Total quality management in English language teaching:a case study in Turkish higher education

The need to improve the management of language learning organizations in the light of the trend toward mass higher education and of the use of English as a world language was the starting point of this thesis. The thesis aims to assess the relevance, adequacy and the relative success of Total Quality Management (TQM) as a management philosophy. Taking this empirical evidence a TQM-oriented management project in a Turkish Higher Education context, the thesis observes the consequences of a change of organizational culture, with specific reference to teachers' attitudes towards management. Both qualitative and quantitative devices are employed to plot change and the value of these devices for identifying such is considered. The main focus of the thesis is the Soft S's (Shared Values, Style, Staff and Skills) of an organization rather than the Hard S's (System, Structure, Strategy). The thesis is not concerned with the teaching and learning processes, though the PDCA cycle (the Action Research Cycle) did play a part in the project for both teachers and the researcher involved in this study of organizational development. Both before the management project was launched, and at the end of the research period, the external measurement devices (Harrison's Culture Specification Device and Hofstede's VSM) were used to describe the culture of the Centre. During the management project, internal measurement devices were used to record the change including middle-management style change (the researcher in this case). The time period chosen for this study was between September 1991 and June 1994. During this period, each device was administered twice within a specific time period, ranging from a year to 32 months.

Management of allergic conjunctivitis and dry eye

Ocular allergy is a common eye condition encountered in clinical practice. However, little is known how seasonal allergic conjunctivitis (SAC), the most common subtype, is managed in clinical practice. Further, dry eye, another common eye condition, may be misdiagnosed as SAC and vice-versa as they share similar signs and symptoms. In addition, despite the frequent recommendation of non-pharmacological treatments for SAC, evidenceto support their use has not been identified in the scientific literature. The aim of this thesis was therefore to determine the actual diagnosis and management of SAC and dry eye in clinical practice and investigate the efficacy of non-pharmacological treatments for these conditions. The diagnostic and management strategies for SAC and dry eye employed by pharmacy staff are found to be inconsistent with current guidelines and scientific evidence based upon a mystery shopper design. Cluster analysis of tear film metrics in normal and dry eye patients identified several clinically relevant groups of patients that may allow for targeted treatment recommendations. Using a novel environmental chamber model of SAC, the use of artificial tears and cold compresses, either alone or combined is an effective treatment modality for acute and symptomatic SAC, on a par with topical anti-allergic medication, and has been demonstrated for the first time. In addition, eyelid warming therapy with a simple, readily available, seed filled device is an effective method of treating meibomian gland dysfunction (MGD) related evaporative dry eye, perhaps the most common dry eye subtype. A greater focus on ophthalmology must be implemented as part of the formal education and training of pharmacy staff, while greater professional communication between community pharmacists, optometrists and the population they serve is required. Artificial tears and cold compresses may be considered as front line agents for acute SAC by pharmacy staff and optometrists, to whom pharmacological treatment options are limited.

Mobile case-based decision support for intelligent patient knowledge management

Hospitals everywhere are integrating health data using electronic health record (EHR) systems, and disparate and multimedia patient data can be input by different caregivers at different locations as encapsulated patient profiles. Healthcare institutions are also using the flexibility and speed of wireless computing to improve quality and reduce costs. We are developing a mobile application that allows doctors to efficiently record and access complete and accurate real-time patient information. The system integrates medical imagery with textual patient profiles as well as expert interactions by healthcare personnel using knowledge management and case-based reasoning techniques. The application can assist other caregivers in searching large repositories of previous patient cases. Patients' symptoms can be input to a portable device and the application can quickly retrieve similar profiles which can be used to support effective diagnoses and prognoses by comparing symptoms, treatments, diagnosis, test results and other patient information. © 2007 Sage Publications.