The Proinflammatory Environment in Potential Heart and Lung Donors: Prevalence and Impact of Donor Management and Hormonal Therapy

BACKGROUND: Brain stem death can elicit a potentially manipulable cardiotoxic proinflammatory cytokine response. We investigated the prevalence of this response, the impact of donor management with tri-iodothyronine (T3) and methylprednisolone (MP) administration, and the relationship of biomarkers to organ function and transplant suitability. METHODS: In a prospective randomized double-blinded factorially designed study of T3 and MP therapy, we measured serum levels of interleukin-1 and -6 (IL-1 and IL-6), tumor necrosis factor-alpha (TNF-alpha), C-reactive protein, and procalcitonin (PCT) levels in 79 potential heart or lung donors. Measurements were performed before and after 4 hr of algorithm-based donor management to optimize cardiorespiratory function and +/-hormone treatment. Donors were assigned to receive T3, MP, both drugs, or placebo. RESULTS: Initial IL-1 was elevated in 16% donors, IL-6 in 100%, TNF-alpha in 28%, CRP in 98%, and PCT in 87%. Overall biomarker concentrations did not change between initial and later measurements and neither T3 nor MP effected any change. Both PCT (P =0.02) and TNF-alpha (P =0.044) levels were higher in donor hearts with marginal hemodynamics at initial assessment. Higher PCT levels were related to worse cardiac index and right and left ventricular ejection fractions and a PCT level more than 2 ng x mL(-1) may attenuate any improvement in cardiac index gained by donor management. No differences were observed between initially marginal and nonmarginal donor lungs. A PCT level less than or equal to 2 ng x mL(-1) but not other biomarkers predicted transplant suitability following management. CONCLUSIONS: There is high prevalence of a proinflammatory environment in the organ donor that is not affected by tri-iodothyronine or MP therapy. High PCT and TNF-alpha levels are associated with donor heart dysfunction. (C) 2009 Lippincott Williams & Wilkins, Inc.

The use of spot simulation imagery for forestry mapping and management

SPOT simulation imagery was acquired for a test site in the Forest of Dean in Gloucestershire, U.K. This data was qualitatively and quantitatively evaluated for its potential application in forest resource mapping and management. A variety of techniques are described for enhancing the image with the aim of providing species level discrimination within the forest. Visual interpretation of the imagery was more successful than automated classification. The heterogeneity within the forest classes, and in particular between the forest and urban class, resulted in poor discrimination using traditional `per-pixel' automated methods of classification. Different means of assessing classification accuracy are proposed. Two techniques for measuring textural variation were investigated in an attempt to improve classification accuracy. The first of these, a sequential segmentation method, was found to be beneficial. The second, a parallel segmentation method, resulted in little improvement though this may be related to a combination of resolution in size of the texture extraction area. The effect on classification accuracy of combining the SPOT simulation imagery with other data types is investigated. A grid cell encoding technique was selected as most appropriate for storing digitised topographic (elevation, slope) and ground truth data. Topographic data were shown to improve species-level classification, though with sixteen classes overall accuracies were consistently below 50%. Neither sub-division into age groups or the incorporation of principal components and a band ratio significantly improved classification accuracy. It is concluded that SPOT imagery will not permit species level classification within forested areas as diverse as the Forest of Dean. The imagery will be most useful as part of a multi-stage sampling scheme. The use of texture analysis is highly recommended for extracting maximum information content from the data. Incorporation of the imagery into a GIS will both aid discrimination and provide a useful management tool.

Management and management education in a less developed economy: the case of Malawi

Malawi is seen as a society in transition, and as a consequence, it is argued, Malawian managers face particular problems where traditional and Western values intersect. The role of the Polytechnic of Malawi as a provider of management education in this environment is thus problematical. The thesis begins with a description of the Malawian business environment in its geographical, historical, political, cultural, economic and institutional forms, and then goes on to examine the problems practising managers themselves feel they face, and attempts to explain these problems in terms of the environmental factors described, and the environmental changes taking place. It is concluded, from the analysis conducted, that the environmental features discussed interact in a complex way to make Malawian managers averse to exercising initiative and taking decisions. The question of what the Polytechnic can do to help overcome this aversion is addressed. The field research was conducted in Malawi in the seven months January to July, 1980, during which time 207 questionnaires were administered to junior and middle managers working in all sectors of the economy at levels equivalent to Polytechnic graduate entry. In addition, a number of senior managers (both Malawian and expatriate) were interviewed, a case study was conducted in a manufacturing organisation, and a second questionnaire was administered to all business students at the Polytechnic. Extensive use of official statistics was also made where appropriate.

Dynamic QoS management and optimisation in service-based systems

Service-based systems that are dynamically composed at run time to provide complex, adaptive functionality are currently one of the main development paradigms in software engineering. However, the Quality of Service (QoS) delivered by these systems remains an important concern, and needs to be managed in an equally adaptive and predictable way. To address this need, we introduce a novel, tool-supported framework for the development of adaptive service-based systems called QoSMOS (QoS Management and Optimisation of Service-based systems). QoSMOS can be used to develop service-based systems that achieve their QoS requirements through dynamically adapting to changes in the system state, environment and workload. QoSMOS service-based systems translate high-level QoS requirements specified by their administrators into probabilistic temporal logic formulae, which are then formally and automatically analysed to identify and enforce optimal system configurations. The QoSMOS self-adaptation mechanism can handle reliability- and performance-related QoS requirements, and can be integrated into newly developed solutions or legacy systems. The effectiveness and scalability of the approach are validated using simulations and a set of experiments based on an implementation of an adaptive service-based system for remote medical assistance.

Culture and the psychological impacts of natural disasters: Implications for disaster management and disaster mental health

In recent decades, natural disasters have caused extensive losses and damages to human psychological wellbeing, economy, and society. It has been argued that cultural factors such as social values, traditions, and attachment to a location influence communities facing and responding to natural disasters. However, the issue of culture in disaster mental health seems to have received limited attention in policy and practice. This review highlights the importance of cultural background in the assessment of vulnerability to the psychological impacts of disasters, disaster preparedness, and provision of disaster mental health services. In particular, this paper suggests the importance of cultural competence in the planning and delivery of effective disaster mental health services. In order to address the varying circumstances of people with different cultural backgrounds, disaster mental health services must be developed in a culturally sensitive manner. Development of culturally competent disaster mental health services requires significant changes in policy making, administration, and direct service provision

Handbook of research on strategic performance management and measurement using data envelopment analysis

Organizations can use the valuable tool of data envelopment analysis (DEA) to make informed decisions on developing successful strategies, setting specific goals, and identifying underperforming activities to improve the output or outcome of performance measurement. The Handbook of Research on Strategic Performance Management and Measurement Using Data Envelopment Analysis highlights the advantages of using DEA as a tool to improve business performance and identify sources of inefficiency in public and private organizations. These recently developed theories and applications of DEA will be useful for policymakers, managers, and practitioners in the areas of sustainable development of our society including environment, agriculture, finance, and higher education sectors. All rights reserved.

Performance management and high performance work practices in emerging markets

In this chapter, we discuss performance management systems (PMSs) and high performance work systems (HPWSs) in emerging economies. We start by discussing PMSs, with specific emphasis on PMSs in global organizations. We follow this up with an introduction of HPWSs, and then discuss PMSs and HPWSs in emerging economies. While the list of emerging economies keeps changing, and is rather long, as one might expect, in this chapter we have concentrated on five key emerging economies – China, India, Mexico, South Korea, and Turkey. Performance management is the process through which organizations set goals, determine standards, assign and evaluate work, coach and give feedback, and distribute rewards (Fletcher, 2001). In this connection, organizations all over the world face the challenge of how best to manage performance, including finding ways to motivate employees to sustain high levels of performance. In other words, organizations must develop and implement PMSs that are appropriate for their environment in such a way that high levels of performance can be achieved and sustained over time (DeNisi, Varma and Budhwar, 2008). While all organizations need to address these issues, the way a firm decides to go about addressing these issues is dependent on its location and context. In other words, differences in local norms, culture, law, and technology, make it critical that organizations develop and/or adapt techniques, policies and practices that are appropriate to the setting (see for example, Hofstede, 1993).

Applicability of non-modular assessment in construction management and allied undergraduate programmes:perspective of the academics involved

Undergraduate programmes on construction management and other closely related built environment disciplines are currently taught and assessed on a modular basis. This is the case in the UK and in many other countries globally. However, it can be argued that professionally oriented programmes like these are better assessed on a non-modular basis, in order to produce graduates who can apply knowledge on different subject contents in cohesion to solve complex practical scenarios in their work environments. The examples of medical programmes where students are assessed on a non-modular basis can be cited as areas where this is already being done. A preliminary study was undertaken to explore the applicability of non-modular assessment within construction management undergraduate education. A selected sample of university academics was interviewed to gather their perspectives on applicability of non-modular assessment. General acceptance was observed among the academics involved that integrating non-modular assessment is applicable and will be beneficial. All academics stated that at least some form of non-modular assessment as being currently used in their programmes. Examples where cross-modular knowledge is assessed included comprehensive/multi-disciplinary project modules and creating larger modules to amalgamate a number of related subject areas. As opposed to a complete shift from modular to non-modular, an approach where non-modular assessment is integrated and its use further expanded within the current system is therefore suggested. This is due to the potential benefits associated with this form of assessment to professionally aligned built environment programmes

Enterprise management and ERP development:case study of Zoomlion using dynamic enterprise reference grid

The enterprise management approach provides a holistic view of organizations and their related information systems. In order to cope with the globalization, virtualization, and volatile competitive environment, traditional firms are seeking to reconstruct their organizational structures and establish new IS architectures to transform from single autonomous entities into more open enterprises supported by new Enterprise Resource Planning (ERP) systems. This paper reports on ERP engage-abilities within three different enterprise management patterns based on the theoretical foundations of the "Dynamic Enterprise Reference Grid". An exploratory inductive study in Zoomlion using the narrative research approach has been conducted. Also, this research delivers a conceptual framework to demonstrate the adoption of ERP in the three enterprise management structures and points to a new architectural type (ERPIII) for operating in the virtual enterprise paradigm. © 2010 Springer-Verlag.

Human resource management and organizational performance:evidence from the retail banking sector

Underpinned by the resource-based view (RBV), social exchange theory (SET), and a theory of intrinsic motivation (empowerment), I proposed and tested a multi-level model that simultaneously examines the intermediate linkages or mechanisms through which HPWS impact individual and organizational performance. First and underpinned by RBV, I examined at the unit level, collective human capital and competitive advantage as path-ways through which the use of HPWS influences – branch market performance. Second and-, underpinned by social exchange (perceived organizational support) and intrinsic motivation (psychological empowerment) theories, I examined cross and individual level mechanisms through which experienced HPWS may influence employee performance. I tested the propositions of this study with multisource data obtained from junior and senior customer contact employees, and managers of 37 branches of two banks in Ghana. Results of the Structural Equation Modeling (SEM) analysis revealed that (i) collective human capital partially mediated the relationship between management-rated HPWS and competitive advantage, while competitive advantage completely mediated the influence of human capital on branch market performance. Consequently, management-rated HPWS influenced branch market performance indirectly through collective human capital and competitive advantage. Additionally, results of hierarchical linear modeling (HLM) tests of the cross-level influences on the motivational implications of HPWS revealed that (i) management-rated HPWS influenced experienced HPWS; (ii) perceived organizational support (POS) and psychological empowerment fully mediated the influence of experienced HPWS on service-oriented organizational citizenship behaviour (OCB), and; (iii) service-oriented OCB mediated the influence of psychological empowerment and POS on service quality and task performance. I discuss the theoretical and practical implications of these findings.

Inventory parameter management and focused continuous improvement for repetitive batch manufacturers

What this thesis proposes is a methodology to assist repetitive batch manufacturers in the adoption of certain aspects of the Lean Production principles. The methodology concentrates on the reduction of inventory through the setting of appropriate batch sizes, taking account of the effect of sequence dependent set-ups and the identification and elimination of bottlenecks. It uses a simple Pareto and modified EBQ based analysis technique to allocate items to period order day classes based on a combination of each item's annual usage value and set-up cost. The period order day classes the items are allocated to are determined by the constraints limits in the three measured dimensions, capacity, administration and finance. The methodology overcomes the limitations associated with MRP in the area of sequence dependent set-ups, and provides a simple way of setting planning parameters taking this effect into account by concentrating on the reduction of inventory through the systematic identification and elimination of bottlenecks through set-up reduction processes, so allowing batch sizes to reduce. It aims to help traditional repetitive batch manufacturers in a route to continual improvement by: Highlighting those areas where change would bring the greatest benefits. Modelling the effect of proposed changes. Quantifying the benefits that could be gained through implementing the proposed changes. Simplifying the effort required to perform the modelling process. It concentrates on increasing flexibility through managed inventory reduction through rationally decreasing batch sizes, taking account of sequence dependent set-ups and the identification and elimination of bottlenecks. This was achieved through the development of a software modelling tool, and validated through a case study approach.

When in Rome ... ?:Human resource management and the performance of foreign firms operating in India

Purpose: The purpose of the paper is to examine the kind of HRM practices being implemented by overseas firms in their Indian subsidiaries and also to analyze the linkage between HRM practices and organizational performance. Design/methodology/approach: The paper utilizes a mixture of both quantitative and qualitative techniques via personal interviews in 76 subsidiaries. Findings: The results show that while the introduction of HRM practices from the foreign parent organization is negatively associated with performance, local adaption of HRM practices is positively related with the performance of foreign firms operating in India. Research limitations/implications: The main limitations include data being collected by only one respondent from each firm, and the relatively small sample size. Practical implications: The key message for practitioners is that HRM systems do improve organizational performance in the Indian subsidiaries of foreign firms, and an emphasis on the localization of HRM practices can further contribute in this regard. Originality/value: This is perhaps the very first investigation of its kind in the Indian context. © Emerald Group Publishing Limited.

Knowledge management and the limits of knowledge codification

Purpose - The idea that knowledge needs to be codified is central to many claims that knowledge can be managed. However, there appear to be no empirical studies in the knowledge management context that examine the process of knowledge codification. This paper therefore seeks to explore codification as a knowledge management process. Design/methodology/approach - The paper draws on findings from research conducted around a knowledge management project in a section of the UK Post Office, using a methodology of participant-observation. Data were collected through observations of project meetings, correspondence between project participants, and individual interviews. Findings - The principal findings about the nature of knowledge codification are first, that the process of knowledge codification also involves the process of defining the codes needed to codify knowledge, and second, that people who participate in the construction of these codes are able to interpret and use the codes more similarly. From this it can be seen that the ability of people to decodify codes similarly places restrictions on the transferability of knowledge between them. Research limitations/implications - The paper therefore argues that a new conceptual approach is needed for the role of knowledge codification in knowledge management that emphasizes the importance of knowledge decodification. Such an approach would start with one's ability to decodify rather than codify knowledge as a prerequisite for knowledge management. Originality/value - The paper provides a conceptual basis for explaining limitations to the management and transferability of knowledge. © Emerald Group Publishing Limited.