Sidney S.; Brightling, Christopher; Callahan-Lyon, Priscilla; Canning, Brendan; Chang, Anne Bernadette; Coeytaux, Remy; Cowley, Terrie; Davenport, Paul; Ebihara, Satoru; El Solh, Ali A.; Escalante, Patricio; Field, Stephen K.; Fisher, Dina; Gibson, Peter; Gould, Michael K.; Harding, Susan M.; Harnden, Anthony; Hill, Adam T.; Kahrilas, Peter J.; Keogh, Karina A.; Lane, Andrew P.; Lim, Kaiser; Malesker, Mark A.; Mazzone, Peter; McCrory, Douglas C.; McGarvey, Lorcan; Murad, M. Hassan; Newcombe, Peter; Nguyen, Huong Q.; Oppenheimer, John; Prezant, David; Pringsheim, Tamara; Restrepo, Marcos I.; Rosen, Mark; Rubin, Bruce; Ryu, Jay H.; Smith, Jaclyn; Tarlo, Susan M.; Turner, Ronald B.; Vertigan, Anne; Weir, Kelly; Wiener, Renda Soylemez

2014-01-01

This overview will demonstrate that cough is a common and potentially expensive health-care problem. Improvement in the quality of care of those with cough has been the focus of study for a variety of disciplines in medicine. The purpose of the Cough Guideline and Expert Panel is to synthesize current knowledge in a form that will aid clinical decision-making for the diagnosis and management of cough across disciplines and also identify gaps in knowledge and treatment options. PMID:25080295

Ten key questions about the management of water in the Yellow River basin.

PubMed

Barnett, Jon; Webber, Michael; Wang, Mark; Finlayson, Brian; Dickinson, Debbie

2006-08-01

Water is scarce in many regions of the world, clean water is difficult to find in most developing countries, there are conflicts between irrigation needs and urban demands, and there is wide debate over appropriate means of resolving these problems. Similarly, in China, there is limited understanding of the ways in which people, groups, and institutions contribute to, are affected by, and respond to changes in water quantity and quality. We use the example of the Yellow River basin to argue that these social, managerial, and policy dimensions of the present water problems are significant and overshadow the physical ones. Despite this, they receive relatively little attention in the research agenda, particularly of the lead agencies in the management of the Yellow River basin. To this end, we ask ten research questions needed to address the policy needs of water management in the basin, split into two groups of five. The first five relate to the importance of water in this basin and the changes that have affected water problems and will continue to do so. The second five questions represent an attempt to explore possible solutions to these problems.

Trade-off decisions in distribution utility management

NASA Astrophysics Data System (ADS)

Slavickas, Rimas Anthony

As a result of the "unbundling" of traditional monopolistic electricity generation and transmission enterprises into a free-market economy, power distribution utilities are faced with very difficult decisions pertaining to electricity supply options and quality of service to the customers. The management of distribution utilities has become increasingly complex, versatile, and dynamic to the extent that conventional, non-automated management tools are almost useless and obsolete. This thesis presents a novel and unified approach to managing electricity supply options and quality of service to customers. The technique formulates the problem in terms of variables, parameters, and constraints. An advanced Mixed Integer Programming (MIP) optimization formulation is developed together with novel, logical, decision-making algorithms. These tools enable the utility management to optimize various cost components and assess their time-trend impacts, taking into account the intangible issues such as customer perception, customer expectation, social pressures, and public response to service deterioration. The above concepts are further generalized and a Logical Proportion Analysis (LPA) methodology and associated software have been developed. Solutions using numbers are replaced with solutions using words (character strings) which more closely emulate the human decision-making process and advance the art of decision-making in the power utility environment. Using practical distribution utility operation data and customer surveys, the developments outlined in this thesis are successfully applied to several important utility management problems. These involve the evaluation of alternative electricity supply options, the impact of rate structures on utility business, and the decision of whether to continue to purchase from a main grid or generate locally (partially or totally) by building Non-Utility Generation (NUG).

Regulation and its role in the prevention of building-associated illness.

PubMed

Besch, E L

1989-01-01

Many groups have as their common goal the maintenance of acceptable indoor air quality, which protects occupants from adverse health effects and discomfort, but no one group possesses the interest or expertise to deal with all of the IAQ issues. Nonetheless, conclusions can be made regarding available alternatives to mitigate indoor air quality problems, including building-associated illness. It has been suggested that congressional action is needed in three areas related to BAI and IAQ: Recognition that controlling outdoor air only--even if "health based"--will not result in substantial improvement of public health; Definition of responsibilities for achieving healthful indoor environments; and Resolution of jurisdictional disputes between various federal agencies. Through their studies of buildings whose occupants complained of building-associated illness, NIOSH and others have concluded that inadequate supply and distribution of outdoor air to indoor spaces are the most common causes of SBS. Nonetheless, there are no reports of follow-up studies which confirm that the recommended ventilation upgrades actually solved the IAQ problems. Other reports indicate that maintenance, energy management, and air distribution are as important as ventilation rate. Corrective action, therefore, should include these issues. Systematic research directed toward providing cost-effective and innovative solutions should be the driving force. Rather than regulation, governments should assist in funding the necessary research, providing educational, technical and legal assistance, and developing policy options directed at reducing indoor air pollutants. In those cases where the specific causes of IAQ problems can be identified, remedial actions should be immediately implemented utilizing available technology. It has been suggested that "sick buildings" resulted from too much emphasis on efficency and safety and not enough on occupant health and well-being. Because health has been defined as "a state of complete physical, mental and social well-being not merely the absence of disease or infirmity," greater emphasis should be given to the concept of control and maintenance of healthy indoor environments (i.e., "healthy buildings") through utilization of quality assurance measures. Also, human response, system performance, and service factors should be utilized to assure an acceptable building performance. Finally, building designers, contractors, owners, managers, and operators must be knowledgeable regarding indoor air quality problems and their consequences and work together to build and maintain healthy buildings. This includes developing training, education, monitoring, and preventive maintenance programs to assure accountability for the proper management of the building systems. The certification (or licensing) of those responsible for providing indoor air quality has been suggested.

MO-E-9A-01: Risk Based Quality Management: TG100 In Action

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

Huq, M; Palta, J; Dunscombe, P

2014-06-15

One of the goals of quality management in radiation therapy is to gain high confidence that patients will receive the prescribed treatment correctly. To accomplish these goals professional societies such as the American Association of Physicists in Medicine (AAPM) has published many quality assurance (QA), quality control (QC), and quality management (QM) guidance documents. In general, the recommendations provided in these documents have emphasized on performing device-specific QA at the expense of process flow and protection of the patient against catastrophic errors. Analyses of radiation therapy incidents find that they are most often caused by flaws in the overall therapymore » process, from initial consult through final treatment, than by isolated hardware or computer failures detectable by traditional physics QA. This challenge is shared by many intrinsically hazardous industries. Risk assessment tools and analysis techniques have been developed to define, identify, and eliminate known and/or potential failures, problems, or errors, from a system, process and/or service before they reach the customer. These include, but are not limited to, process mapping, failure modes and effects analysis (FMEA), fault tree analysis (FTA), and establishment of a quality management program that best avoids the faults and risks that have been identified in the overall process. These tools can be easily adapted to radiation therapy practices because of their simplicity and effectiveness to provide efficient ways to enhance the safety and quality of treatment processes. Task group 100 (TG100) of AAPM has developed a risk-based quality management program that uses these tools. This session will be devoted to a discussion of these tools and how these tools can be used in a given radiotherapy clinic to develop a risk based QM program. Learning Objectives: Learn how to design a process map for a radiotherapy process. Learn how to perform a FMEA analysis for a given process. Learn what Fault tree analysis is all about. Learn how to design a quality management program based upon the information obtained from process mapping, FMEA and FTA.« less

Telecardiology application in jordan: its impact on diagnosis and disease management, patients' quality of life, and time- and cost-savings.

PubMed

Khader, Yousef Saleh; Jarrah, Mohamad Ismail; Al-Shudifat, Abde-Ellah M; Shdaifat, Amjad; Aljanabi, Husham; Al-Fakeh, Shadwan Ismeil; Turk, Elias Emil; Zayed, Khaled Ali; Al Quran, Hanadi A; Ellauzi, Ziad Mohd; Al Tahan, Mohammad

2014-01-01

Objectives. To assess the impact of live interactive telecardiology on diagnosis and disease management, patients' quality of life, and time- and cost-savings. Methods. All consecutive patients who attended or were referred to the teleclinics for suspected cardiac problems in two hospitals in remote areas of Jordan during the study period were included in the study. Patients were interviewed for relevant information and their quality of life was assessed during the first visit and 8 weeks after the last visit. Results. A total of 76 patients were included in this study. Final diagnosis and treatment plan were established as part of the telecardiology consultations in 71.1% and 77.3% of patients, respectively. Patients' travel was avoided for 38 (50.0%) who were managed locally. The majority of patients perceived that the visit to the telecardiology clinic results in less travel time (96.1%), less waiting time (98.1%), and lower cost (100.0%). Telecardiology consultations resulted in an improvement in the quality of life after two months of the first visit. Conclusions. Telecardiology care in remote areas of Jordan would improve the access to health care, help to reach proper diagnosis and establish the treatment plan, and improve the quality of life.

Telecardiology Application in Jordan: Its Impact on Diagnosis and Disease Management, Patients' Quality of Life, and Time- and Cost-Savings

PubMed Central

Khader, Yousef Saleh; Jarrah, Mohamad Ismail; Al-Shudifat, Abde-Ellah M.; Shdaifat, Amjad; Aljanabi, Husham; Al-Fakeh, Shadwan Ismeil; Turk, Elias Emil; Zayed, Khaled Ali; Al Quran, Hanadi A.; Ellauzi, Ziad Mohd; Al Tahan, Mohammad

2014-01-01

Objectives. To assess the impact of live interactive telecardiology on diagnosis and disease management, patients' quality of life, and time- and cost-savings. Methods. All consecutive patients who attended or were referred to the teleclinics for suspected cardiac problems in two hospitals in remote areas of Jordan during the study period were included in the study. Patients were interviewed for relevant information and their quality of life was assessed during the first visit and 8 weeks after the last visit. Results. A total of 76 patients were included in this study. Final diagnosis and treatment plan were established as part of the telecardiology consultations in 71.1% and 77.3% of patients, respectively. Patients' travel was avoided for 38 (50.0%) who were managed locally. The majority of patients perceived that the visit to the telecardiology clinic results in less travel time (96.1%), less waiting time (98.1%), and lower cost (100.0%). Telecardiology consultations resulted in an improvement in the quality of life after two months of the first visit. Conclusions. Telecardiology care in remote areas of Jordan would improve the access to health care, help to reach proper diagnosis and establish the treatment plan, and improve the quality of life. PMID:25400661

Pain management: new initiatives arise to provide quality care.

PubMed

Simmons, J C

2001-06-01

During the past decade, many advances have been made in the diagnosis, treatment, and management of pain. However, undertreatment of pain among all population groups is still a nationwide problem. Changes, though, are occurring this year, with many hospitals, health systems, and health plans placing pain management on the top of their patient agendas--due in part to the introduction of new pain management standards by the Joint Commission on Accreditation of Healthcare Organizations. This issue looks at how health care providers are working together across the country to make those changes--and meet JCAHO standards--while fulfilling the needs of their patient populations through innovative pain assessment and management strategies.

Content and quality of websites supporting self-management of chronic breathlessness in advanced illness: a systematic review

PubMed Central

Luckett, Tim; Disler, Rebecca; Hosie, Annmarie; Johnson, Miriam; Davidson, Patricia; Currow, David; Sumah, Anthony; Phillips, Jane

2016-01-01

Chronic breathlessness is a common, burdensome and distressing symptom in many advanced chronic illnesses. Self-management strategies are essential to optimise treatment, daily functioning and emotional coping. People with chronic illness commonly search the internet for advice on self-management. A review was undertaken in June 2015 to describe the content and quality of online advice on breathlessness self-management, to highlight under-served areas and to identify any unsafe content. Google was searched from Sydney, Australia, using the five most common search terms for breathlessness identified by Google Trends. We also hand-searched the websites of national associations. Websites were included if they were freely available in English and provided practical advice on self-management. Website quality was assessed using the American Medical Association Benchmarks. Readability was assessed using the Flesch–Kincaid grades, with grade 8 considered the maximum acceptable for enabling access. Ninety-one web pages from 44 websites met the inclusion criteria, including 14 national association websites not returned by Google searches. Most websites were generated in the USA (n=28, 64%) and focused on breathing techniques (n=38, 86%) and chronic obstructive pulmonary disease (n=27, 61%). No websites were found to offer unsafe advice. Adherence to quality benchmarks ranged from 9% for disclosure to 77% for currency. Fifteen (54%) of 28 written websites required grade ⩾9 reading level. Future development should focus on advice and tools to support goal setting, problem solving and monitoring of breathlessness. National associations are encouraged to improve website visibility and comply with standards for quality and readability. PMID:27225898

Use of multicriteria analysis (MCA) for sustainable hydropower planning and management.

PubMed

Vassoney, Erica; Mammoliti Mochet, Andrea; Comoglio, Claudio

2017-07-01

Multicriteria analysis (MCA) is a decision-making tool applied to a wide range of environmental management problems, including renewable energy planning and management. An interesting field of application of MCA is the evaluation and analysis of the conflicting aspects of hydropower (HP) exploitation, affecting the three pillars of sustainability and involving several different stakeholders. The present study was aimed at reviewing the state of the art of MCA applications to sustainable hydropower production and related decision-making problems, based on a detailed analysis of the scientific papers published over the last 15 years on this topic. The papers were analysed and compared, focusing on the specific features of the MCA methods applied in the described case studies, highlighting the general aspects of the MCA application (purpose, spatial scale, software used, stakeholders, etc.) and the specific operational/technical features of the selected MCA technique (methodology, criteria, evaluation, approach, sensitivity, etc.). Some specific limitations of the analysed case studies were identified and a set of "quality indexes" of an exhaustive MCA application were suggested as potential improvements for more effectively support decision-making processes in sustainable HP planning and management problems. Copyright © 2017 Elsevier Ltd. All rights reserved.

Solid waste management problems in secondary schools in Ibadan, Nigeria.

PubMed

Ana, G R E E; Oloruntoba, E O; Shendell, D; Elemile, O O; Benjamin, O R; Sridhar, M K C

2011-09-01

Inappropriate solid waste management practices in schools in less-developed countries, particularly in major urban communities, constitute one of the major factors leading to declining environmental health conditions. The objective of the authors' descriptive, cross-sectional study was to assess solid waste management problems in selected urban schools in Ibadan, Nigeria. Eight secondary schools with average pupil populations not less than 500 per school were selected randomly. Four hundred questionnaires (50 per school) were administered. In addition, an observational checklist was used to assess the physical environment. Paper and plastics were the most frequently generated wastes. Common methods of solid waste disposal reported were use of dustbins for collection and open burning. Major problems perceived with current refuse disposal methods by the study students were odors, pest infestation, and spillages. Littering and spillages of solid waste were also common features reported. Data suggested inadequate waste management facilities and practices in study schools. The lack of refuse bins may have contributed to waste spillages and the burning practices. Odors may have arisen from both the decay of overstored organic waste rich in moisture and emissions from refuse burning. This scenario poses a community environmental health nuisance and may compromise school environmental quality.

The Pharmacological Management of Oppositional Behaviour, Conduct Problems, and Aggression in Children and Adolescents With Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder: A Systematic Review and Meta-Analysis. Part 1: Psychostimulants, Alpha-2 Agonists, and Atomoxetine

PubMed Central

Pringsheim, Tamara; Hirsch, Lauren; Gardner, David; Gorman, Daniel A

2015-01-01

Objective: Children with attention-deficit hyperactivity disorder (ADHD) may have oppositional behaviour, conduct problems, and aggression. These symptoms vary in severity, and may be related to a comorbid diagnosis of oppositional defiant disorder (ODD) or conduct disorder (CD). Critical evaluation of the efficacy of ADHD medications may guide the clinician regarding the usefulness of medications for these symptoms. Method: We performed a systematic review and meta-analysis of psychostimulants, alpha-2 agonists, and atomoxetine for oppositional behaviour, conduct problems, and aggression in youth with ADHD, ODD, and CD. The quality of evidence for medications was rated using the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Two systematic reviews and 20 randomized controlled trials were included. There is high-quality evidence that psychostimulants have a moderate-to-large effect on oppositional behaviour, conduct problems, and aggression in youth with ADHD, with and without ODD or CD. There is very-low-quality evidence that clonidine has a small effect on oppositional behaviour and conduct problems in youth with ADHD, with and without ODD or CD. There is moderate-quality evidence that guanfacine has a small-to-moderate effect on oppositional behaviour in youth with ADHD, with and without ODD. There is high-quality evidence that atomoxetine has a small effect on oppositional behaviour in youth with ADHD, with and without ODD or CD. Conclusions: Evidence indicates that psychostimulants, alpha-2 agonists, and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms; however, psychostimulants generally provide the most benefit. PMID:25886655

The pharmacological management of oppositional behaviour, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: a systematic review and meta-analysis. Part 1: psychostimulants, alpha-2 agonists, and atomoxetine.

PubMed

Pringsheim, Tamara; Hirsch, Lauren; Gardner, David; Gorman, Daniel A

2015-02-01

Children with attention-deficit hyperactivity disorder (ADHD) may have oppositional behaviour, conduct problems, and aggression. These symptoms vary in severity, and may be related to a comorbid diagnosis of oppositional defiant disorder (ODD) or conduct disorder (CD). Critical evaluation of the efficacy of ADHD medications may guide the clinician regarding the usefulness of medications for these symptoms. We performed a systematic review and meta-analysis of psychostimulants, alpha-2 agonists, and atomoxetine for oppositional behaviour, conduct problems, and aggression in youth with ADHD, ODD, and CD. The quality of evidence for medications was rated using the Grading of Recommendations Assessment, Development and Evaluation approach. Two systematic reviews and 20 randomized controlled trials were included. There is high-quality evidence that psychostimulants have a moderate-to-large effect on oppositional behaviour, conduct problems, and aggression in youth with ADHD, with and without ODD or CD. There is very-low-quality evidence that clonidine has a small effect on oppositional behaviour and conduct problems in youth with ADHD, with and without ODD or CD. There is moderate-quality evidence that guanfacine has a small-to-moderate effect on oppositional behaviour in youth with ADHD, with and without ODD. There is high-quality evidence that atomoxetine has a small effect on oppositional behaviour in youth with ADHD, with and without ODD or CD. Evidence indicates that psychostimulants, alpha-2 agonists, and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms; however, psychostimulants generally provide the most benefit.

Total quality management: It works for aerospace information services

NASA Technical Reports Server (NTRS)

Erwin, James; Eberline, Carl; Colquitt, Wanda

1993-01-01

Today we are in the midst of information and 'total quality' revolutions. At the NASA STI Program's Center for AeroSpace Information (CASI), we are focused on using continuous improvements techniques to enrich today's services and products and to ensure that tomorrow's technology supports the TQM-based improvement of future STI program products and services. The Continuous Improvements Program at CASI is the foundation for Total Quality Management in products and services. The focus is customer-driven; its goal, to identify processes and procedures that can be improved and new technologies that can be integrated with the processes to gain efficiencies, provide effectiveness, and promote customer satisfaction. This Program seeks to establish quality through an iterative defect prevention approach that is based on the incorporation of standards and measurements into the processing cycle. Four projects are described that utilize cross-functional, problem-solving teams for identifying requirements and defining tasks and task standards, management participation, attention to critical processes, and measurable long-term goals. The implementation of these projects provides the customer with measurably improved access to information that is provided through several channels: the NASA STI Database, document requests for microfiche and hardcopy, and the Centralized Help Desk.

Multidrug-resistant bacteria infection and nursing quality management application in the department of physical examination.

PubMed

Xu, Li; Luo, Qiang; Chen, Liangzhen; Jiao, Lingmei

2017-09-01

The main problem of clinical prevention and control of multi drug resistant bacteria infection is to strengthen the monitoring of pathogenic bacteria spectrum, this study research on the multi drug-resistant bacteria infection and nursing quality management application in the department of physical examination. The results of this study showed that the number of patients with multiple drug resistant infections showed an increasing trend. Therefore, once the patients with multiple drug-resistant bacteria infection are found, the prevention and control of the patients with multiple drug-resistant bacteria should be strictly followed, and the patient's medication care should be highly valued. Also, the nurses need to be classified based on the knowledge and skill characteristics of the nurses in the department of physical examination, and compare the nursing effect before and after classification and grouping. The physicians and individuals receiving physical examinations in the department of physical examination had a higher degree of satisfaction for nursing effect after classification compared with those before classification. Classification and grouping management helps improve the nursing quality and overall quality of the nurses in the department of physical examination.

Bowel function and quality of life after colostomy in individuals with spinal cord injury

PubMed Central

Staun, Michael; Kalhauge, Anna; Langholz, Ebbe; Biering-Sørensen, Fin

2016-01-01

Objective To evaluate the effect of colostomy on bowel function and quality of life (QoL) in individuals with spinal cord injury (SCI). Design Cross-sectional descriptive study. Setting Department for Spinal Cord Injuries and Departments of Gastroenterology and Radiology, Rigshospitalet. Participants Eighteen individuals with SCI and a colostomy performed post injury, 12 males, 6 females, 8 with tetraplegia and 10 with paraplegia. Median age at time of study was 49.9 years, years since lesion was 3–56 years, and time since colostomy was performed 0.5 to 20 years. Interventions Questionnaires and measurement of gastrointestinal transit time (GITT). Outcome measures Retrospective data collection from patient records, a questionnaire on bowel management pre and post colostomy, quality of life (QoL) by SF-36, and GITT. Results Seventy-two percent significantly reduced their use of time on bowel emptying after the colostomy. All but one reported being content with the colostomy. Thirty-nine percent reported one or more problems related to the colostomy. Seventy-five percent had a GITT within normal range for able-bodied populations. When disregarding the physical component, QoL was not significantly lower in the total study group compared to a Danish norm group, but significantly lower when compared the subgroup of persons with tetraplegia. Conclusion A colostomy reduces the time necessary for bowel management. The majority of individuals with SCI and a colostomy did not perceive bowel management as being a problem. The results indicate that colostomy is a favourable option for individuals with SCI, who spend long hours on bowel management and for whom non-invasive procedures did not improve the situation enough. PMID:25738657

Improving ostomates' confidence with a discharge-solidifying agent.

PubMed

Slater, Rebecca

Not every person with a stoma will develop problems or even feel that he or she is unable to manage a stoma independently. However, for the individual who does experience problems and struggles to cope, the stoma nurse is pivotal in providing resources and product experience. He or she can enable the ostomate to adapt to the stoma and maintain their quality of life. This article provides an overview of a solidifying agent and case studies illustrating how it can be used to help patients achieve independence.

The entrepreneurial revolution in health care delivery.

PubMed

Silver, A D

1987-06-01

The rapid changes in the health marketplace have opened the door for entrepreneurs. The author shows how entrepreneurs seek previously unthought of solutions to problems and through a team effort increase corporate value. According to the author, there is a specific profile of the successful entrepreneur. The qualities of the entrepreneur and the managers that work with them, therefore, are discussed in detail. Finally, several examples of problems in health care that present entrepreneurial opportunities are presented. The author includes scenarios for taking advantage of these opportunities.

Data quality system using reference dictionaries and edit distance algorithms

NASA Astrophysics Data System (ADS)

Karbarz, Radosław; Mulawka, Jan

2015-09-01

The real art of management it is important to make smart decisions, what in most of the cases is not a trivial task. Those decisions may lead to determination of production level, funds allocation for investments etc. Most of the parameters in decision-making process such as: interest rate, goods value or exchange rate may change. It is well know that these parameters in the decision-making are based on the data contained in datamarts or data warehouse. However, if the information derived from the processed data sets is the basis for the most important management decisions, it is required that the data is accurate, complete and current. In order to achieve high quality data and to gain from them measurable business benefits, data quality system should be used. The article describes the approach to the problem, shows the algorithms in details and their usage. Finally the test results are provide. Test results show the best algorithms (in terms of quality and quantity) for different parameters and data distribution.

Cancer survivors' self-efficacy to self-manage in the year following primary treatment.

PubMed

Foster, C; Breckons, M; Cotterell, P; Barbosa, D; Calman, L; Corner, J; Fenlon, D; Foster, R; Grimmett, C; Richardson, A; Smith, P W

2015-03-01

Cancer survivors are increasingly expected to manage the consequences of cancer and its treatment for themselves. There is evidence that self-efficacy is important for successful self-management and that this can be enhanced with support. The purpose of this study was to assess self-efficacy to manage problems in the year following primary treatment. This cross-sectional online survey included cancer survivors who had completed their treatment within the past 12 months. Self-efficacy was assessed and variables expected to be associated with self-efficacy were measured using validated scales including quality of life, well-being, illness perceptions, depression and social support. One hundred eighty-two respondents (mean age 50; 81% female) completed the survey. They had been treated for a range of cancers; most commonly breast (45%). Self-efficacy scores varied between individuals and according to the illness-related task to be managed. Respondents were least confident in managing fatigue and most confident in accessing information about their cancer. Individuals most likely to report low self-efficacy were women, those experiencing higher levels of pain and/or depression, lower well-being scores, lower socio-economic status, low levels of social support, or a more negative perception of cancer. Self-efficacy to self-manage problems faced as a consequence of cancer and its treatment can vary widely in the year following treatment. Fatigue may be particularly difficult to manage. Variations in self-efficacy highlight the importance of assessing specific problems faced and people's confidence to manage them in order to tailor appropriate self-management support.

When More is Less: The Case of Disconnected Information Systems in Indonesian Public Health Facilities

NASA Astrophysics Data System (ADS)

Wahid, Fathul; Teduh Dirgahayu, Raden; Hamzah, Almed; Setiaji, Hari

2018-03-01

The clear majority of previous studies have found that the absence of information systems to properly manage data is one of the main challenges in improving public health management. The present study offers an alternate perspective, revealing other emerging problems in cases where there are many information systems in place but without sufficient orchestration. The national government of Indonesia has been coercive in its implementation of various information systems without involving users at public health facilities, which has created many problems on the ground. The problems identified relate to the quality of the disconnected information systems currently in use, the lack of human resource development, unclear procedures, uncoordinated reports and the absence of an incentive scheme. The present study also highlights some practical implications, including the use of a more holistic perspective in designing and developing an integrated public health information infrastructure.

Health care reform: will quality remodeling affect obstetrician-gynecologists in addition to patients?

PubMed

von Gruenigen, Vivian E; Deveny, T Clifford

2011-05-01

The Patient Protection and Affordable Care Act is a federal statute that attempts to address many fundamental problems with the current health care system including the uninsured, rising health care costs, and quality care. Quality metrics have been in development for years (by private and governmental sectors), and momentum is growing. The purpose of this commentary is to explore quality changes in the way practicing obstetricians and gynecologists will be held accountable for quality service. Two new options being explored for health care, both focusing on improving quality and physician metrics, include value-based purchasing and accountable-care organizations. Both will likely consist of universal clinical algorithms and cost monitoring as measures. For obstetrics this will probably include physician's rates of cesarean deliveries and elective inductions. For gynecology this may comprise of indications for hysterectomy with documented failed medical management, minor surgical management, or both medical and minor surgical management. It is anticipated patients will no longer be able to request obstetric testing, pregnancy induction, or hysterectomy. It is imperative we, as obstetrician-gynecologists, are involved in health care reform that inevitably involves the care of women. The expectation is that the American Congress of Obstetricians and Gynecologists (ACOG) will further develop evidenced-based opinions and guidelines, as medical communities embrace ACOG documents and reference these in hospital policies and peer review.

Using creative problem solving (TRIZ) in improving the quality of hospital services.

PubMed

LariSemnani, Behrouz; Mohebbi Far, Rafat; Shalipoor, Elham; Mohseni, Mohammad

2014-08-14

TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients' expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients' satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ' needs.

The effectiveness of a multidisciplinary pain management programme managing chronic pain.

PubMed

Dysvik, Elin; Vinsnes, Anne Guttormsen; Eikeland, Ole-Johan

2004-10-01

The aim of this study was to develop and evaluate the effects of a multidisciplinary pain management programme on coping, health-related quality of life and pain intensity. Seventy-six outpatients suffering from chronic pain completed this eight-week programme with the primary aims to increase coping, as measured by the Ways of Coping Checklist, and health-related quality of life, as measured by the Short Form-36 Health Survey. Therapeutic dialogues and education, combined with physical activity, were given in order to increase understanding of and attention to non-medical factors that might affect pain perception. The programme was active, time-limited and structured on the basis of multidisciplinary pain management programmes based on a cognitive-behavioural approach. The findings suggest that this programme has the potential to improve coping skills and health-related quality of life. Additionally, pain intensity, as measured by the Visual Analogue Scale, was reduced. Age and disability were revealed as the prominent predictors of change after treatment. The differences in this sample indicated that the drop-outs tended to be older and reported more health problems, although these findings were non-significant. Clinical and research implications are discussed.

Vehicle Routing Problem Using Genetic Algorithm with Multi Compartment on Vegetable Distribution

NASA Astrophysics Data System (ADS)

Kurnia, Hari; Gustri Wahyuni, Elyza; Cergas Pembrani, Elang; Gardini, Syifa Tri; Kurnia Aditya, Silfa

2018-03-01

The problem that is often gained by the industries of managing and distributing vegetables is how to distribute vegetables so that the quality of the vegetables can be maintained properly. The problems encountered include optimal route selection and little travel time or so-called TSP (Traveling Salesman Problem). These problems can be modeled using the Vehicle Routing Problem (VRP) algorithm with rating ranking, a cross order based crossing, and also order based mutation mutations on selected chromosomes. This study uses limitations using only 20 market points, 2 point warehouse (multi compartment) and 5 vehicles. It is determined that for one distribution, one vehicle can only distribute to 4 market points only from 1 particular warehouse, and also one such vehicle can only accommodate 100 kg capacity.

An Innovative Time-Cost-Quality Tradeoff Modeling of Building Construction Project Based on Resource Allocation

PubMed Central

2014-01-01

The time, quality, and cost are three important but contradictive objectives in a building construction project. It is a tough challenge for project managers to optimize them since they are different parameters. This paper presents a time-cost-quality optimization model that enables managers to optimize multiobjectives. The model is from the project breakdown structure method where task resources in a construction project are divided into a series of activities and further into construction labors, materials, equipment, and administration. The resources utilized in a construction activity would eventually determine its construction time, cost, and quality, and a complex time-cost-quality trade-off model is finally generated based on correlations between construction activities. A genetic algorithm tool is applied in the model to solve the comprehensive nonlinear time-cost-quality problems. Building of a three-storey house is an example to illustrate the implementation of the model, demonstrate its advantages in optimizing trade-off of construction time, cost, and quality, and help make a winning decision in construction practices. The computational time-cost-quality curves in visual graphics from the case study prove traditional cost-time assumptions reasonable and also prove this time-cost-quality trade-off model sophisticated. PMID:24672351

Examining the Effectiveness of Mindfulness Meditation for Chronic Pain Management in Combat Veterans with Traumatic Brain Injury

DTIC Science & Technology

2013-01-01

third had commented on issues related to his work schedule before losing contact with the researchers. Finally, one patient was excluded due to a...M., Keller, S., & Ware, J. E. (2001). Sleep problems, health- related quality of life, work functioning and health care utilization among the...et al., 2006). Military deployment to a war zone may significantly alter health status and quality of life, elevating the risk of long -term physical

Bottom Line II Conference. Quality -- The Vital Link in Production and Readiness.

DTIC Science & Technology

1983-06-01

Business schools teach the concept, and popular books such as MEGATRENDS and IN SEARC CF MMECELT11E, reiterate it. Similarly, it is important that leaders...work the Quality problem. You rarely find it in universities - Dr. Hunter, talked to the issue, but if you go back and look at the business schools , or...biggest. We have developed some sloppy management practices in this country. I think our business schools have turned out people disciplined to think

LQAS usefulness in an emergency department.

PubMed

de la Orden, Susana Granado; Rodríguez-Rieiro, Cristina; Sánchez-Gómez, Amaya; García, Ana Chacón; Hernández-Fernández, Tomás; Revilla, Angel Abad; Escribano, Dolores Vigil; Pérez, Paz Rodríguez

2008-01-01

This paper aims to explore lot quality assurance sampling (LQAS) applicability and usefulness in the evaluation of quality indicators in a hospital emergency department (ED) and to determine the degree of compliance with quality standards according to this sampling method. Descriptive observational research in the Hospital General Universitario Gregorio Marañón (HGUGM) emergency department (ED). Patients older than 15 years, diagnosed with dyspnoea, chest pain, urinary tract colic or bronchial asthma attending the HGUGM ED from December 2005 to May 2006, and patients admitted during 2005 with exacerbation of chronic obstructive pulmonary disease or acute meningitis were included in the study. Sample sizes were calculated using LQAS. Different quality indicators, one for each process, were selected. The upper (acceptable quality level (AQL)) and lower thresholds (rejectable quality level (RQL)) were established considering risk alpha = 5 per cent and beta = 20 per cent, and the minimum number of observations required was calculated. It was impossible to reach the necessary sample size for bronchial asthma and urinary tract colic patients. For chest pain, acute exacerbation of chronic obstructive pulmonary disease, and acute meningitis, quality problems were detected. The lot was accepted only for the dyspnoea indicator. The usefulness of LQAS to detect quality problems in the management of health processes in one hospital's ED. The LQAS could complement traditional sampling methods.

Parts Quality Management: Direct Part Marking via Data Matrix Symbols for Mission Assurance

NASA Technical Reports Server (NTRS)

Moss, Chantrice

2013-01-01

A United States Government Accountability Office (GAO) review of twelve NASA programs found widespread parts quality problems contributing to significant cost overruns, schedule delays, and reduced system reliability. Direct part-marking with Data Matrix symbols could significantly improve the quality of inventory control and parts lifecycle management. This paper examines the feasibility of using 15 marking technologies for use in future NASA programs. A structural analysis is based on marked material type, operational environment (e.g., ground, suborbital, orbital), durability of marks, ease of operation, reliability, and affordability. A cost-benefits analysis considers marking technology (data plates, label printing, direct part marking) and marking types (two-dimensional machine-readable, human-readable). Previous NASA parts marking efforts and historical cost data are accounted for, including in-house vs. outsourced marking. Some marking methods are still under development. While this paper focuses on NASA programs, results may be applicable to a variety of industrial environments.

Does Nursing Facility Use of Habilitation Therapy Improve Performance on Quality Measures?

PubMed

Fitzler, Sandra; Raia, Paul; Buckley, Fredrick O; Wang, Mei

2016-12-01

The purpose of the project, Centers for Medicare & Medicaid Services (CMS) Innovation study, was to evaluate the impact on 12 quality measures including 10 Minimum Data Set (MDS) publicly reported measures and 2 nursing home process measures using habilitation therapy techniques and a behavior team to manage dementia-related behaviors. A prospective design was used to assess the changes in the measures. A total of 30 Massachusetts nursing homes participated in the project over a 12-month period. Project participation required the creation of an interdisciplinary behavior team, habilitation therapy training, facility visit by the program coordinator, attendance at bimonthly support and sharing calls, and monthly collection of process measure data. Participating facilities showed improvement in 9 of the 12 reported measures. Findings indicate potential quality improvement in having nursing homes learn habilitation therapy techniques and know how to use the interdisciplinary team to manage problem behaviors. © The Author(s) 2016.

Manufacturing Credibility: The National Energy Management Institute and the Tobacco Institute's Strategy for Indoor Air Quality

PubMed Central

Balbach, Edith D.

2011-01-01

Objectives. We studied tobacco industry efforts during the 1980s and 1990s to promote the National Energy Management Institute (NEMI), a nonprofit organization, as an authority on indoor air quality as part of the industry's strategy to oppose smoke-free worksite policies. Methods. We analyzed tobacco industry documents, conducted literature searches in Lexis–Nexis for background and historical literature, and reviewed relevant public health and policy literature. Results. The tobacco industry provided more than US $6 million to NEMI to establish it as an authority on indoor air quality and to work with it to undermine support for smoke-free air policies by promoting ventilation as a solution to indoor air quality problems. Tobacco industry support for NEMI was not publicly disclosed. Conclusions. NEMI was a valuable ally for the tobacco industry through NEMI's ties to organized labor, its technical background, and its status as a third-party actor. NEMI also helped the industry to portray ventilation to improve overall indoor air quality and smoke-free worksites as an either–or choice; in fact, both can improve worker health. PMID:21233427

Manufacturing credibility: the National Energy Management Institute and the Tobacco Institute's strategy for indoor air quality.

PubMed

Campbell, Richard B; Balbach, Edith D

2011-03-01

We studied tobacco industry efforts during the 1980s and 1990s to promote the National Energy Management Institute (NEMI), a nonprofit organization, as an authority on indoor air quality as part of the industry's strategy to oppose smoke-free worksite policies. We analyzed tobacco industry documents, conducted literature searches in Lexis-Nexis for background and historical literature, and reviewed relevant public health and policy literature. The tobacco industry provided more than US $6 million to NEMI to establish it as an authority on indoor air quality and to work with it to undermine support for smoke-free air policies by promoting ventilation as a solution to indoor air quality problems. Tobacco industry support for NEMI was not publicly disclosed. NEMI was a valuable ally for the tobacco industry through NEMI's ties to organized labor, its technical background, and its status as a third-party actor. NEMI also helped the industry to portray ventilation to improve overall indoor air quality and smoke-free worksites as an either-or choice; in fact, both can improve worker health.

Whistle Blowing: A Message to Leaders and Managers Comment on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organizations".

PubMed

Schein, Edgar H

2015-11-29

This comment argues that instead of worrying about the pros and cons of whistleblowing one should focus on the more general problem of the failure of upward communication around safety and quality problems and consider what leaders and managers must do to stimulate subordinates to communicate and reward such communication. The article analyzes why safety failures occur and introduces the concept of practical drift and adaptive moves as necessary for systemic safety to be understood and better handled. It emphasizes the key role of senior leadership in creating a climate in which critical upward communication will become more likely. © 2016 by Kerman University of Medical Sciences.

Centralization of dairy farming facilities for improved economics and environmental quality.

PubMed

Inaba, Rokuta; Furuichi, Tohru; Komatsu, Toshihiro; Tanikawa, Noboru; Ishii, Kazuei

2009-01-01

In Japan, most farm animal excreta has been stored directly on farmland. Runoff from this storage has often caused water pollution. Biogasification is anticipated as an important technology to manage excreta properly, but complex problems hinder its introduction. Economic aspects of management have been especially difficult for dairy farmers. For this study, structural problems regarding introduction of biogasification into dairy farming were identified. Subsequently, a desirable system of dairy farming including biogasification was suggested, and an evaluation model of the financial balance was constructed. A case study using current financial balances of several systems of dairy farming was evaluated using the constructed model and actual data. The systems were based on several policy alternatives including the suggested system mentioned above. Results show that a farmer can obtain sufficient income from a system featuring centralization of dairy housing and biogasification facilities and coordinated management by over six farmers.

Application of the MERIT survey in the multi-criteria quality assessment of occupational health and safety management.

PubMed

Korban, Zygmunt

2015-01-01

Occupational health and safety management systems apply audit examinations as an integral element of these systems. The examinations are used to verify whether the undertaken actions are in compliance with the accepted regulations, whether they are implemented in a suitable way and whether they are effective. One of the earliest solutions of that type applied in the mining industry in Poland involved the application of audit research based on the MERIT survey (Management Evaluation Regarding Itemized Tendencies). A mathematical model applied in the survey facilitates the determination of assessment indexes WOPi for each of the assessed problem areas, which, among other things, can be used to set up problem area rankings and to determine an aggregate (synthetic) assessment. In the paper presented here, the assessment indexes WOPi were used to calculate a development measure, and the calculation process itself was supplemented with sensitivity analysis.

Smart wireless continence management system for persons with dementia.

PubMed

Wai, Aung Aung Phyo; Fook, Victor Foo Siang; Jayachandran, Maniyeri; Biswas, Jit; Nugent, Chris; Mulvenna, Maurice; Lee, Jer-En; Kiat, Philp Yap Lian

2008-10-01

Incontinence is highly prevalent in the elderly population, especially in nursing home residents with dementia. It is a distressing and costly health problem that affects not only the patients but also the caregivers. Effective continence management is required to provide quality care, and to eliminate high labor costs and annoyances to the caregivers resulting from episodes of incontinence. This paper presents the design, development, and preliminary deployment of a smart wireless continence management system for dementia-impaired elderly or patients in institutional care settings such as nursing homes and hospitals. Specifically, the mote wireless platform was used to support the deployment of potentially large quantities of wetness sensors with wider coverage and with dramatically less complexity and cost. It consists of an intelligent signal relay mechanism so that the residents are free to move about in the nursing home or hospital and allows personalized continence management service. Preliminary results from a trial in a local nursing home are promising and can significantly improve the quality of care for patients.

High-rise construction in Russia as one of the objectives of improving the management mechanism for living standards of the population

NASA Astrophysics Data System (ADS)

Sergeeva, Svetlana; Komyshova, Lyudmila; Nagibina, Natalia

2018-03-01

The article is aimed at determining the significance of solving the problem of high-rise construction in Russia as one of the tasks of improving the mechanism of managing the living standards of the population. To determine the effectiveness of measures aimed at improving the quality of life management mechanism, the expert evaluation method is used. The paper presents the measures to improve the quality of life and consequently the migration attractiveness of the region. Despite a number of actual difficulties and lack of sufficient experience, there is an interest in the development of high-rise construction. The result of the analysis of the general demographic dynamics for the last fifteen years is shown. Migration is the most mobile tool for managing short-term demographic processes; therefore, great attention should be paid to this component. Moreover, it is necessary to take into account other consequences of migration.

GIS and Game Theory for Water Resource Management

NASA Astrophysics Data System (ADS)

Ganjali, N.; Guney, C.

2017-11-01

In this study, aspects of Game theory and its application on water resources management combined with GIS techniques are detailed. First, each term is explained and the advantages and limitations of its aspect is discussed. Then, the nature of combinations between each pair and literature on the previous studies are given. Several cases were investigated and results were magnified in order to conclude with the applicability and combination of GIS- Game Theory- Water Resources Management. It is concluded that the game theory is used relatively in limited studies of water management fields such as cost/benefit allocation among users, water allocation among trans-boundary users in water resources, water quality management, groundwater management, analysis of water policies, fair allocation of water resources development cost and some other narrow fields. Also, Decision-making in environmental projects requires consideration of trade-offs between socio-political, environmental, and economic impacts and is often complicated by various stakeholder views. Most of the literature on water allocation and conflict problems uses traditional optimization models to identify the most efficient scheme while the Game Theory, as an optimization method, combined GIS are beneficial platforms for agent based models to be used in solving Water Resources Management problems in the further studies.

[Drug shortage: determinants, consequences and management].

PubMed

Reis, Adriano Max Moreira; Perini, Edson

2008-04-01

The present study analyzes drug shortage as a problem reaching beyond the logistic aspect of the health field and discusses its consequences with respect to quality, safety and cost of health care delivery. The pharmaceutical supply chain and the factors that determine the distribution and availability of drugs are discussed. The contribution of the Pharmacy and Therapeutics Committee in preventing and managing drug shortage in health institutions is stressed and measures for drug shortage management are suggested. Finally it is emphasized that drugs should be considered health products rather than consumer goods and as such be given a different treatment by the supply chain.

A Multiple Period Problem in Distributed Energy Management Systems Considering CO2 Emissions

NASA Astrophysics Data System (ADS)

Muroda, Yuki; Miyamoto, Toshiyuki; Mori, Kazuyuki; Kitamura, Shoichi; Yamamoto, Takaya

Consider a special district (group) which is composed of multiple companies (agents), and where each agent responds to an energy demand and has a CO2 emission allowance imposed. A distributed energy management system (DEMS) optimizes energy consumption of a group through energy trading in the group. In this paper, we extended the energy distribution decision and optimal planning problem in DEMSs from a single period problem to a multiple periods one. The extension enabled us to consider more realistic constraints such as demand patterns, the start-up cost, and minimum running/outage times of equipment. At first, we extended the market-oriented programming (MOP) method for deciding energy distribution to the multiple periods problem. The bidding strategy of each agent is formulated by a 0-1 mixed non-linear programming problem. Secondly, we proposed decomposing the problem into a set of single period problems in order to solve it faster. In order to decompose the problem, we proposed a CO2 emission allowance distribution method, called an EP method. We confirmed that the proposed method was able to produce solutions whose group costs were close to lower-bound group costs by computational experiments. In addition, we verified that reduction in computational time was achieved without losing the quality of solutions by using the EP method.

[Quality assurance of hospital medical records as a risk management tool].

PubMed

Terranova, Giuseppina; Cortesi, Elisabetta; Briani, Silvia; Giannini, Raffaella

2006-01-01

A retrospective analysis of hospital medical records was performed jointly by the Medicolegal department of the Pistoia Local Health Unit N. 3 and by the management of the SS. Cosma and Damiano di Pescia Hospital. Evaluation was based on ANDEM criteria, JCAHO standards, and the 1992 discharge abstract guidelines of the Italian Health Ministry. In the first phase of the study, data were collected and processed for each hospital ward and then discussed with clinicians and audited. After auditing, appropriate actions were agreed upon for correcting identified problems. Approximately one year later a second smaller sample of medical records was evaluated and a higher compliance rate with the established corrective actions was found in all wards for all data categories. In this study the evaluation of medical records can be considered in the wider context of risk management, a multidisciplinary process directed towards identifying and monitoring risk through the use of appropriate quality indicators.

An inexact multistage fuzzy-stochastic programming for regional electric power system management constrained by environmental quality.

PubMed

Fu, Zhenghui; Wang, Han; Lu, Wentao; Guo, Huaicheng; Li, Wei

2017-12-01

Electric power system involves different fields and disciplines which addressed the economic system, energy system, and environment system. Inner uncertainty of this compound system would be an inevitable problem. Therefore, an inexact multistage fuzzy-stochastic programming (IMFSP) was developed for regional electric power system management constrained by environmental quality. A model which concluded interval-parameter programming, multistage stochastic programming, and fuzzy probability distribution was built to reflect the uncertain information and dynamic variation in the case study, and the scenarios under different credibility degrees were considered. For all scenarios under consideration, corrective actions were allowed to be taken dynamically in accordance with the pre-regulated policies and the uncertainties in reality. The results suggest that the methodology is applicable to handle the uncertainty of regional electric power management systems and help the decision makers to establish an effective development plan.

Implementing total quality management in an academic surgery setting: lessons learned.

PubMed

Townes, C; Petit, B; Young, B

1995-01-01

Total Quality Management, a philosophy developed by W. Edwards Deming, has been used successfully in many countries and in many types of organizations to improve the quality of processes. The system is based upon the scientific method and provides the ability to solve long-standing, recalcitrant problems. The application of the TQM philosophy to health care, although recommended by many medical economists, is still in its infancy. At our medical center, three departments (Surgery, Anesthesiology, and Operating Room Services) joined forces to implement TQM. Critical activities early in implementation included establishing a Steering Committee, training key employees, providing systems for communicating TQM activities, and developing the leadership, facilitator, and other resources needed to support teams. Two of our first teams studied very different processes (one in the Operating Room, the other in outpatient Surgery clinics), providing many useful insights regarding keys to successful application of the TQM philosophy. We have learned strategies for increasing acceptance of and participation in TQM efforts on the part of staff members and, in particular, physicians, and for initiating the cultural change needed for TQM. Although the teams have met with resistance to behavioral changes and a lack of full support from some upper-level administrators in the Medical Center and the Hospital, most of them have been quite successful in improving the processes under study. We conclude that, with the proper leadership and facilitation, the TQM philosophy can be successfully implemented in the health care environment. Total Quality Management (TQM) as a system for improving the quality of processes has been successful in many countries throughout the world for organizations offering a wide variety of products and services. This article will describe specific TQM endeavors, both successful and unsuccessful, undertaken in an academic surgery department in the United States. This description will illustrate the lessons we have learned in our attempt to change a complex organization and will enable readers to determine whether an analogy exists between our organization's response to problem solving and theirs.

Safety, Tolerability and Efficacy of Drugs for Treating Behavioural Insomnia in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review with Methodological Quality Assessment.

PubMed

Anand, Shweta; Tong, Henry; Besag, Frank M C; Chan, Esther W; Cortese, Samuele; Wong, Ian C K

2017-06-01

A large proportion of paediatric patients with attention-deficit/hyperactivity disorder (ADHD) have associated sleep problems which not only affect the child's wellbeing but also impact family functioning. Management of sleep problems is consequently an important aspect of overall ADHD management in paediatric patients. Although some drugs are being used off-label for the management of paediatric insomnia, there is scant clinical evidence supporting their use. Our aim was to identify and assess the quality of published studies reporting the safety, tolerability and efficacy of drugs used for treating behavioural insomnia in children with ADHD. After an initial screen to determine which drugs were most commonly used, we conducted a systematic review of English-language publications from searches of PubMed, EMBASE, PsycINFO and two trial register databases to February 2017, using keywords 'clonidine', 'melatonin', 'zolpidem', 'eszopiclone', 'L-theanine', 'guanfacine', 'ADHD', 'sleep disorder' and 'children'. For quality assessment of included studies, we used the CONSORT checklist for randomised control trials (RCTs) and the Downs and Black checklist for non-RCTs. Twelve studies were included. Two case series for clonidine, two RCTs and four observational studies for melatonin and one RCT each for zolpidem, eszopiclone, L-theanine and guanfacine. Of the 12 included studies, only one on eszopiclone scored excellent for quality. The quality of the rest of the studies varied from moderate to low. For clonidine, melatonin and L-theanine, improvements in sleep-onset latency and total sleep duration were reported; however, zolpidem, eszopiclone and guanfacine failed to show any improvement when compared with placebo. Clonidine, melatonin, L-theanine, eszopiclone and guanfacine were well tolerated with mild to moderate adverse events; zolpidem was associated with neuropsychiatric adverse effects. There is generally poor evidence for prescribing drugs for behavioural insomnia in children with ADHD. Further controlled studies are warranted.

[Evaluation of primary health care activities at the Albert Schweitzer hospital in Lambarene, Gabon].

PubMed

Diallo, M; Ninteretse, B

2007-06-01

In 1999 the Albert Schweitzer Hospital in Lambrene, Gabon set up a community health care service that provides immunization campaigns and mother/child health care and manages 9 village health care centers in a district with a population of approximately 64000 inhabitants. An evaluation conducted in April 2006 showed that collection of a consultation charge (15 euros) could cover the basic costs of operating these centers and purchasing necessary medicines. Three of the four centers evaluated demonstrated good quality indicators including properly kept records, posting of information bulletins for patients, appropriate referrals, and good relations with village authorities. At the center that performed poorly, the nurse apparently received no pay or lodging. Analysis of data about pediatric activity showed that diagnosis of diarrhea, malnutrition and anemia has fallen while hospitalization for tuberculosis and urinary schistomiasis is now being recorded. At the same time, village health centers are increasingly concerned with problems related to management and prevention of AIDS, malaria and urinary schistomiasis. This service shows that with good supervision it is possible to improve the quality of primary health care with partial but adequate recovery of costs and that basic health care workers are able to provide overall management for complicated patients, facilitate the work of reference hospital, and report new health problems.

A Brief Study of Software Engineering Professional Continuing Education in DoD Acquisition

DTIC Science & Technology

2010-04-01

Lifecycle Processes (IEEE 12207 ) (810) 37% 61% 2% Guide to the Software Engineering Body of K l d (SWEBOK) (804) 67% 31% 2% now e ge Software...Engineering-Software Measurement Process ( ISO /IEC 15939) (797) 55% 44% 2% Capability Maturity Model Integration (806) 17% 81% 2% Six Sigma Process...Improvement (804) 7% 91% 1% ISO 9000 Quality Management Systems (803) 10% 89% 1% 28 Conclusions Significant problem areas R i tequ remen s Management Very

Wyoming's industrial siting permit process and environmental impact assessment

NASA Astrophysics Data System (ADS)

Hyman, Eric L.

1982-01-01

The problem of management of industrial residuals can be reduced through a rational system for siting and planning major industrial facilities. In the United States, Wyoming has moved in the direction of establishing a one-stop permitting system that provides important information for air and water quality planning and solid waste management with a minimum of regulatory overlap. This paper describes Wyoming's Industrial Development Information and Siting Act of 1975 and suggests ways in which the Wyoming permitting system can be improved and applied elsewhere.

Painful decisions for senior pets.

PubMed

Fox, Steven M

2012-07-01

Osteoarthritis and cancer are the inevitable consequences of aging and significantly contribute to the cause of death in cats and dogs. Managing the pain associated with these disease states is the veterinarian’s mandate. Many treatment modalities and agents are available for patient management; however, it is only with an understanding of disease neurobiology and a mechanism-based approach to problem diagnosis that the clinician can offer patients an optimal quality of life based on evidence-based best medicine. When treating pain, knowledge is still our best weapon.

The newest miracle drug: quality circles in hospitals.

PubMed

McKinney, M M

1984-01-01

In recent years, a number of hospitals throughout the United States have been exploring the use of Japanese-style quality circles to reduce their operating expenses, improve productivity, and enhance the quality of work life for hospital employees. This article examines the organizational climate necessary for quality circles, methods used to implement quality circles, and management's role in guiding and responding to circle activities. Ideas for building and maintaining staff support are presented along with a cost/benefit analysis of quality circle programs. The author concludes that quality circles are most successful in hospitals where they are part of a larger organizational development effort. When administrators believe in their employees' ability to contribute to the institution and are willing to invest necessary time and resources in employee education and the measurement of quality circle achievements, quality circles can produce creative solutions to perplexing institutional problems.

Research on the Intensive Material Management System of Biomass Power Plant

NASA Astrophysics Data System (ADS)

Zhang, Ruosi; Hao, Tianyi; Li, Yunxiao; Zhang, Fangqing; Ding, Sheng

2017-05-01

In view of the universal problem which the material management is loose, and lack of standardization and interactive real-time in the biomass power plant, a system based on the method of intensive management is proposed in this paper to control the whole process of power plant material. By analysing the whole process of power plant material management and applying the Internet of Things, the method can simplify the management process. By making use of the resources to maximize and data mining, material utilization, circulation rate and quality control management can be improved. The system has been applied in Gaotang power plant, which raised the level of materials management and economic effectiveness greatly. It has an important significance for safe, cost-effective and highly efficient operation of the plant.

[Errors in wound management].

PubMed

Filipović, Marinko; Novinscak, Tomislav

2014-10-01

Chronic ulcers have adverse effects on the patient quality of life and productivity, thus posing financial burden upon the healthcare system. Chronic wound healing is a complex process resulting from the interaction of the patient general health status, wound related factors, medical personnel skill and competence, and therapy related products. In clinical practice, considerable improvement has been made in the treatment of chronic wounds, which is evident in the reduced rate of the severe forms of chronic wounds in outpatient clinics. However, in spite of all the modern approaches, efforts invested by medical personnel and agents available for wound care, numerous problems are still encountered in daily practice. Most frequently, the problems arise from inappropriate education, of young personnel in particular, absence of multidisciplinary approach, and inadequate communication among the personnel directly involved in wound treatment. To perceive them more clearly, the potential problems or complications in the management of chronic wounds can be classified into the following groups: problems mostly related to the use of wound coverage and other etiology related specificities of wound treatment; problems related to incompatibility of the agents used in wound treatment; and problems arising from failure to ensure aseptic and antiseptic performance conditions.

Modeling sedimentation-filtration basins for urban watersheds using Soil and Water Assessment Tool

USDA-ARS?s Scientific Manuscript database

Sedimentation-filtration (SedFil) basins are one of the storm-water best management practices (BMPs) that are intended to mitigate water quality problems in urban creeks and rivers. A new physically based model of variably saturated flows was developed for simulating flow and sediment in SedFils wi...

Searching for the value of a view

Treesearch

Arthur W. Magill; Charles F. Schwan

1989-01-01

Assessing the trade-offs between market and nonmarket products of wildlands poses a major problem fornatural resource planners and managers. Scenic quality is a resource that is not quantifiable in monetary terms. To determine if market values of real estate offering views could define relative dollar values for physical dimensions and objects in views, they were...

Assessment of the potential quality of preservative-treated pilings removed from service : [abstract

Treesearch

Xiping Wang; John W. Forsman; John R. Erickson; Robert J. Ross; Douglas J. Gardner; Gary D. McGinnis; Rodney C. DeGroot

1999-01-01

Preservative-treated wood products are important construction materials. Preservative-treated wood pilings, after removal from service, constitute a major disposal problem for managers of waterfront facilities. For example, approximately 7,000 to 8,000 tons of mechanically or biologically deteriorated wood pilings are currently removed from U.S. naval facilities...

Worker Participation--Productivity and the Quality of Work Life. Worldwatch Paper 25.

ERIC Educational Resources Information Center

Stokes, Bruce

The world economic situation is beset by growing worker dissatisfaction, slowing economic growth, and rising energy and resource costs. A partial solution to these problems may be worker participation in management and ownership. As production has become more dehumanized and workers have become increasingly dissatisfied and alienated, the quality…

Application of Artificial Intelligence to the DoD Corporate Information Management (CIM) Program

DTIC Science & Technology

1992-04-01

problem of balancing the investments of the corporation between several possible assets; buildings, machine tools, training, R&D and "information...and quality of worklife /learning/empowerment. For the moment the driving factor for the DoD has been identified as cost reduction, however it is clear

Evaluating Quality Management of Acute Low Back Problems Provided By Air Force Nurse Practitioners

DTIC Science & Technology

1999-05-01

evaluate acute back pain, acute back pain with sciatica , and chronic low back pain. Nine treatments were listed in part one, and physicians were asked to...corsets, trigger point injections, and epidural steroid injections for sciatica are effective for chronic back pain. The study concluded that there

Tillage system and time post-liquid dairy manure: Effects on runoff, sediment and nutrients losses

USDA-ARS?s Scientific Manuscript database

Liquid manure applied in agricultural lands improves soil quality. However, incorrect management of manure may cause environmental problems due to sediments and nutrients losses associated to runoff. The aims of this work were to: (i) evaluate the time effect of post-liquid dairy manure (LDM) applic...