Knowledge-based clinical pathway for medical quality improvement

Clinical pathways have been adopted for various diseases in clinical departments for quality improvement as a result of standardization of medical activities in treatment process. Using knowledge-based decision support on the basis of clinical pathways is a promising strategy to improve medical quality effectively. However, the clinical pathway knowledge has not been fully integrated into treatment process and thus cannot provide comprehensive support to the actual work practice. Therefore this paper proposes a knowledgebased clinical pathway management method which contributes to make use of clinical knowledge to support and optimize medical practice. We have developed a knowledgebased clinical pathway management system to demonstrate how the clinical pathway knowledge comprehensively supports the treatment process. The experiences from the use of this system show that the treatment quality can be effectively improved by the extracted and classified clinical pathway knowledge, seamless integration of patient-specific clinical pathway recommendations with medical tasks and the evaluating pathway deviations for optimization.

Studies on weed infestation and tea growth under various weed management methods in a young Tea (Camellia sinensis [L.] kuntze) plantation

A field experiment was conducted in the low country of Sri Lanka, during the period 1994–1995 to investigate the severity of weed infestation and tea growth in relation to weed management methods in newly established tea (Camellia sinensis[L.] Kuntze). Manual weeding (hand and slash weeding) at various intervals was compared with various herbicides, with or without mulching. Weed control with herbicides was superior to that of hand weeding at 6-week intervals or more. Weed control with oxyfluorfen at 0.29 kg ai ha−1 + paraquat at 0.17 kg ai ha−1 or glyphosate at 0.99 kg ai ha−1 + kaolin at 3.42 kg ha−1 were superior. Plots unweeded for 12 weeks or more produced significantly greater (P < 0.05) weed biomass than plots unweeded for 6 weeks. Although the least weed dry weight (P < 0.05) and the greatest number of weed species were recorded with hand weeding at 2 week intervals, there was no particular benefit on tea growth when compared with hand weeding at 6 and 12 week intervals. Inter row mulching in chemically treated plots was more favorable for tea growth than no mulching, while living weed cover in unmulched slash weeded plots suppressed tea growth. A combination of mulching and herbicides, particularly oxyfluorfen and paraquat, followed by hand weeding at least every 6–8 weeks was considered the most appropriate weed management system for young tea.

A model of intelligent building energy management for the indoor environment

People's interaction with the indoor environment plays a significant role in energy consumption in buildings. Mismatching and delaying occupants' feedback on the indoor environment to the building energy management system is the major barrier to the efficient energy management of buildings. There is an increasing trend towards the application of digital technology to support control systems in order to achieve energy efficiency in buildings. This article introduces a holistic, integrated, building energy management model called `smart sensor, optimum decision and intelligent control' (SMODIC). The model takes into account occupants' responses to the indoor environments in the control system. The model of optimal decision-making based on multiple criteria of indoor environments has been integrated into the whole system. The SMODIC model combines information technology and people centric concepts to achieve energy savings in buildings.

A normative approach to multi-agent systems for intelligent buildings

Building Management Systems (BMS) are widely adopted in modern buildings around the world in order to provide high-quality building services, and reduce the running cost of the building. However, most BMS are functionality-oriented and do not consider user personalization. The aim of this research is to capture and represent building management rules using organizational semiotics methods. We implement Semantic Analysis, which determines semantic units in building management and their relationship patterns of behaviour, and Norm Analysis, which extracts and specifies the norms that establish how and when these management actions occur. Finally, we propose a multi-agent framework for norm based building management. This framework contributes to the design domain of intelligent building management system by defining a set of behaviour patterns, and the norms that govern the real-time behaviour in a building.

An integrated view of data quality in Earth observation

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.

Adapted customer relationship management implementation framework:facilitating value creation in nursing homes

This paper proposes a framework to support Customer Relationship Management (CRM) implementation in nursing homes. The work extends research by Cheng et al. (2005) who conducted in-depth questionnaires to identify critical features (termed value-characteristics), which are areas identified as adding the most value if implemented. Although Cheng et al. did proposed an implementation framework, summary of, and inconsistent inclusion of value-characteristics, limits the practical use of this contribution during implementation. In this paper we adapt the original framework to correct perceived deficiencies. We link the value characteristics to operational, analytical, strategic and/or collaborative CRM solution types, to allow consideration in context of practical implementation solutions. The outcome of this paper shows that, practically, a 'one solution meets all characteristic' approach to CRM implementation within nursing homes is inappropriate. Our framework, however, supports implementers in identifying how value can be gained when implementing a specific CRM solution within nursing homes; which subsequently support project management and expectation management.

Executive project management structure and the challenges acing its adoption in the Nigerian construction industry

Project management (PM) is a globally recognized discipline and has been widely adopted within the construction industry. Despite advancements in the PM discipline, the ineffective traditional management system, typical of the non-executive PM structure, is still widely used in the Nigerian construction industry. The aim of this paper is thus to explore the challenges facing the adoption of the executive PM structure in Nigeria. The paper first assesses the level of growth of PM in Nigeria using UK best practices as a benchmark and identifies the key PM characteristics in the two countries. Focus group interviews were used to collect the primary data for the study and content analysis was used to present the results in a thematic format. The study revealed the key barriers to the adoption of an executive PM structure in Nigeria as a lack of proper awareness, unfavorable policies, skill shortages, the traditional culture of stakeholders and the absence of a regulatory body. It is recommended that the government, as a major player/client in the Nigerian construction industry, should lead the campaign to change the traditional industry approach to project management. This is necessary if construction stakeholders in Nigeria are to be educated and encouraged towards adopting and putting into practice effective PM.

Urban integrated meteorological observations: practice and experience in Shanghai, China

Observations of atmospheric conditions and processes in citiesare fundamental to understanding the interactions between the urban surface and weather/climate, improving the performance of urban weather, air quality and climate models, and providing key information for city end-users (e.g. decision-makers, stakeholders, public). In this paper, Shanghai's urban integrated meteorological observation network (SUIMON) and some examples of intended applications are introduced. Its characteristics include being: multi- purpose (e.g. forecast, research, service), multi-function (high impact weather, city climate, special end-users), multi-scale (e.g. macro/meso-, urban-, neighborhood, street canyon), multi-variable (e.g. thermal, dynamic, chemical, bio-meteorological, ecological), and multi- platform (e.g. radar, wind profiler, ground-based, satellite based, in-situ observation/ sampling). Underlying SUIMON is a data management system to facilitate exchange of data and information. The overall aim of the network is to improve coordination strategies and instruments; to identify data gaps based on science and user driven requirements; and to intelligently combine observations from a variety of platforms by using a data assimilation system that is tuned to produce the best estimate of the current state of the urban atmosphere.

Linking alkaline phosphatase activity with bacterial phoD gene abundance in soil from a long-term management trial

Changes in land management practices may have significant implications for soil microbial communities important in organic P turnover. Soil bacteria can increase plant P availability by excreting phosphatase enzymes which catalyze the hydrolysis of ester-phosphate bonds. Examining the diversity and abundance of alkaline phosphatase gene harboring bacteria may provide valuable insight into alkaline phosphatase production in soils. This study examined the effect of 20 years of no input organic (ORG), organic with composted manure (ORG + M), conventional (CONV) and restored prairie (PRA) management on soil P bioavailability, alkaline phosphatase activity (ALP), and abundance and diversity of ALP gene (phoD) harboring bacteria in soils from the northern Great Plains of Canada. Management system influenced bioavailable P (P < 0.001), but not total P, with the lowest concentrations in the ORG systems and the highest in PRA. Higher rates of ALP were observed in the ORG and ORG + M treatments with a significant negative correlation between bioavailable P and ALP in 2011 (r2 = 0.71; P = 0.03) and 2012 (r2 = 0.51; P = 0.02), suggesting that ALP activity increased under P limiting conditions. The phoD gene abundance was also highest in ORG and ORG + M resulting in a significant positive relationship between bacterial phoD abundance and ALP activity (r2 = 0.71; P = 0.009). Analysis of phoD bacterial community fingerprints showed a higher number of species in CONV compared to ORG and ORG + M, contrary to what was expected considering greater ALP activity under ORG management. In 2012, banding profiles of ORG + M showed fewer phoD bacterial species following the second manure application, although ALP activity is higher than in 2011. This indicates that a few species may be producing more ALP and that quantitative gene analysis was a better indicator of activity than the number of species present.

Soil bacterial phoD gene abundance and expression in response to applied phosphorus and long-term management

Bacterial transformation of phosphorus (P) compounds in soil is largely dependent on soil microbial community function, and is therefore sensitive to anthropogenic disturbances such as fertilization or cropping systems. However, the effect of soil management on the transcription of bacterial genes that encode phosphatases, such as phoD, is largely unknown. This greenhouse study examined the effect of long-term management and P amendment on potential alkaline phosphatase (ALP) activity and phoD gene (DNA) and transcript (RNA) abundance. Soil samples (0–15 cm) were collected from the Glenlea Long-term Rotation near Winnipeg, Manitoba, to compare organic, conventional and prairie management systems. In the greenhouse, pots of soil from each management system were amended with P as either soluble mineral fertilizer or cattle manure and then planted with Italian ryegrass (Lolium multiforum). Soils from each pot were sampled for analysis immediately and after 30 and 106 days. Significant differences among the soil/P treatments were detected for inorganic P, but not the organic P in NaHCO3-extracts. At day 0, ALP activity was similar among the soil/P treatments, but was higher after 30 days for all P amendments in soil from organically managed plots. In contrast, ALP activity in soils under conventional and prairie management responded to increasing rates of manure only, with significant effects from medium and high manure application rates at 30 and 106 days. Differences in ALP activity at 30 days corresponded to the abundance of bacterial phoD genes, which were also significantly higher in soils under organic management. However, this correlation was not significant for transcript abundance. Next-generation sequencing allowed the identification of 199 unique phoD operational taxonomic units (OTUs) from the metagenome (soil DNA) and 35 unique OTUs from the metatranscriptome (soil RNA), indicating that a subset of phoD genes was being transcribed in all soils.