Gender and general practice: the single-handed woman General Practitioner

This research examines women GPs' careers, how they run their practices and how they reconcile professional and domestic lives. It looks at the particular experiences of women GPs who practise alone, and at the pressures in past practice experience which have led them to do so. It is argued that many of the problems of group practice which can be identified are attributable to gender. For example, one reason given for entering general practice is a desire to be able to provide the full range of medical care and not to specialise. Women GPs, however, may find themselves seeing more women patients for "women's problems" and children than they would freely choose. Women have not entered general practice in order to specialise in these areas of medicine. Indeed, if they had wanted to specialise in obstetrics, gynaecology or paediatrics they would have had difficulty advancing very far in these male-dominated areas of hospital hierarchy. Other gender related problems exist for women in general practice and practising single-handedly is one strategy that women GPs have used to counter the problems of working in male-dominated practices and partnerships. However, the twenty-four hour commitment of single-handed practice may bring further pressures in reconciling this with responsibility for home life. Out-of-hours cover, which can be viewed as the link between professional and domestic life, where the one intrudes into the other, is also examined in terms of the gender issues it raises. The interaction of gender and ethnicity is also considered for the 11 Asian women GPs in the study. Interviews were conducted with 29 single-handed women GPs in the Midlands. In addition, some cases were studied in greater depth by being observed in their surgeries and on home visits for a day each. A qualitative/feminist approach to analysis has been employed.

Design and construction for traditional house building

This study is concerned with quality and productivity aspects of traditional house building. The research focuses on these issues by concentrating on the services and finishing stages of the building process. These are work stages which have not been fully investigated in previous productivity related studies. The primary objective of the research is to promote an integrated design and construction led approach to traditional house building based on an original concept of 'development cycles'. This process involves the following: site monitoring; the analysis of work operations; implementing design and construction changes founded on unique information collected during site monitoring; and subsequent re-monitoring to measure and assess Ihe effect of change. A volume house building firm has been involved in this applied research and has allowed access to its sites for production monitoring purposes. The firm also assisted in design detailing for a small group of 'experimental' production houses where various design and construction changes were implemented. Results from the collaborative research have shown certain quality and productivity improvements to be possible using this approach, albeit on a limited scale at this early experimental stage. The improvements have been possible because an improved activity sampling technique, developed for, and employed by the study, has been able to describe why many quality and productivity related problems occur during site building work. Experience derived from the research has shown the following attributes to be important: positive attitudes towards innovation; effective communication; careful planning and organisation; and good coordination and control at site level. These are all essential aspects of quality led management and determine to a large extent the overall success of this approach. Future work recommendations must include a more widespread use of innovative practices so that further design and construction modifications can be made. By doing this, productivity can be improved, cost savings made and better quality afforded.

Physicians' perceptions, attitudes and expectations regarding the role of hospital-based pharmacists in the West Bank, Palestine

Objective - To evaluate the perceptions, expectations and experiences of physicians with regard to hospital-based pharmacists in the West Bank, Palestine. Methods - A self-administered questionnaire was distributed to 250 physicians practising in four general hospitals in the West Bank, Palestine. The main sections of the questionnaire comprised a series of statements pertaining to physicians' perceptions, expectations and experiences with pharmacists. Key findings - One hundred and fifty seven questionnaires were completed and returned (response rate, 62.8%). The majority of respondents were most comfortable with pharmacists detecting and preventing prescription errors (76.4%; 95% confidence interval (CI) 69.5–81.2%) and patient education (57.9%; CI 51.2–63.4%) but they were not comfortable with pharmacists suggesting the use of prescription medications to patients (56.7%; CI 49.8–62.4%). Most physicians (62.4%; CI 56.8–69.1%) expected the pharmacist to educate their patients about the safe and appropriate use of their medication. However, approximately one-third (31.7%; CI 26.0–39.6%) did not expect pharmacists to be available for consultation during rounds. Physicians' experiences with pharmacists were less favourable; whereas 77% (CI 70.2–81.5%) of the physicians agreed that pharmacists were always a reliable source of information, only 11.5% (CI 6.2–16.4%) agreed that pharmacists appeared to be willing to take responsibility for solving any drug-related problems. Conclusion -The present study showed that hospital physicians are more likely to accept traditional pharmacy services than newer clinical services for hospital-based pharmacists in the West Bank, Palestine. Pharmacists should therefore interact more positively and more frequently with physicians. This will close the gap between the physicians' commonly held perceptions of what they expect pharmacists to do and what pharmacists can actually do, and gain support for an extended role of hospital-based pharmacists in future patient therapy management.

Perspectives of carers on medication management in dementia:lessons from collaboratively developing a research proposal

Background: The need for carers to manage medication-related problems for people with dementia living in the community raises dilemmas, which can be identified by carers and people with dementia as key issues for developing carer-relevant research projects.A research planning Public Patient Involvement (PPI) workshop using adapted focus group methodology was held at the Alzheimer's Society's national office, involving carers of people with dementia who were current members of the Alzheimer's Society Research Network (ASRN) in dialogue with health professionals aimed to identify key issues in relation to medication management in dementia from the carer viewpoint. The group was facilitated by a specialist mental health pharmacist, using a topic guide developed systematically with carers, health professionals and researchers. Audio-recordings and field notes were made at the time and were transcribed and analysed thematically. The participants included nine carers in addition to academics, clinicians, and staff from DeNDRoN (Dementias and Neurodegenerative Diseases Research Network) and the Alzheimer's Society. Findings. Significant themes, for carers, which emerged from the workshop were related to: (1) medication usage and administration practicalities, (2) communication barriers and facilitators, (3) bearing and sharing responsibility and (4) weighing up medication risks and benefits. These can form the basis for more in-depth qualitative research involving a broader, more diverse sample. Discussion. The supported discussion enabled carer voices and perspectives to be expressed and to be linked to the process of identifying problems in medications management as directly experienced by carers. This was used to inform an agenda for research proposals which would be meaningful for carers and people with dementia. © 2014 Poland et al.; licensee BioMed Central Ltd.

Tsunami disaster recovery experience:a case study on micro, small and medium scale enterprises in Southern Sri Lanka

Post-disaster recovery of Micro, Small and Medium-Scale Enterprises (SMEs) remains an issue of interest for policy and practice given the wide scale occurrences of natural disasters around the globe and their significant impacts on local economies and SMEs. Asian Tsunami of December 2004 affected many SMEs in southern Sri Lanka. The study was developed to identify the main issues encountered by the Tsunami affected SMEs in Southern Sri Lanka in the process of their post-tsunami recovery. The study: a) identifies tsunami damage and loss in micro and SMEs in the Galle district; b) ascertains the type of benefits received from various parties by the affected micro and SMEs; c) evaluates the problems and difficulties faced by the beneficiary organizations in the benefit distribution process; and d) recommends strategies and policies for the tsunami-affected micro and SMEs for them to become self-sustaining within a reasonable time frame. Fifty randomly selected tsunami-affected micro and SMEs were surveyed for this study. Interviews were conducted in person with the business owners in order to identify the damages, recovery, rehabilitation, re-establishment and difficulties faced in the benefit distribution process. The analysis identifies that the benefits were given the wrong priorities and that they were not sufficient for the recovery process. In addition, the many governance-related problems that arose while distributing benefits are discussed. Overall, the business recovery rate was approximately 65%, and approximately 88% of business organizations were sole proprietorships. Therefore, the policies of the tsunami relief agencies should adequately address the needs of sole proprietorship business requirements. Consideration should also be given to strengthen the capacity and skills of the entrepreneurs by improving operational, technological, management and marketing skills and capabilities.

On the Generation of Heronian Triangles

We describe several algorithms for the generation of integer Heronian triangles with diameter at most n. Two of them have running time O(n^(2+ε)). We enumerate all integer Heronian triangles for n ≤ 600000 and apply the complete list on some related problems.

Designing a Cultural Heritage Sector Broker Using SDBC

Among the actual cultural-heritage-related problems is the one of effectively managing and globally distributing digitized cultural (and scientific) information. The only feasible way to realize this goal is via the Internet. Hence, a significant issue to be considered is the adequate design of software applications which to realize brokerage tasks within the global space. However, due to the great complexity of this cultural-heritage- related task (compared to other brokerage tasks successfully realized by software systems), the usage of the existing popular modeling instrumentarium seems inadequate. Hence, in this paper, an approach is presented and it is briefly discussed how the approach could be useful for building cultural heritage sector brokers.

Education in Computer Science and the Role of the Teacher in the Environment of Open Educational Resources

Report published in the Proceedings of the National Conference on "Education in the Information Society", Plovdiv, May, 2013

Maximization of a Linear Utility Function over the Set of the Housing Market Short-Term Equilibria

AMS subject classification: 90C05, 90A14.

Combined quality function deployment and logical framework analysis to improve quality of emergency care in Malta

Purpose – The purpose of this paper is to develop an integrated patient-focused analytical framework to improve quality of care in accident and emergency (A&E) unit of a Maltese hospital. Design/methodology/approach – The study adopts a case study approach. First, a thorough literature review has been undertaken to study the various methods of healthcare quality management. Second, a healthcare quality management framework is developed using combined quality function deployment (QFD) and logical framework approach (LFA). Third, the proposed framework is applied to a Maltese hospital to demonstrate its effectiveness. The proposed framework has six steps, commencing with identifying patients’ requirements and concluding with implementing improvement projects. All the steps have been undertaken with the involvement of the concerned stakeholders in the A&E unit of the hospital. Findings – The major and related problems being faced by the hospital under study were overcrowding at A&E and shortage of beds, respectively. The combined framework ensures better A&E services and patient flow. QFD identifies and analyses the issues and challenges of A&E and LFA helps develop project plans for healthcare quality improvement. The important outcomes of implementing the proposed quality improvement programme are fewer hospital admissions, faster patient flow, expert triage and shorter waiting times at the A&E unit. Increased emergency consultant cover and faster first significant medical encounter were required to start addressing the problems effectively. Overall, the combined QFD and LFA method is effective to address quality of care in A&E unit. Practical/implications – The proposed framework can be easily integrated within any healthcare unit, as well as within entire healthcare systems, due to its flexible and user-friendly approach. It could be part of Six Sigma and other quality initiatives. Originality/value – Although QFD has been extensively deployed in healthcare setup to improve quality of care, very little has been researched on combining QFD and LFA in order to identify issues, prioritise them, derive improvement measures and implement improvement projects. Additionally, there is no research on QFD application in A&E. This paper bridges these gaps. Moreover, very little has been written on the Maltese health care system. Therefore, this study contributes demonstration of quality of emergency care in Malta.

The impact of CEO compensation and CEO horizon on a firm's discretionary research and development expenditures

Agency costs are said to arise as a result of the separation of ownership from control inherent in the corporate form of ownership. One such agency problem concerns the potential variance between the time horizons of principal shareholders and agent managers. Agency theory suggests that these costs can be alleviated or controlled through performance-based Chief Executive Officer (CEO) contracting. However, components of a CEO's compensation contract can exacerbate or mitigate agency-related problems (Antle and Smith, 1985). According to the horizon hypothesis, a self-serving CEO reduces discretionary research and development (R&D) expenditures to increase earnings and earnings-based bonus compensation. Agency theorists contend that a CEO's market-based compensation component can mitigate horizon problems. This study seeks to determine whether there is a relationship between CEO earnings- and market-based compensation components and R&D expenditures in the largest United States industrial firms from 1987 to 1993.^ Consistent with the horizon hypothesis, results provide evidence of a negative and statistically significant relationship between CEO cash compensation (i.e., salary and bonus) and the firm's R&D expenditures. Consistent with the expectations of agency theory, results provide evidence of a positive and statistically significant relationship between market-based CEO compensation and R&D.^ Further results of this study provide evidence of a positive and statistically significant relationship between CEO tenure and the firm's R&D expenditures. Although there is a negative relationship between CEO age and the firm's R&D, it was not statistically significant at the 0.5 level. ^

Minimizing makespan for hybrid flowshops with batch, discrete processing machines and arbitrary job sizes

This research aims at a study of the hybrid flow shop problem which has parallel batch-processing machines in one stage and discrete-processing machines in other stages to process jobs of arbitrary sizes. The objective is to minimize the makespan for a set of jobs. The problem is denoted as: FF: batch1,sj:Cmax. The problem is formulated as a mixed-integer linear program. The commercial solver, AMPL/CPLEX, is used to solve problem instances to their optimality. Experimental results show that AMPL/CPLEX requires considerable time to find the optimal solution for even a small size problem, i.e., a 6-job instance requires 2 hours in average. A bottleneck-first-decomposition heuristic (BFD) is proposed in this study to overcome the computational (time) problem encountered while using the commercial solver. The proposed BFD heuristic is inspired by the shifting bottleneck heuristic. It decomposes the entire problem into three sub-problems, and schedules the sub-problems one by one. The proposed BFD heuristic consists of four major steps: formulating sub-problems, prioritizing sub-problems, solving sub-problems and re-scheduling. For solving the sub-problems, two heuristic algorithms are proposed; one for scheduling a hybrid flow shop with discrete processing machines, and the other for scheduling parallel batching machines (single stage). Both consider job arrival and delivery times. An experiment design is conducted to evaluate the effectiveness of the proposed BFD, which is further evaluated against a set of common heuristics including a randomized greedy heuristic and five dispatching rules. The results show that the proposed BFD heuristic outperforms all these algorithms. To evaluate the quality of the heuristic solution, a procedure is developed to calculate a lower bound of makespan for the problem under study. The lower bound obtained is tighter than other bounds developed for related problems in literature. A meta-search approach based on the Genetic Algorithm concept is developed to evaluate the significance of further improving the solution obtained from the proposed BFD heuristic. The experiment indicates that it reduces the makespan by 1.93 % in average within a negligible time when problem size is less than 50 jobs.

Exploring the integration of data mining and data visualization

Due to the rapid advances in computing and sensing technologies, enormous amounts of data are being generated everyday in various applications. The integration of data mining and data visualization has been widely used to analyze these massive and complex data sets to discover hidden patterns. For both data mining and visualization to be effective, it is important to include the visualization techniques in the mining process and to generate the discovered patterns for a more comprehensive visual view. In this dissertation, four related problems: dimensionality reduction for visualizing high dimensional datasets, visualization-based clustering evaluation, interactive document mining, and multiple clusterings exploration are studied to explore the integration of data mining and data visualization. In particular, we 1) propose an efficient feature selection method (reliefF + mRMR) for preprocessing high dimensional datasets; 2) present DClusterE to integrate cluster validation with user interaction and provide rich visualization tools for users to examine document clustering results from multiple perspectives; 3) design two interactive document summarization systems to involve users efforts and generate customized summaries from 2D sentence layouts; and 4) propose a new framework which organizes the different input clusterings into a hierarchical tree structure and allows for interactive exploration of multiple clustering solutions.

Industry Education: The Merger Continues

In the discussion - Industry Education: The Merger Continues - by Rob Heiman Assistant Professor Hospitality Food Service Management at Kent State University, the author originally declares, “Integrating the process of an on-going catering and banquet function with that of selected behavioral academic objectives leads to an effective, practical course of instruction in catering and banquet management. Through an illustrated model, this article highlights such a merger while addressing a variety of related problems and concerns to the discipline of hospitality food service management education.” The article stresses the importance of blending the theoretical; curriculum based learning process with that of a hands-on approach, in essence combining an in-reality working program, with academics, to develop a well rounded hospitality student. “How many programs are enjoying the luxury of excessive demand for students from industry [?],” the author asks in proxy for, and to highlight the immense need for qualified personnel in the hospitality industry. As the author describes it, “An ideal education program concerns itself with the integration of theory and simulation with hands-on experience to teach the cognitive as well as the technical skills required to achieve the pre-determined hospitality education objectives.” In food service one way to achieve this integrated learning curve is to have the students prepare foods and then consume them. Heiman suggests this will quickly illustrate to students the rights and wrongs of food preparation. Another way is to have students integrating the academic program with feeding the university population. Your author offers more illustrations on similar principles. Heiman takes special care in characterizing the banquet and catering portions of the food service industry, and he offers empirical data to support the descriptions. It is in these areas, banquet and catering, that Heiman says special attention is needed to produce qualified students to those fields. This is the real focus of the discussion, and it is in this venue that the remainder of the article is devoted. “Based on the perception that quality education is aided by implementing project assignments through the course of study in food service education, a model description can be implemented for a course in Catering and Banquet Management and Operations. This project model first considers the prioritized objectives of education and industry and then illustrates the successful merging of resources for mutual benefits,” Heiman sketches. The model referred to above is also the one aforementioned in the thesis statement at the beginning of the article. This model is divided into six major components; Heiman lists and details them. “The model has been tested through two semesters involving 29 students,” says Heiman. “Reaction by all participants has been extremely positive. Recent graduates of this type of program have received a sound theoretical framework and demonstrated their creative interpretation of this theory in practical application,” Heiman says in summation.

Reservatório Tabatinga (Macaíba-RN): qualidade ambiental, conflitos e uso

The reservoirs are water sources built along the fluvial basins, between rivers and dams made by concrete or earth. In Brazil they are built for different purposes, standing out the generation of energy (hydroelectric power station), flowing regulation, water reserves and flooding control, therefore they have played and still play an important role in the modern society.In the Northeastern semiarid region, they are typically used to supply cities and as a source of food.In the state of Rio Grande do Norte, the large reservoirs are intended for the same purpose.The cities settled in the riverbanks, or which have river channels crossing them, face flooding related problems. In the city of Macaíba-RN, flooding occurred systematically during the rainy season, causing great inconvenience to the local population.As product of the collective claim Tabatinga Reservoir in Jundiaí river was built, upstream of the city. Facing this background, this thesis aimed to assess the sócio-environmental quality of this reservoir.To achieve this goal, methodologies pointed to assess water quality along with the aplication of a questionnaire were used aimed to verify the quality of water and to know the perception of the residents from urban and rural área settled near to the reservoir was performed. The results showed the existence of conflicts of residents of rural communities and the presence of the reservoir, while for the city's population, the reservoir is considered not only the right solution to solve flooding in urban areas, but also as economic source for the rural population. Considering the water source assessment, this study concluded that the Tabatinga Reservoir is unfit for human use, due to the presence of metals of toxicological significance with the potential to elicit damage to the genetic material of individuals that use water from this reservoir, leading to cause serious risks to health population.