19 resultados para Payment by performance


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Objective To investigate the provision of pharmaceutical care by community pharmacists across Europe and to examine the various factors that could affect its implementation. Methods A questionnaire-based survey of community pharmacies was conducted within 13 European countries. The questionnaire consisted of two sections. The first section focussed on demographic data and services provided in the pharmacy. The second section was a slightly adapted version of the Behavioral Pharmaceutical Care Scale (BPCS) which consists of three main dimensions (direct patient care activities, referral and consultation activities and instrumental activities). Results Response rates ranged from 10–71% between countries. The mean total score achieved by community pharmacists, expressed as a percentage of the total score achievable, ranged from 31.6 (Denmark) to 52.2% (Ireland). Even though different aspects of pharmaceutical care were implemented to different extents across Europe, it was noted that the lowest scores were consistently achieved in the direct patient care dimension (particularly those related to documentation, patient assessment and implementation of therapeutic objectives and monitoring plans) followed by performance evaluation and evaluation of patient satisfaction. Pharmacists who dispensed higher daily numbers of prescriptions in Ireland, Germany and Switzerland had significantly higher total BPCS scores. In addition, pharmacists in England and Ireland who were supported in their place of work by other pharmacists scored significantly higher on referral and consultation and had a higher overall provision of pharmaceutical care. Conclusion The present findings suggest that the provision of pharmaceutical care in community pharmacy is still limited within Europe. Pharmacists were routinely engaged in general activities such as patient record screening but were infrequently involved in patient centred professional activities such as the implementation of therapeutic objectives and monitoring plans, or in self-evaluation of performance.

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This thesis records the design and development of an electrically driven, air to water, vapour compression heat pump of nominally 6kW heat output, for residential space heating. The study was carried out on behalf of GEC Research Ltd through the Interdisciplinary Higher Degrees Scheme at Aston University. A computer based mathematical model of the vapour compression cycle was produced as a design aid, to enable the effects of component design changes or variations in operating conditions to be predicted. This model is supported by performance testing of the major components, which revealed that improvements in the compressor isentropic efficiency offer the greatest potential for further increases in cycle COPh. The evaporator was designed from first principles, and is based on wire-wound heat transfer tubing. Two evaporators, of air side area 10.27 and 16.24m2, were tested in a temperature and humidity controlled environment, demonstrating that the benefits of the large coil are greater heat pump heat output and lower noise levels. A systematic study of frost growth rates suggested that this problem is most severe at the conditions of saturated air at 0oC combined with low condenser water temperature. A dynamic simulation model was developed to predict the in-service performance of the heat pump. This study confirmed the importance of an adequate radiator area for heat pump installations. A prototype heat pump was designed and manufactured, consisting of a hermetic reciprocating compressor, a coaxial tube condenser and a helically coiled evaporator, using Refrigerant 22. The prototype was field tested in a domestic environment for one and a half years. The installation included a comprehensive monitoring system. Initial problems were encountered with defrosting and compressor noise, both of which were solved. The unit then operated throughout the 1985/86 heating season without further attention, producing a COPh of 2.34.

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The performance of MoS2 as a hydrogen evolution catalyst is diminished by exposure to air. We demonstrate a solution phase technique to resulfidate MoSxO2-x using Na2S2O3. The success of the method was judged by performance as a H+ reduction catalyst. Following sulfidation samples displayed a favourable decrease in both onset potential and Tafel slope, with the best decreasing from -0.23 V to -0.18 V (vs. SHE), and 282 mV dec-1 to 87 mV dec-1 respectively. Ageing studies indicate that this method may be used to recycle the MoS2 repeatedly without losing catalytic performance, although repeated sulfidation did result in homogenisation of the nanostructure.

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This paper discusses the use of the non-parametric free disposal hull (FDH) and the parametric multi-level model (MLM) as alternative methods for measuring pupil and school attainment where hierarchical structured data are available. Using robust FDH estimates, we show how to decompose the overall inefficiency of a unit (a pupil) into a unit specific and a higher level (a school) component. By a sample of entry and exit attainments of 3017 girls in British ordinary single sex schools, we test the robustness of the non-parametric and parametric estimates. Finally, the paper uses the traditional MLM model in a best practice framework so that pupil and school efficiencies can be computed.

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Visual detection performance (d') is usually an accelerating function of stimulus contrast, which could imply a smooth, threshold-like nonlinearity in the sensory response. Alternatively, Pelli (1985 Journal of the Optical Society of America A 2 1508 - 1532) developed the 'uncertainty model' in which responses were linear with contrast, but the observer was uncertain about which of many noisy channels contained the signal. Such internal uncertainty effectively adds noise to weak signals, and predicts the nonlinear psychometric function. We re-examined these ideas by plotting psychometric functions (as z-scores) for two observers (SAW, PRM) with high precision. The task was to detect a single, vertical, blurred line at the fixation point, or identify its polarity (light vs dark). Detection of a known polarity was nearly linear for SAW but very nonlinear for PRM. Randomly interleaving light and dark trials reduced performance and rendered it non-linear for SAW, but had little effect for PRM. This occurred for both single-interval and 2AFC procedures. The whole pattern of results was well predicted by our Monte Carlo simulation of Pelli's model, with only two free parameters. SAW (highly practised) had very low uncertainty. PRM (with little prior practice) had much greater uncertainty, resulting in lower contrast sensitivity, nonlinear performance, and no effect of external (polarity) uncertainty. For SAW, identification was about v2 better than detection, implying statistically independent channels for stimuli of opposite polarity, rather than an opponent (light - dark) channel. These findings strongly suggest that noise and uncertainty, rather than sensory nonlinearity, limit visual detection.

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Often observations are nested within other units. This is particularly the case in the educational sector where school performance in terms of value added is the result of school contribution as well as pupil academic ability and other features relating to the pupil. Traditionally, the literature uses parametric (i.e. it assumes a priori a particular function on the production process) Multi-Level Models to estimate the performance of nested entities. This paper discusses the use of the non-parametric (i.e. without a priori assumptions on the production process) Free Disposal Hull model as an alternative approach. While taking into account contextual characteristics as well as atypical observations, we show how to decompose non-parametrically the overall inefficiency of a pupil into a unit specific and a higher level (i.e. a school) component. By a sample of entry and exit attainments of 3017 girls in British ordinary single sex schools, we test the robustness of the non-parametric and parametric estimates. We find that the two methods agree in the relative measures of the scope for potential attainment improvement. Further, the two methods agree on the variation in pupil attainment and the proportion attributable to pupil and school level.

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This thesis proposes that despite many experimental studies of thinking, and the development of models of thinking, such as Bruner's (1966) enactive, iconic and symbolic developmental modes, the imagery and inner verbal strategies used by children need further investigation to establish a coherent, theoretical basis from which to create experimental curricula for direct improvement of those strategies. Five hundred and twenty-three first, second and third year comprehensive school children were tested on 'recall' imagery, using a modified Betts Imagery Test; and a test of dual-coding processes (Paivio, 1971, p.179), by the P/W Visual/Verbal Questionnaire, measuring 'applied imagery' and inner verbalising. Three lines of investigation were pursued: 1. An investigation a. of hypothetical representational strategy differences between boys and girls; and b. the extent to which strategies change with increasing age. 2. The second and third year children's use of representational processes, were taken separately and compared with performance measures of perception, field independence, creativity, self-sufficiency and self-concept. 3. The second and third year children were categorised into four dual-coding strategy groups: a. High Visual/High Verbal b. Low Visual/High Verbal c. High Visual/Low Verbal d. Low Visual/Low Verbal These groups were compared on the same performance measures. The main result indicates that: 1. A hierarchy of dual-coding strategy use can be identified that is significantly related (.01, Binomial Test) to success or failure in the performance measures: the High Visual/High Verbal group registering the highest scores, the Low Visual/High Verbal and High Visual/Low Verbal groups registering intermediate scores, and the Low Visual/Low Verbal group registering the lowest scores on the performance measures. Subsidiary results indicate that: 2. Boys' use of visual strategies declines, and of verbal strategies increases, with age; girls' recall imagery strategy increases with age. Educational implications from the main result are discussed, the establishment of experimental curricula proposed, and further research suggested.

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The last major study of sales performance variance explained by salespeople attributes was by Churchill et al. (1985). They examined the effect of role, skills, motivation, personal factors, aptitude, and organizational/environmental factors on sales performance—factors that have dominated the sales performance area. About the same time, Weitz, Sujan, and Sujan (1986) introduced the concepts of salespeople's knowledge structures. Considerable work on the relationship of the elements of knowledge structures and performance can be found in the literature. In this research note, we determine the degree to which sales performance can be explained by knowledge structure variables, a heretofore unexplored area. If knowledge structure variables explain more variance than traditional variables, then this paper would be a call to further research in this area. In examining this research question in a retail context, we find that knowledge structure variables explain 50.2 percent of the variance in sales performance. We also find that variance explained by knowledge structures is significantly different based on gender. The impact of knowledge structures on performance was higher for men than for women. The models using education demonstrated smaller differences.

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Renewable non-edible plant oils such as jatropha and karanj have potential to substitute fossil diesel fuels in CI engines. A multi-cylinder water cooled IDI type CI engine has been tested with jatropha and karanj oils and comparisons made against fossil diesel. The physical and chemical properties of the three fuels were measured to investigate the suitability of jatropha and karanj oils as fuels for CI engines. The engine cooling water circuit and fuel supply systems were modified such that hot jacket water preheated the neat plant oil prior to injection. Between jatropha and karanj there was little difference in the performance, emission and combustion results. Compared to fossil diesel, the brake specific fuel consumption on volume basis was around 3% higher for the plant oils and the brake thermal efficiency was almost similar. Jatropha and karanj operation resulted in higher CO 2 and NO x emissions by 7% and 8% respectively, as compared to diesel. The cylinder gas pressure diagram showed stable engine operation with both plant oils. At full load, the plant oils gave around 3% higher peak cylinder pressure than fossil diesel. With the plant oils, cumulative heat release was smaller at low load and almost similar at full load, compared to diesel. At full load, the plant oils exhibited 5% shorter combustion duration. The study concludes that the IDI type CI engine can be efficiently operated with neat jatropha (or karanj) oil preheated by jacket water, after small modifications of the engine cooling and fuel supply circuits. © 2012 Elsevier Ltd.

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We demonstrate a novel time-resolved Q-factor measurement technique and demonstrate its application in the analysis of optical packet switching systems with high information spectral density. For the first time, we report the time-resolved Q-factor measurement of 42.6 Gbit/s AM-PSK and DQPSK modulated packets, which were generated by a SGDBR laser under wavelength switching. The time dependent degradation of Q-factor performance during the switching transient was analyzed and was found to be correlated with different laser switching characteristics in each case.

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De-inking sludge can be converted into useful forms of energy to provide economic and environmental benefits. In this study, pyrolysis oil produced from de-inking sludge through an intermediate pyrolysis technique was blended with biodiesel derived from waste cooking oil, and tested in a multi-cylinder indirect injection type CI engine. The physical and chemical properties of pyrolysis oil and its blends (20 and 30 vol.%) were measured and compared with those of fossil diesel and pure biodiesel (B100). Full engine power was achieved with both blends, and very little difference in engine performance and emission results were observed between 20% and 30% blends. At full engine load, the brake specific fuel consumption on a volume basis was around 6% higher for the blends when compared to fossil diesel. The brake thermal efficiencies were about 3-6% lower than biodiesel and were similar to fossil diesel. Exhaust gas emissions of the blends contained 4% higher CO2 and 6-12% lower NOx, as compared to fossil diesel. At full load, CO emissions of the blends were decreased by 5-10 times. The cylinder gas pressure diagram showed stable engine operation with the 20% blend, but indicated minor knocking with 30% blend. Peak cylinder pressure of the 30% blend was about 5-6% higher compared to fossil diesel. At full load, the peak burn rate of combustion from the 30% blend was about 26% and 12% higher than fossil diesel and biodiesel respectively. In comparison to fossil diesel the combustion duration was decreased for both blends; for 30% blend at full load, the duration was almost 12% lower. The study concludes that up to 20% blend of de-inking sludge pyrolysis oil with biodiesel can be used in an indirect injection CI engine without adding any ignition additives or surfactants.

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Quality, production and technological innovation management rank among the most important matters of concern to modern manufacturing organisations. They can provide companies with the decisive means of gaining a competitive advantage, especially within industries where there is an increasing similarity in product design and manufacturing processes. The papers in this special issue of International Journal of Technology Management have all been selected as examples of how aspects of quality, production and technological innovation can help to improve competitive performance. Most are based on presentations made at the UK Operations Management Association's Sixth International Conference held at Aston University at which the theme was 'Getting Ahead Through Technology and People'. At the conference itself over 80 papers were presented by authors from 15 countries around the world. Among the many topics addressed within the conference theme, technological innovation, quality and production management emerged as attracting the greatest concern and interest of delegates, particularly those from industry. For any new initiative to be implemented successfully, it should be led from the top of the organization. Achieving the desired level of commitment from top management can, however, be a difficulty. In the first paper of this issue, Mackness investigates this question by explaining how systems thinking can help. In the systems approach, properties such as 'emergence', 'hierarchy', 'commnication' and 'control' are used to assist top managers in preparing for change. Mackness's paper is then complemented by Iijima and Hasegawa's contribution in which they investigate the development of Quality Information Management (QIM) in Japan. They present the idea of a Design Review and demonstrate how it can be used to trace and reduce quality-related losses. The next paper on the subject of quality is by Whittle and colleagues. It relates to total quality and the process of culture change within organisations. Using the findings of investigations carried out in a number of case study companies, they describe four generic models which have been identified as characterising methods of implementing total quality within existing organisation cultures. Boaden and Dale's paper also relates to the management of quality, but looks specifically at the construction industry where it has been found there is still some confusion over the role of Quality Assurance (QA) and Total Quality Management (TQM). They describe the results of a questionnaire survey of forty companies in the industry and compare them to similar work carried out in other industries. Szakonyi's contribution then completes this group of papers which all relate specifically to the question of quality. His concern is with the two ways in which R&D or engineering managers can work on improving quality. The first is by improving it in the laboratory, while the second is by working with other functions to improve quality in the company. The next group of papers in this issue all address aspects of production management. Umeda's paper proposes a new manufacturing-oriented simulation package for production management which provides important information for both design and operation of manufacturing systems. A simulation for production strategy in a Computer Integrated Manufacturing (CIM) environment is also discussed. This paper is then followed by a contribution by Tanaka and colleagues in which they consider loading schedules for manufacturing orders in a Material Requirements Planning (MRP) environment. They compare mathematical programming with a knowledge-based approach, and comment on their relative effectiveness for different practical situations. Engstrom and Medbo's paper then looks at a particular aspect of production system design, namely the question of devising group working arrangements for assembly with new product structures. Using the case of a Swedish vehicle assembly plant where long cycle assembly work has been adopted, they advocate the use of a generally applicable product structure which can be adapted to suit individual local conditions. In the last paper of this particular group, Tay considers how automation has affected the production efficiency in Singapore. Using data from ten major industries he identifies several factors which are positively correlated with efficiency, with capital intensity being of greatest interest to policy makers. The two following papers examine the case of electronic data interchange (EDI) as a means of improving the efficiency and quality of trading relationships. Banerjee and Banerjee consider a particular approach to material provisioning for production systems using orderless inventory replenishment. Using the example of a single supplier and multiple buyers they develop an analytical model which is applicable for the exchange of information between trading partners using EDI. They conclude that EDI-based inventory control can be attractive from economic as well as other standpoints and that the approach is consistent with and can be instrumental in moving towards just-in-time (JIT) inventory management. Slacker's complementary viewpoint on EDI is from the perspective of the quality relation-ship between the customer and supplier. Based on the experience of Lucas, a supplier within the automotive industry, he concludes that both banks and trading companies must take responsibility for the development of payment mechanisms which satisfy the requirements of quality trading. The three final papers of this issue relate to technological innovation and are all country based. Berman and Khalil report on a survey of US technological effectiveness in the global economy. The importance of education is supported in their conclusions, although it remains unclear to what extent the US government can play a wider role in promoting technological innovation and new industries. The role of technology in national development is taken up by Martinsons and Valdemars who examine the case of the former Soviet Union. The failure to successfully infuse technology into Soviet enterprises is seen as a factor in that country's demise, and it is anticipated that the newly liberalised economies will be able to encourage greater technological creativity. This point is then taken up in Perminov's concluding paper which looks in detail at Russia. Here a similar analysis is made of the concluding paper which looks in detail at Russia. Here a similar analysis is made of the Soviet Union's technological decline, but a development strategy is also presented within the context of the change from a centralised to a free market economy. The papers included in this special issue of the International Journal of Technology Management each represent a unique and particular contribution to their own specific area of concern. Together, however, they also argue or demonstrate the general improvements in competitive performance that can be achieved through the application of modern principles and practice to the management of quality, production and technological innovation.

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This paper studies the characteristics of blends of biodiesel and a new type of SSPO (sewage sludge derived intermediate pyrolysis oil) in various ratios, and evaluates the application of such blends in an unmodified Lister diesel engine. The engine performance and exhaust emissions were investigated and compared to those of diesel and biodiesel. The engine injectors were inspected and tested after the experiment. The SSPO-biodiesel blends were found to have comparable heating values to biodiesel, but relatively high acidity and carbon residue. The diesel engine has operated with a 30/70 SSPO-biodiesel blend and a 50/50 blend for up to 10h and there was no apparent deterioration in operation observed. It is concluded that with 30% SSPO, the engine gives better overall performance and fuel consumption than with 50% SSPO. The exhaust temperatures of 30% SSPO and 50% SSPO are similar, but 30% SSPO gives relatively lower NO emission than 50% SSPO. The CO and smoke emissions are lower with 50% SSPO than with 30% SSPO. The injectors of the engine operated with SSPO blends were found to have heavy carbon deposition and noticeably reduced opening pressure, which may lead to deteriorated engine performance and exhaust emissions in extended operation. © 2013 Elsevier Ltd.

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This report analyses the 2001 cohort of UK SMEs. The specific focus is on the link between IP activity in 2001 and subsequent performance (to 2004). The 2001 cohort contains 130,082 SMEs of which 3,123 were IP active (2.4%). Specifically, 1,872 SMEs had at least one UK trade mark publication; 697 had one or more Community trade mark registrations; 646 SMEs had one or more UK patents; and 443 had one or more EPO patent publications. The outcome and financial performance of the SMEs is analysed in various ways. Initially, we look at the determinants of survival to 2004. We then look at growth of assets and turnover for the period 2001 to 2004.

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A transmission performance investigation using ultra-long Raman fibre laser based amplification with different co-pump power is presented. We attribute Q2 factor degradation to RIN of co-pump and induced fibre laser as well as increased SBS.