877 resultados para System level policy
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Os Organismos públicos encontram-se, actualmente, a desenvolver estudos a nível dos Sistemas Integrados de Gestão, motivados pela necessidade que existe em adoptar novas técnicas de Gestão capazes de responder às novas exigências de informação. Em termos gerais, os Organismos públicos encontram-se numa fase de viragem na sua actuação, em que surge a necessidade de dispor de novos sistemas de informação capazes de dar resposta às exigências da Nova Gestão Pública. É certo que a Nova Gestão Pública conduz a uma maior motivação, proporcionando uma melhoria na obtenção dos resultados e modernizando a relação entre o controlo das despesas públicas e a prestação de contas a nível dos órgãos do Estado, e onde a uniformização de critérios se apresenta como um dos principais requisitos para criar condições de implementação de uma contabilidade pública que funcione como instrumento de apoio aos utilizadores da informação e, em particular, aos Órgãos de Chefia e Direcção. Este trabalho analisa o caso do Exército Português, como exemplo de um Organismo público que aproveitou a obrigatoriedade de adesão ao novo Regime de Administração Financeira do Estado, para promover a implementação de um Sistema Integrado de Gestão capaz de responder às novas exigências de informação. Analisam-se também as estratégias de actuação e reorientação organizacional utilizadas pelo Exército Português, de modo a permitir o desenvolvimento e implementação do sistema baseado na uniformização de critérios que garanta os requisitos e as técnicas de Gestão capazes de criar condições para desenvolver uma contabilidade pública que funcione como instrumento de apoio à decisão. ABSTRACT; At present, government entities are developing studies at an Integrated Management System level, impelled by the actual need of adopting new Management techniques capable of responding to the new demands regarding Information. ln global terms, government entities are reaching a turning point in its way of acting, due to the arising need of settling new information systems which provide an answer to the demands of the New Public Management. It is assured that the New Public Management leads to a higher motivation, providing an improvement in accomplishing results and modernizing the link between the control of public expenditure and presenting accounts of State Organs. It also presents the criteria standards as one of the main requirements to create implementation conditions of a public accounting which operates as a support mean to the information users and, more specifically, to the Command and Boarding Bodies. This study analyses the Portuguese Army, an example of government entity which seized the obligation of joining the New Public Financial Management Regime to promote the implementation of an Integrated Management System capable of responding to the new information demands. The performing strategies and organizational refocus used by the Portuguese Army are also analyzed in order to allow the development and implementation of the system. It is based in the standard criteria that secure the requirements and Management techniques which enable the progress of a public accounting acting as a support resource in decision-making.
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The concept of patient activation has gained traction as the term referring to patients who understand their role in the care process and have “the knowledge, skills and confidence” necessary to manage their illness over time (Hibbard & Mahoney, 2010). Improving health outcomes for vulnerable and underserved populations who bear a disproportionate burden of health disparities presents unique challenges for nurse practitioners who provide primary care in nurse-managed health centers. Evidence that activation improves patient self-management is prompting the search for theory-based self-management support interventions to activate patients for self-management, improve health outcomes, and sustain long-term gains. Yet, no previous studies investigated the relationship between Self-determination Theory (SDT; Deci & Ryan, 2000) and activation. The major purpose of this study, guided by the Triple Aim (Berwick, Nolan, & Whittington, 2008) and nested in the Chronic Care Model (Wagner et al., 2001), was to examine the degree to which two constructs– Autonomy Support and Autonomous Motivation– independently predicted Patient Activation, controlling for covariates. For this study, 130 nurse-managed health center patients completed an on-line 38-item survey onsite. The two independent measures were the 6-item Modified Health Care Climate Questionnaire (mHCCQ; Williams, McGregor, King, Nelson, & Glasgow, 2005; Cronbach’s alpha =0.89) and the 8-item adapted Treatment Self-Regulation Questionnaire (TSRQ; Williams, Freedman, & Deci, 1998; Cronbach’s alpha = 0.80). The Patient Activation Measure (PAM-13; Hibbard, Mahoney, Stock, & Tusler, 2005; Cronbach’s alpha = 0.89) was the dependent measure. Autonomy Support was the only significant predictor, explaining 19.1% of the variance in patient activation. Five of six autonomy support survey items regressed on activation were significant, illustrating autonomy supportive communication styles contributing to activation. These results suggest theory-based patient, provider, and system level interventions to enhance self-management in primary care and educational and professional development curricula. Future investigations should examine additional sources of autonomy support and different measurements of autonomous motivation to improve the predictive power of the model. Longitudinal analyses should be conducted to further understand the relationship between autonomy support and autonomous motivation with patient activation, based on the premise that patient activation will sustain behavior change.
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Catering to society’s demand for high performance computing, billions of transistors are now integrated on IC chips to deliver unprecedented performances. With increasing transistor density, the power consumption/density is growing exponentially. The increasing power consumption directly translates to the high chip temperature, which not only raises the packaging/cooling costs, but also degrades the performance/reliability and life span of the computing systems. Moreover, high chip temperature also greatly increases the leakage power consumption, which is becoming more and more significant with the continuous scaling of the transistor size. As the semiconductor industry continues to evolve, power and thermal challenges have become the most critical challenges in the design of new generations of computing systems. In this dissertation, we addressed the power/thermal issues from the system-level perspective. Specifically, we sought to employ real-time scheduling methods to optimize the power/thermal efficiency of the real-time computing systems, with leakage/ temperature dependency taken into consideration. In our research, we first explored the fundamental principles on how to employ dynamic voltage scaling (DVS) techniques to reduce the peak operating temperature when running a real-time application on a single core platform. We further proposed a novel real-time scheduling method, “M-Oscillations” to reduce the peak temperature when scheduling a hard real-time periodic task set. We also developed three checking methods to guarantee the feasibility of a periodic real-time schedule under peak temperature constraint. We further extended our research from single core platform to multi-core platform. We investigated the energy estimation problem on the multi-core platforms and developed a light weight and accurate method to calculate the energy consumption for a given voltage schedule on a multi-core platform. Finally, we concluded the dissertation with elaborated discussions of future extensions of our research.
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It is well-recognized that exercise improves mental health, e.g., by decreasing depressive behaviors, improving hippocampal-dependent learning and neurogenesis, and increasing dendritic plasticity. Yet how exercise influences the brain at the molecular level is not clearly understood. Yau et al recently reported that the antidepressant effects of physical exercise are mainly mediated by adiponectin, an adipocyte-secreted hormone ('adipocytokine') with neuroprotective effects at the central nervous system level (Yau et al., 2014). This article is protected by copyright. All rights reserved
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Sumário: A morbilidade evitável relacionada com medicamentos (MERM) é um problema de saúde pública com considerável impacto negativo para os doentes e os sistemas de saúde. Os indicadores de MERM constituem medidas operacionais de gestão do risco terapêutico, uma vez que permitem identificar processos de cuidados de saúde que predizem um resultado clínico negativo potencialmente evitável. O uso destes indicadores pode contribuir para reduzir a morbilidade evitável relacionada com medicamentos, evitando danos desnecessários e desperdício de recursos. Objectivo: Desenvolver novos indicadores de MERM para cuidados primários em Portugal a partir da análise de resumos das características de medicamentos (RCM's) e determinar a validade preliminar de face e de conteúdo dos indicadores derivados para este setting. Métodos: A primeira fase deste estudo consistiu num ensaio piloto, com o intuito de testar uma metodologia de inclusão dos RCM's com base na frequência de dispensa da especialidade farmacêutica no ambulatório. Seguidamente procedeu-se ao desenvolvimento de mais indicadores de MERM utilizando a metodologia testada no ensaio piloto. Os indicadores obtidos foram alvo de uma primeira análise com base em aspectos como duplicações e relevância para cuidados primários, de modo a seleccionar os que poderiam passar à fase de validade preliminar de face e de conteúdo. Procedeu se então à pesquisa de evidência clínica em fontes de referência para estes indicadores. Na última fase do estudo estes indicadores, bem como a respectiva evidência clínica, foram analisados por um painel de peritos constituído por quatro académicos (dois médicos de família e dois farmacêuticos), sendo aprovados ou eliminados com base num critério de consenso. Resultados: Obteve-se um total de 64 indicadores de MERM, a partir da análise de 35 RCM's. Sujeitaram-se à determinação da validade preliminar de face e de conteúdo 44 indicadores. Foram aprovados por consenso 28 indicadores, tendo sido excluídos 17 (4 por consenso e 13 sem obtenção de consenso). Conclusão: É exequível derivar novos indicadores de MERM para cuidados primários a partir da análise de RCM's. A validade formal de face e de conteúdo destes indicadores obtidos será objecto de estudo de ulterior investigação. /ABSTRACT: Backgroud: Preventable drug-relate morbidity (PDRM) is a public health problem with significant negative impact at a patient and system level. PDRM indicators are operational measures of therapeutic risk management; they identifying processes of care leading to preventable adverse outcomes. The use of these indicators may contribute to tackle preventable drug related morbidity, avoiding unnecessary harm and waste of resources. Objective: To develop new PDRM indicators to Portuguese primary care based on the analysis of summaries of product characteristics (SPC’s) and to determine their preliminary face and content validity to this setting. Methods: Firstly a pilot study was conducted to test a methodology for including SPC's based on the most frequently sold medicines in the ambulatory. Then more indicators were developed using the previously tested methodology. The indicators obtained were analyzed in respect to aspects such as duplications and relevance for primary care to select those that could proceed to the next stage. Clinical evidence was searched for each of these indicators in gold-standard information sources. Finally, this set of indicators and the respective clinical evidence were analysised by a panel of four experts (two academic general practitioners and two academic pharmacists). Preliminary face and content validity was established by means of consensus. Results: A total of 64 indicators was obtained, based on the analysis of 35 SPCs. Forty four indicators were subjected to a preliminary assessment of face and content validity, resulting in 28 consensus-approved indicators. Seventeen indicators were excluded (4 rejected by consensus and 13 that did not reach consensus). Conclusion: lt is feasible to derive new PDRM indicators for primary care based on SPC's. The formal face and content validity of the indicators will be determined in a further study.
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Introduction • The Australian Institute of Criminology (AIC) is Australia's national research and knowledge centre on crime and justice. • The Institute seeks to promote justice and reduce crime by undertaking and communicating evidence-based research to inform policy and practice. • The AIC is governed by the Criminology Research Act and has been in operation since 1973. • The AIC is pleased to have the opportunity to contribute to the Committee's Inquiry into the high level of involvement of Indigenous juveniles and young adults in the criminal justice system. • There is a great deal of evidence to demonstrate that Indigenous young people are significantly over-represented at every stage of the criminal justice system in Australia.
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The conventional meaning of culture is ‘widely shared and strongly held values’ of a particular group or society (Bradley and Parker, 2006: 89). Culture is not a rigid concept; it can be influenced or altered by new ideas or forces. This research examines the ways in which one set of ideas in particular, that is, those associated with New Public Management, have impacted upon the administrative culture of 'street-level' bureaucrats and professionals within Irish social policy. Lipsky (1980: 3) defined 'street-level' bureaucrats as ‘public service workers who interact directly with citizens in the course of their jobs, and who have substantial discretion in the execution of their work’. Utilising the Competing Values Framework (CVF) in the analysis of eighty three semi-structured interviews with 'street-level' bureaucrats and professionals, an evaluation is made as to the impact of NPM ideas on both visible and invisible aspects of administrative culture. Overall, the influence of NPM is confined to superficial aspects of administrative culture such as; increased flexibility in working hours and to some degree job contracts; increased time commitment; and a customer service focus. However, the extent of these changes varies depending on policy sector and occupational group. Aspects of consensual and hierarchical cultures remain firmly in place. These coincide with features of developmental and market cultures. Contrary to the view that members of hierarchical and consensual culture would pose resistance to change, this research clearly illustrates that a very large appetite for change exists in the attitudes of 'street-level' bureaucrats and professionals within Irish social policy, with many of them suggesting changes that correspond to NPM ideas. This study demonstrates the relevance of employing the CVF model as it is clear that administrative culture is very much a dynamic system of competing and co-existing cultures.
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The student bullying of teachers (SBT) is a distinct and complex form of bullying with a multiplicity of diverse, changeable and intersecting causes which is experienced by and affects teachers in a variety of ways. SBT is both a national and an international phenomenon which is under-recognised in academic, societal and political spheres, resulting in limited conceptual understanding and awareness of the issue. This study explores teachers’ experiences of SBT behaviours in Irish second level schools as well as teachers’ perceptions regarding training, policies and supports in Ireland to address the issue. Specifically, the study seeks to explore the influence of historical low State intervention in education on contemporary policies and supports to deal with SBT in Ireland. A mixed methods approach involving a survey of 531 second level school teachers and 17 semi-structured interviews with teachers, Year Heads and representatives from teacher trade unions and school management bodies was employed to collect and analyse data. Findings indicate that SBT behaviours are prevalent in many forms in Irish second level schools. The hidden nature of the phenomenon has simultaneously contributed to and is reinforced by limited understanding of the issue as well as teachers’ reluctance to disclose their experiences. Findings reveal that teachers perceive the contemporary policies, training and support structures in Ireland to be inadequate in equipping them to effectively deal with SBT. State intervention in addressing SBT behaviours to date, has been limited, therefore many teachers are forced to respond to the issue based on their own initiatives and assumptions rather than from an informed critically reflective approach, supported by national guidelines and sufficient State investment. This has resulted in a piecemeal, un-coordinated and ad-hoc approach to SBT in Irish schools both in terms of teachers’ management of SBT behaviours and with respect to the supports extended to staff. The potential negative consequences of SBT behaviours on teachers’ wellbeing and professional performance and thus, on the education system itself, underlines the need for a strategic, evidence-based, resourced and integrated approach which includes, as a pivotal component, consultation with teachers, whose contribution to the process is crucial.
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Systemic challenges within child welfare have prompted many states to explore new strategies aimed at protecting children while meeting the needs of families, but doing so within the confines of shrinking budgets. Differential Response has emerged as a promising practice for low or moderate risk cases of child maltreatment. This mixed methods evaluation explored various aspects of North Carolina's differential response system, known as the Multiple Response System (MRS), including: child safety, timeliness of response and case decision, frontloading of services, case distribution, implementation of Child and Family Teams, collaboration with community-based service providers and Shared Parenting. Utilizing Child Protective Services (CPS) administrative data, researchers found that compared to matched control counties, MRS: had a positive impact on child safety evidenced by a decline in the rates of substantiations and re-assessments; temporarily disrupted timeliness of response in pilot counties but had no effect on time to case decision; and increased the number of upfront services provided to families during assessment. Qualitative data collected through focus groups with providers and phone interviews with families provided important information on key MRS strategies, highlighting aspects that families and social workers like as well as identifying areas for improvement. This information is useful for continuous quality improvement efforts, particularly related to the development of training and technical assistance programs at the state and local level.
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In 2004, the Ontario Ministry of Health Promotion and Sport (MHPS) established Active2010: Ontario’s Sport and Physical Activity Strategy. Active2010 demonstrates a strong provincial government policy emphasis regarding sport participation and physical activity (PA), and identifies the school system as a primary vehicle for enhancing PA levels. This study examines the sport and PA initiatives MHPS is undertaking within the school system. Theoretical context regarding neo-liberalism in Canada and Canadian sport frames this study, while a revised version of Van Meter and Van Horn’s (1975) top-down model of policy implementation guides the research process. A case study of the school-based PA system is conducted which relies on the analysis of 11 semi-structured interviews and 47 official organizational documents. Four emergent categories of Jurisdictional Funding, Coercive Policy, Sector Silos, and Community Champions are identified. Additional insight is provided regarding neo-liberalism, provincial level government, interministerial collaboration, and government/non-profit sector partnership.
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La formation des sociétés fondées sur la connaissance, le progrès de la technologie de communications et un meilleur échange d'informations au niveau mondial permet une meilleure utilisation des connaissances produites lors des décisions prises dans le système de santé. Dans des pays en voie de développement, quelques études sont menées sur des obstacles qui empêchent la prise des décisions fondées sur des preuves (PDFDP) alors que des études similaires dans le monde développé sont vraiment rares. L'Iran est le pays qui a connu la plus forte croissance dans les publications scientifiques au cours de ces dernières années, mais la question qui se pose est la suivante : quels sont les obstacles qui empêchent l'utilisation de ces connaissances de même que celle des données mondiales? Cette étude embrasse trois articles consécutifs. Le but du premier article a été de trouver un modèle pour évaluer l'état de l'utilisation des connaissances dans ces circonstances en Iran à l’aide d'un examen vaste et systématique des sources suivie par une étude qualitative basée sur la méthode de la Grounded Theory. Ensuite au cours du deuxième et troisième article, les obstacles aux décisions fondées sur des preuves en Iran, sont étudiés en interrogeant les directeurs, les décideurs du secteur de la santé et les chercheurs qui travaillent à produire des preuves scientifiques pour la PDFDP en Iran. Après avoir examiné les modèles disponibles existants et la réalisation d'une étude qualitative, le premier article est sorti sous le titre de «Conception d'un modèle d'application des connaissances». Ce premier article sert de cadre pour les deux autres articles qui évaluent les obstacles à «pull» et «push» pour des PDFDP dans le pays. En Iran, en tant que pays en développement, les problèmes se situent dans toutes les étapes du processus de production, de partage et d’utilisation de la preuve dans la prise de décision du système de santé. Les obstacles qui existent à la prise de décision fondée sur des preuves sont divers et cela aux différents niveaux; les solutions multi-dimensionnelles sont nécessaires pour renforcer l'impact de preuves scientifiques sur les prises de décision. Ces solutions devraient entraîner des changements dans la culture et le milieu de la prise de décision afin de valoriser la prise de décisions fondées sur des preuves. Les critères de sélection des gestionnaires et leur nomination inappropriée ainsi que leurs remplaçants rapides et les différences de paiement dans les secteurs public et privé peuvent affaiblir la PDFDP de deux façons : d’une part en influant sur la motivation des décideurs et d'autre part en détruisant la continuité du programme. De même, tandis que la sélection et le remplacement des chercheurs n'est pas comme ceux des gestionnaires, il n'y a aucun critère pour encourager ces deux groupes à soutenir le processus décisionnel fondés sur des preuves dans le secteur de la santé et les changements ultérieurs. La sélection et la promotion des décideurs politiques devraient être basées sur leur performance en matière de la PDFDP et les efforts des universitaires doivent être comptés lors de leurs promotions personnelles et celles du rang de leur institution. Les attitudes et les capacités des décideurs et des chercheurs devraient être encouragés en leur donnant assez de pouvoir et d’habiliter dans les différentes étapes du cycle de décision. Cette étude a révélé que les gestionnaires n'ont pas suffisamment accès à la fois aux preuves nationales et internationales. Réduire l’écart qui sépare les chercheurs des décideurs est une étape cruciale qui doit être réalisée en favorisant la communication réciproque. Cette question est très importante étant donné que l'utilisation des connaissances ne peut être renforcée que par l'étroite collaboration entre les décideurs politiques et le secteur de la recherche. Dans ce but des programmes à long terme doivent être conçus ; la création des réseaux de chercheurs et de décideurs pour le choix du sujet de recherche, le classement des priorités, et le fait de renforcer la confiance réciproque entre les chercheurs et les décideurs politiques semblent être efficace.
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Soil erosion models and soil erosion risk maps are often used as indicators to assess potential soil erosion in order to assist policy decisions. This paper shows the scientific basis of the soil erosion risk map of Switzerland and its application in policy and practice. Linking a USLE/RUSLE-based model approach (AVErosion) founded on multiple flow algorithms and the unit contributing area concept with an extremely precise and high-resolution digital terrain model (2 m × 2 m grid) using GIS allows for a realistic assessment of the potential soil erosion risk, on single plots, i.e. uniform and comprehensive for the agricultural area of Switzerland (862,579 ha in the valley area and the lower mountain regions). The national or small-scale soil erosion prognosis has thus reached a level heretofore possible only in smaller catchment areas or single plots. Validation was carried out using soil loss data from soil erosion damage mappings in the field from long-term monitoring in different test areas. 45% of the evaluated agricultural area of Switzerland was classified as low potential erosion risk, 12% as moderate potential erosion risk, and 43% as high potential erosion risk. However, many of the areas classified as high potential erosion risk are located at the transition from valley to mountain zone, where many areas are used as permanent grassland, which drastically lowers their current erosion risk. The present soil erosion risk map serves on the one hand to identify and prioritise the high-erosion risk areas, and on the other hand to promote awareness amongst farmers and authorities. It was published on the internet and will be made available to the authorities in digital form. It is intended as a tool for simplifying and standardising enforcement of the legal framework for soil erosion prevention in Switzerland. The work therefore provides a successful example of cooperation between science, policy and practice.
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Despite the vast research examining the evolution of Caribbean education systems, little is chronologically tied to the postcolonial theoretical perspectives of specific island-state systems, such as the Jamaican education system and its relationship with the underground shadow education system. This dissertation study sought to address the gaps in the literature by critically positioning postcolonial theories in education to examine the macro- and micro-level impacts of extra lessons on secondary education in Jamaica. The following postcolonial theoretical (PCT) tenets in education were contextualized from a review of the literature: (a) PCT in education uses colonial discourse analysis to critically deconstruct and decolonize imperialistic and colonial representations of knowledge throughout history; (b) PCT in education uses an anti-colonial discursive framework to re-position indigenous knowledge in schools, colleges, and universities to challenge hegemonic knowledge; (c) PCT in education involves the "unlearning" of dominant, normative ideologies, the use of self-reflexivity, and deconstruction; and (d) PCT in education calls for critical pedagogical approaches that reject the banking concept of education and introduces inclusive pedagogy to facilitate "the passage from naïve to critical transitivity" (Freire, 1973, p. 32). Specifically, using a transformative mixed-methods design, grounded and informed by a postcolonial theoretical lens, I quantitatively uncovered and then qualitatively highlighted how if at all extra lessons can improve educational outcomes for students at the secondary level in Jamaica. Accordingly, the quantitative data was used to test the hypotheses that the practice of extra lessons in schools is related to student academic achievement and the practice of critical-inclusive pedagogy in extra lessons is related to academic achievement. The two-level hierarchical linear model analysis revealed that hours spent in extra lessons, average household monthly income, and critical-inclusive pedagogical tents were the best predictors for academic achievement. Alternatively, the holistic multi-case study explored how extra-lessons produces increased academic achievement. The data revealed new ways of knowledge construction and critical pedagogical approaches to galvanize systemic change in secondary education. Furthermore, the data showed that extra lessons can improve educational outcomes for students at the secondary level if the conditions for learning are met. This study sets the stage for new forms of knowledge construction and implications for policy change.
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Early water resources modeling efforts were aimed mostly at representing hydrologic processes, but the need for interdisciplinary studies has led to increasing complexity and integration of environmental, social, and economic functions. The gradual shift from merely employing engineering-based simulation models to applying more holistic frameworks is an indicator of promising changes in the traditional paradigm for the application of water resources models, supporting more sustainable management decisions. This dissertation contributes to application of a quantitative-qualitative framework for sustainable water resources management using system dynamics simulation, as well as environmental systems analysis techniques to provide insights for water quality management in the Great Lakes basin. The traditional linear thinking paradigm lacks the mental and organizational framework for sustainable development trajectories, and may lead to quick-fix solutions that fail to address key drivers of water resources problems. To facilitate holistic analysis of water resources systems, systems thinking seeks to understand interactions among the subsystems. System dynamics provides a suitable framework for operationalizing systems thinking and its application to water resources problems by offering useful qualitative tools such as causal loop diagrams (CLD), stock-and-flow diagrams (SFD), and system archetypes. The approach provides a high-level quantitative-qualitative modeling framework for "big-picture" understanding of water resources systems, stakeholder participation, policy analysis, and strategic decision making. While quantitative modeling using extensive computer simulations and optimization is still very important and needed for policy screening, qualitative system dynamics models can improve understanding of general trends and the root causes of problems, and thus promote sustainable water resources decision making. Within the system dynamics framework, a growth and underinvestment (G&U) system archetype governing Lake Allegan's eutrophication problem was hypothesized to explain the system's problematic behavior and identify policy leverage points for mitigation. A system dynamics simulation model was developed to characterize the lake's recovery from its hypereutrophic state and assess a number of proposed total maximum daily load (TMDL) reduction policies, including phosphorus load reductions from point sources (PS) and non-point sources (NPS). It was shown that, for a TMDL plan to be effective, it should be considered a component of a continuous sustainability process, which considers the functionality of dynamic feedback relationships between socio-economic growth, land use change, and environmental conditions. Furthermore, a high-level simulation-optimization framework was developed to guide watershed scale BMP implementation in the Kalamazoo watershed. Agricultural BMPs should be given priority in the watershed in order to facilitate cost-efficient attainment of the Lake Allegan's TP concentration target. However, without adequate support policies, agricultural BMP implementation may adversely affect the agricultural producers. Results from a case study of the Maumee River basin show that coordinated BMP implementation across upstream and downstream watersheds can significantly improve cost efficiency of TP load abatement.