Factors influencing the output of rural cataract surgical facilities in China: the SHARP study

Purpose: To identify factors associated prospectively with increased cataract surgical rate (CSR) in rural Chinese hospitals.

Methods: Annual cataract surgical output was obtained at baseline and 24 months later from operating room records at 42 rural, county-level hospitals. Total local CSR (cases/million population/y), and proportion of CSR from hospital and local competitors were calculated from government records. Hospital administrators completed questionnaires providing demographic and professional information, and annual clinic and outreach screening volume. Independent cataract surgeons provided clinical information and videotapes of cases for grading by two masked experts using the Ophthalmology Surgical Competency Assessment Rubric (OSCAR). Uncorrected vision was recorded for 10 consecutive cataract cases at each facility, and 10 randomly-identified patients completed hospital satisfaction questionnaires. Total value of international nongovernmental development organization (INGDO) investment in the previous three years and demographic information on hospital catchment areas were obtained. Main outcome was 2-year percentage change in hospital CSR.

Results: Among the 42 hospitals (median catchment population 530,000, median hospital CSR 643), 78.6% (33/42) were receiving INGDO support. Median change in hospital CSR (interquartile range) was 33.3% (-6.25%, 72.3%). Predictors of greater increase in CSR included higher INGDO investment (P = 0.02, simple model), reducing patient dissatisfaction (P = 0.03, simple model), and more outreach patient screening (P = 0.002, simple and multiple model).

Conclusions: Outreach cataract screening was the strongest predictor of increased surgical output. Government and INGDO investment in screening may be most likely to enhance output of county hospitals, a major goal of China's Blindness Prevention Plan.

Developing Food Products For Consumers on a Gluten Free Diet

There is a significant increase in people that choose to follow an avoidance diet, especially excluding gluten. Unlike previously, there is now a demand for ‘no compromise’ gluten-free cereal products that have the same properties as their wheat contain counterparts. This is very challenging for the bakers and the cereal technologists due to the functional role of the gluten network in some of these products. Numerous combinations of raw materials form natural sources have been studied and critically evaluated in this review. Most of the gluten-free products are made of native and modified starches blended with different hydrocolloids due to their structure-building and water binding properties. These ingredients are added to a gluten-free flour, such as rice and corn. The legislation framework, formulations for manufacturing of highl nutritional value bread, pasta and cakes/biscuits as well as quality assurance aspects for the gluten-free manufacturers are discussed in this review.

Lean principles and techniques for improving the quality and productivity of software development projects: a case study

Software product development is recognised as difficult due to the intangible nature of the product, requirements elicitation, effective progress measurement, and so forth. In this paper, we describe some of the challenges of software product development and how the challenges are being met by lean management principles and techniques. Specifically, we examine lean principles and techniques that were devised by Toyota and other manufacturers over the last 50 years. Applying lean principles to software development projects has been advocated for over ten years and it will be shown that the extensive lean literature is a valuable source of ideas for software development. A case study with a software development organisation, Timberline Inc., will demonstrate that lean principles and techniques can be successfully applied to software product development.

Analytical strategies for the early quality and safety assurance in the global feed chain. Approaches for nitrogen adulterants in soybean meal and mineral and transformer oils in vegetable oils.

In the past decade, several major food safety crises originated from problems with feed. Consequently, there is an urgent need for early detection of fraudulent adulteration and contamination in the feed chain. Strategies are presented for two specific cases, viz. adulterations of (i) soybean meal with melamine and other types of adulterants/contaminants and (ii) vegetable oils with mineral oil, transformer oil or other oils. These strategies comprise screening at the feed mill or port of entry with non-destructive spectroscopic methods (NIRS and Raman), followed by post-screening and confirmation in the laboratory with MS-based methods. The spectroscopic techniques are suitable for on-site and on-line applications. Currently they are suited to detect fraudulent adulteration at relatively high levels but not to detect low level contamination. The potential use of the strategies for non-targeted analysis is demonstrated.

Lean software management case study: Timberline Inc.

This paper is believed to be the first documented account of a full adoption of lean by a software company. Lean techniques were devised by Toyota and other manufacturers over the last 50 years. The techniques are termed lean because they require less resource to produce more product and exceptional quality. Lean ideas have also been successful in service industries and product development. Applying lean to software has been advocated for over 10 years. Timberline, Inc started their lean initiative in Spring 2001 and this paper records their journey, results and lessons learned up to Fall 2003. This case study demonstrates that lean thinking can work successfully for software developers. It also indicates that the extensive lean literature is a valuable source of new ideas for software engineering.

Sources of Software Requirements Change from the Perspectives of Development and Maintenance

Changes to software requirements occur during initial development and subsequent to delivery, posing a risk to cost and quality while at the same time providing an opportunity to add value. Provision of a generic change source taxonomy will support requirements change risk visibility, and also facilitate richer recording of both pre- and post-delivery change data. In this paper we present a collaborative study to investigate and classify sources of requirements change, drawing comparison between those pertaining to software development and maintenance. We begin by combining evolution, maintenance and software lifecycle research to derive a definition of software maintenance, which provides the foundation for empirical context and comparison. Previously published change ‘causes’ pertaining to development are elicited from the literature, consolidated using expert knowledge and classified using card sorting. A second study incorporating causes of requirements change during software maintenance results in a taxonomy which accounts for the entire evolutionary progress of applications software. We conclude that the distinction between the terms maintenance and development is imprecise, and that changes to requirements in both scenarios arise due to a combination of factors contributing to requirements uncertainty and events that trigger change. The change trigger taxonomy constructs were initially validated using a small set of requirements change data, and deemed sufficient and practical as a means to collect common requirements change statistics across multiple projects.

Are We Ready for SDN? Implementation Challenges for Software-Defined Networks

Cloud services are exploding, and organizations are converging their data centers in order to take advantage of the predictability, continuity, and quality of service delivered by virtualization technologies. In parallel, energy-efficient and high-security networking is of increasing importance. Network operators, and service and product providers require a new network solution to efficiently tackle the increasing demands of this changing network landscape. Software-defined networking has emerged as an efficient network technology capable of supporting the dynamic nature of future network functions and intelligent applications while lowering operating costs through simplified hardware, software, and management. In this article, the question of how to achieve a successful carrier grade network with software-defined networking is raised. Specific focus is placed on the challenges of network performance, scalability, security, and interoperability with the proposal of potential solution directions.