Postoperative analgesic requirements - total laparoscopic hysterectomy versus vaginal hysterectomy

Background: There is limited information available on the requirement for postoperative analgesic drugs in patients submitted to total laparoscopic hysterectomy (TLH) compared with patients undergoing vaginal hysterectomy (VH). Aim: To compare the postoperative analgesic requirements in patients who underwent a TLH with patients who had a VH. Methods: Chart review of 53 patients who had TLH and 47 who had VH and were seen postoperatively by an acute pain management service in order to assess postoperative analgesic requirements. Patient controlled analgesia (PCA) was part of the standard protocol for postoperative pain management. Analgesic requirement was recorded as the mean doses of morphine and number of days that patients used non-steroidal anti-inflammatory drugs (NSAIDs), oxycodone and tramadol. Results: The requirement for total morphine was approximately half the dose in patients who had a TLH (10.8 +/- 12.6 mg) compared with patients who had a VH (19.4 +/- 21.9 mg) (P 0.017). The length of use of NSAIDs was significantly reduced in patients who had undergone a TLH (2.0 +/- 0.95 days) as compared with patients who had a VH (2.85 +/- 1.1 days) (P < 0.0001). Conclusions: Patients submitted to TLH require less postoperative analgesic drugs when compared with patients who had VH. Prospective randomised trials are warranted to compare analgesic requirements between patients submitted to TLH and VH.

Making media work in space: An interdisciplinary perspective on media and communication requirements for current and future space communities

As humans expand into space communities will form. These have already begun to form in small ways, such as long-duration missions on the International Space Station and the space shuttle, and small-scale tourist excursions into space. Social, behavioural and communications data emerging from such existing communities in space suggest that the physically-bounded, work-oriented and traditionally male-dominated nature of these extremely remote groups present specific problems for the resident astronauts, groups of them viewed as ‘communities’, and their associated groups who remain on Earth, including mission controllers, management and astronauts’ families. Notionally feminine group attributes such as adaptive competence, social adaptation skills and social sensitivity will be crucial to the viability of space communities and in the absence of gender equity, ‘staying in touch’ by means of ‘news from home’ becomes more important than ever. A template of news and media forms and technologies is suggested to service those needs and enhance the social viability of future terraforming activities.

Feline obesity: causes, consequences and management

Regulation of food intake and body weight involves a complex balance between long-term control of fat mass involving insulin, adrenal steroids and leptin signals to the CNS and short-term, meal-related signals. Cats will normally limit their food intake to their energy requirements. However, in some instances cats appear unable to regulate energy balance. Our research has demonstrated that despite elevated circulating leptin levels in obese cats associated with increased fat mass, they continue to overeat and gain weight. This paradox of increased leptin concentrations in obesity has been observed in other species and is hypothesized to be a consequence of 'leptin resistance'.

Towards a standards-based autonomic context management system

Pervasive computing applications must be sufficiently autonomous to adapt their behaviour to changes in computing resources and user requirements. This capability is known as context-awareness. In some cases, context-aware applications must be implemented as autonomic systems which are capable of dynamically discovering and replacing context sources (sensors) at run-time. Unlike other types of application autonomy, this kind of dynamic reconfiguration has not been sufficiently investigated yet by the research community. However, application-level context models are becoming common, in order to ease programming of context-aware applications and support evolution by decoupling applications from context sources. We can leverage these context models to develop general (i.e., application-independent) solutions for dynamic, run-time discovery of context sources (i.e., context management). This paper presents a model and architecture for a reconfigurable context management system that supports interoperability by building on emerging standards for sensor description and classification.

Efficient Data Management with Applications to IoT

The Internet of Things (IoT) consists of a worldwide “network of networks,” composed by billions of interconnected heterogeneous devices denoted as things or “Smart Objects” (SOs). Significant research efforts have been dedicated to port the experience gained in the design of the Internet to the IoT, with the goal of maximizing interoperability, using the Internet Protocol (IP) and designing specific protocols like the Constrained Application Protocol (CoAP), which have been widely accepted as drivers for the effective evolution of the IoT. This first wave of standardization can be considered successfully concluded and we can assume that communication with and between SOs is no longer an issue. At this time, to favor the widespread adoption of the IoT, it is crucial to provide mechanisms that facilitate IoT data management and the development of services enabling a real interaction with things. Several reference IoT scenarios have real-time or predictable latency requirements, dealing with billions of device collecting and sending an enormous quantity of data. These features create a new need for architectures specifically designed to handle this scenario, hear denoted as “Big Stream”. In this thesis a new Big Stream Listener-based Graph architecture is proposed. Another important step, is to build more applications around the Web model, bringing about the Web of Things (WoT). As several IoT testbeds have been focused on evaluating lower-layer communication aspects, this thesis proposes a new WoT Testbed aiming at allowing developers to work with a high level of abstraction, without worrying about low-level details. Finally, an innovative SOs-driven User Interface (UI) generation paradigm for mobile applications in heterogeneous IoT networks is proposed, to simplify interactions between users and things.

The design and evaluation of distributed virtual environment to support learning in global operations management

The primary goal of this research is to design and develop an education technology to support learning in global operations management. The research implements a series of studies to determine the right balance among user requirements, learning methods and applied technologies, on a view of student-centred learning. This research is multidisciplinary by nature, involving topics from various disciplines such as global operations management, curriculum and contemporary learning theory, and computer aided learning. Innovative learning models that emphasise on technological implementation are employed and discussed throughout this research.

Project risk management:a combined analytic hierarchy process and decision tree approach

Time, cost and quality achievements on large-scale construction projects are uncertain because of technological constraints, involvement of many stakeholders, long durations, large capital requirements and improper scope definitions. Projects that are exposed to such an uncertain environment can effectively be managed with the application of risk management throughout the project life cycle. Risk is by nature subjective. However, managing risk subjectively poses the danger of non-achievement of project goals. Moreover, risk analysis of the overall project also poses the danger of developing inappropriate responses. This article demonstrates a quantitative approach to construction risk management through an analytic hierarchy process (AHP) and decision tree analysis. The entire project is classified to form a few work packages. With the involvement of project stakeholders, risky work packages are identified. As all the risk factors are identified, their effects are quantified by determining probability (using AHP) and severity (guess estimate). Various alternative responses are generated, listing the cost implications of mitigating the quantified risks. The expected monetary values are derived for each alternative in a decision tree framework and subsequent probability analysis helps to make the right decision in managing risks. In this article, the entire methodology is explained by using a case application of a cross-country petroleum pipeline project in India. The case study demonstrates the project management effectiveness of using AHP and DTA.

Operations management

The SAGE Course Companion on Operations Management is an accessible introduction to the subject that will help readers to extend their understanding of key concepts and enhance their thinking skills in line with course requirements. It provides support on how to revise for exams and prepare for and write assessed pieces. Readers are encouraged not only to think like an operations manager but also to think about the subject critically.

Introduction: improving manufacturing performance through technology diffusion, implementation and management

The role of technology management in achieving improved manufacturing performance has been receiving increased attention as enterprises are becoming more exposed to competition from around the world. In the modern market for manufactured goods the demand is now for more product variety, better quality, shorter delivery and greater flexibility, while the financial and environmental cost of resources has become an urgent concern to manufacturing managers. This issue of the International Journal of Technology Management addresses the question of how the diffusion, implementation and management of technology can improve the performance of manufacturing industries. The authors come from a large number of different countries and their contributions cover a wide range of topics within this general theme. Some papers are conceptual, others report on research carried out in a range of different industries including steel production, iron founding, electronics, robotics, machinery, precision engineering, metal working and motor manufacture. In some cases they describe situations in specific countries. Several are based on presentations made at the UK Operations Management Association's Sixth International Conference held at Aston University at which the conference theme was 'Achieving Competitive Edge: Getting Ahead Through Technology and People'. The first two papers deal with questions of advanced manufacturing technology implementation and management. Firstly Beatty describes a three year longitudinal field study carried out in ten Canadian manufacturing companies using CADICAM and CIM systems. Her findings relate to speed of implementation, choice of system type, the role of individuals in implementation, organization and job design. This is followed by a paper by Bessant in which he argues that a more a strategic approach should be taken towards the management of technology in the 1990s and beyond. Also considered in this paper are the capabilities necessary in order to deploy advanced manufacturing technology as a strategic resource and the way such capabilities might be developed within the firm. These two papers, which deal largely with the implementation of hardware, are supplemented by Samson and Sohal's contribution in which they argue that a much wider perspective should be adopted based on a new approach to manufacturing strategy formulation. Technology transfer is the topic of the following two papers. Pohlen again takes the case of advanced manufacturing technology and reports on his research which considers the factors contributing to successful realisation of AMT transfer. The paper by Lee then provides a more detailed account of technology transfer in the foundry industry. Using a case study based on a firm which has implemented a number of transferred innovations a model is illustrated in which the 'performance gap' can be identified and closed. The diffusion of technology is addressed in the next two papers. In the first of these, by Lowe and Sim, the managerial technologies of 'Just in Time' and 'Manufacturing Resource Planning' (or MRP 11) are examined. A study is described from which a number of factors are found to influence the adoption process including, rate of diffusion and size. Dahlin then considers the case of a specific item of hardware technology, the industrial robot. Her paper reviews the history of robot diffusion since the early 1960s and then tries to predict how the industry will develop in the future. The following two papers deal with the future of manufacturing in a more general sense. The future implementation of advanced manufacturing technology is the subject explored by de Haan and Peters who describe the results of their Dutch Delphi forecasting study conducted among a panel of experts including scientists, consultants, users and suppliers of AMT. Busby and Fan then consider a type of organisational model, 'the extended manufacturing enterprise', which would represent a distinct alternative pure market-led and command structures by exploiting the shared knowledge of suppliers and customers. The three country-based papers consider some strategic issues relating manufacturing technology. In a paper based on investigations conducted in China He, Liff and Steward report their findings from strategy analyses carried out in the steel and watch industries with a view to assessing technology needs and organizational change requirements. This is followed by Tang and Nam's paper which examines the case of machinery industry in Korea and its emerging importance as a key sector in the Korean economy. In his paper which focuses on Venezuela, Ernst then considers the particular problem of how this country can address the problem of falling oil revenues. He sees manufacturing as being an important contributor to Venezuela's future economy and proposes a means whereby government and private enterprise can co-operate in development of the manufacturing sector. The last six papers all deal with specific topics relating to the management manufacturing. Firstly Youssef looks at the question of manufacturing flexibility, introducing and testing a conceptual model that relates computer based technologies flexibility. Dangerfield's paper which follows is based on research conducted in the steel industry. He considers the question of scale and proposes a modelling approach determining the plant configuration necessary to meet market demand. Engstrom presents the results of a detailed investigation into the need for reorganising material flow where group assembly of products has been adopted. Sherwood, Guerrier and Dale then report the findings of a study into the effectiveness of Quality Circle implementation. Stillwagon and Burns, consider how manufacturing competitiveness can be improved individual firms by describing how the application of 'human performance engineering' can be used to motivate individual performance as well as to integrate organizational goals. Finally Sohal, Lewis and Samson describe, using a case study example, how just-in-time control can be applied within the context of computer numerically controlled flexible machining lines. The papers in this issue of the International Journal of Technology Management cover a wide range of topics relating to the general question of improving manufacturing performance through the dissemination, implementation and management of technology. Although they differ markedly in content and approach, they have the collective aim addressing the concepts, principles and practices which provide a better understanding the technology of manufacturing and assist in achieving and maintaining a competitive edge.

Rules for mapping a conceptual model onto various data base management systems. Available in 2 volumes.

The design and implementation of data bases involve, firstly, the formulation of a conceptual data model by systematic analysis of the structure and information requirements of the organisation for which the system is being designed; secondly, the logical mapping of this conceptual model onto the data structure of the target data base management system (DBMS); and thirdly, the physical mapping of this structured model into storage structures of the target DBMS. The accuracy of both the logical and physical mapping determine the performance of the resulting systems. This thesis describes research which develops software tools to facilitate the implementation of data bases. A conceptual model describing the information structure of a hospital is derived using the Entity-Relationship (E-R) approach and this model forms the basis for mapping onto the logical model. Rules are derived for automatically mapping the conceptual model onto relational and CODASYL types of data structures. Further algorithms are developed for partly automating the implementation of these models onto INGRES, MIMER and VAX-11 DBMS.

The interaction between master production scheduling and detailed capacity requirements planning : closing the loop in manufacturing resource planning (MRPII) systems

The widespread implementation of Manufacturing Resource Planning (MRPII) systems in this country and abroad and the reported dissatisfaction with their use formed the initial basis of this piece of research which concentrates on the fundamental theory and design of the Closed Loop MRPII system itself. The dissertation concentrates on two key aspects namely; how Master Production Scheduling is carried out in differing business environments and how well the `closing of the loop' operates by checking the capcity requirements of the different levels of plans within an organisation. The main hypothesis which is tested is that in U.K. manufacturing industry, resource checks are either not being carried out satisfactorily or they are not being fed back to the appropriate plan in a timely fashion. The research methodology employed involved initial detailed investigations into Master Scheduling and capacity planning in eight diverse manufacturing companies. This was followed by a nationwide survey of users in 349 companies, a survey of all the major suppliers of Production Management software in the U.K. and an analysis of the facilities offered by current software packages. The main conclusion which is drawn is that the hypothesis is proved in the majority of companies in that only just over 50% of companies are attempting Resource and Capacity Planning and only 20% are successfully feeding back CRP information to `close the loop'. Various causative factors are put forward and remedies are suggested.

Some aspects of system design for production management in the rolling-mill industry

Case studies in copper-alloy rolling mill companies showed that existing planning systems suffer from numerous shortcomings. Where computerised systems are in use, these tend to simply emulate older manual systems and still rely heavily on modification by experienced planners on the shopfloor. As the size and number of orders increase, the task of process planners, while seeking to optimise the manufacturing objectives and keep within the production constraints, becomes extremely complicated because of the number of options for mixing or splitting the orders into batches. This thesis develops a modular approach to computerisation of the production management and planning functions. The full functional specification of each module is discussed, together with practical problems associated with their phased implementation. By adapting the Distributed Bill of Material concept from Material Requirements Planning (MRP) philosophy, the production routes generated by the planning system are broken down to identify the rolling stages required. Then to optimise the use of material at each rolling stage, the system generates an optimal cutting pattern using a new algorithm that produces practical solutions to the cutting stock problem. It is shown that the proposed system can be accommodated on a micro-computer, which brings it into the reach of typical companies in the copper-alloy rolling industry, where profit margins are traditionally low and the cost of widespread use of mainframe computers would be prohibitive.

Employability management needs analysis and the ICT sector in Europe:the case of small and medium-sized enterprises

The purpose of this paper is to deal with the outcomes of a so-called “employability management needs analysis” that is meant to provide more insight into current employability management activities and its possible benefits for Information and Communication Technology (ICT) professionals working in Small- and Medium-sized enterprises (SMEs) throughout Europe. A considerable series of interviews (N=107) were conducted with managers in SMEs in seven European countries, including Germany, Greece, Italy, the Netherlands, Norway, Poland, and the UK. A semi-structured interview protocol was used during the interviews to cover three issues: employability (13 items), ageing (8 items), and future developments and requirements (13 items). Analysis of all final interview transcriptions was at a national level using an elaborate common coding scheme. Although an interest in employability emerged, actual policy and action lagged behind. The recession in the ICT sector at the time of the investigation and the developmental stage of the sector in each participating country appeared connected. Ageing was not seen as a major issue in the ICT sector because managers considered ICT to be a relatively young sector. There appeared to be a serious lack of investment in the development of expertise of ICT professionals. Generalization of the results to large organizations in the ICT sector should be made with caution. The interview protocol developed is of value for further research and complements survey research undertaken within the employability field of study. It can be concluded that proactive HRM (Human Resource Management) policies and strategies are essential, even in times of economic downturn. Employability management activities are especially important in the light of current career issues. The study advances knowledge regarding HRM practices adopted by SMEs in the ICT sector, especially as there is a gap in knowledge about career development issues in that particular sector.