878 resultados para implementation of change management strategies


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This dissertation consists of three essays on different aspects of water management. The first essay focuses on the sustainability of freshwater use by introducing the notion that altruistic parents do bequeath economic assets for their offspring. Constructing a two-period, over-lapping generational model, an optimal ratio of consumption and pollution for old and young generations in each period is determined. Optimal levels of water consumption and pollution change according to different parameters, such as, altruistic degree, natural recharge rate, and population growth. The second essay concerns water sharing between countries in the case of trans-boundary river basins. The paper recognizes that side payments fail to forge water-sharing agreement among the international community and that downstream countries have weak bargaining power. An interconnected game approach is developed by linking the water allocation issue with other non-water issues such as trade or border security problems, creating symmetry between countries in bargaining power. An interconnected game forces two countries to at least partially cooperate under some circumstances. The third essay introduces the concept of virtual water (VW) into a traditional international trade model in order to estimate water savings for a water scarce country. A two country, two products and two factors trade model is developed, which includes not only consumers and producer's surplus, but also environmental externality of water use. The model shows that VW trade saves water and increases global and local welfare. This study should help policy makers to design appropriate subsidy or tax policy to promote water savings especially in water scarce countries.^

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Globally, small-scale fisheries (SSFs) are driven by climate, governance, and market factors of social-ecological change, presenting both challenges and opportunities. The ability of small-scale fishermen and buyers to adapt to changing conditions allows participants to survive economic or environmental disturbances and to benefit from optimal conditions. This study presented here identifies key large-scale factors that drive SSFs in California to shift focus among targets and that dictate long-term trends in landings. We use Elinor Ostrom’s Social-Ecological System (SES) framework to apply an interdisciplinary approach when identifying potential factors and when understanding the complex dynamics of these fisheries. We analyzed the interactions among Monterey Bay SSFs over the past four decades since the passage of the Magnuson Stevens Fisheries Conservation and Management Act of 1976. In this region, the Pacific sardine (Sardinops sagax), northern anchovy (Engraulis mordax), and market squid (Loligo opalescens) fisheries comprise a tightly linked system where shifting focus among fisheries is a key element to adaptive capacity and reduced social and ecological vulnerability. Using a cluster analysis of landings, we identified four modes from 1974 to 2012 that were dominated by squid, sardine, anchovy, or lacked any dominance, enabling us to identify external drivers attributed to a change in fishery dominance during seven distinct transition points. Overall, we show that market and climate factors drive the transitions among dominance modes. Governance phases most dictated long-term trends in landings and are best viewed as a response to changes in perceived biomass and thus a proxy for biomass. Our findings suggest that globally, small-scale fishery managers should consider enabling shifts in effort among fisheries and retaining existing flexibility, as adaptive capacity is a critical determinant for social and ecological resilience.

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Microelectronic systems are multi-material, multi-layer structures, fabricated and exposed to environmental stresses over a wide range of temperatures. Thermal and residual stresses created by thermal mismatches in films and interconnections are a major cause of failure in microelectronic devices. Due to new device materials, increasing die size and the introduction of new materials for enhanced thermal management, differences in thermal expansions of various packaging materials have become exceedingly important and can no longer be neglected. X-ray diffraction is an analytical method using a monochromatic characteristic X-ray beam to characterize the crystal structure of various materials, by measuring the distances between planes in atomic crystalline lattice structures. As a material is strained, this interplanar spacing is correspondingly altered, and this microscopic strain is used to determine the macroscopic strain. This thesis investigates and describes the theory and implementation of X-ray diffraction in the measurement of residual thermal strains. The design of a computer controlled stress attachment stage fully compatible with an Anton Paar heat stage will be detailed. The stress determined by the diffraction method will be compared with bimetallic strip theory and finite element models.

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The rewards and sanctions associated with high-stakes testing may induce educators to participate in practices that will ensure the elimination of the scores of low-achieving students from the testing pool. Two ways in which scores may be eliminated is through retention or referral to special education. This study examined the use of these practices at 179 elementary schools in Miami-Dade County Public Schools, the 4th largest school district in the country. Between- and within-subjects designs were analyzed using repeated measures analysis of variance to compare retention and referral to special education practices over a five-year period of time, two years prior to and two years after the implementation of Florida's high-stakes test, the Florida Comprehensive Assessment Test, FCAT. Significant main effects for referral and retention over time were demonstrated. The use of retention steadily increased over the first three years, with its usage maintained during the fourth year. While the use of referral actually decreased from the first to second years, a significant change occurred after the implementation of the FCAT. Examination of the use of these practices according to student and school characteristics revealed significant differences. Increases in the use of referral across time was significant for Black, non-Hispanic and Hispanic students, all limited English proficiency population categories, medium and low socioeconomic status category schools, all grade levels, and for schools with accountability grades of A, C, D and F with the most striking absolute increase occurring for F schools. Increases in the use of retention across time were significant for all ethnic groups, limited English proficiency categories, and socioeconomic status categories, for grades kindergarten through four and by gender. Significant increases occurred for schools with accountability performance grades of C, D and F; however the most dramatic increase occurred for the F schools. A direct relationship between performance category grade of school and their use of retention was demonstrated. The results suggest that schools changed their use of referral and retention in response to the implementation of the FCAT.

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This dissertation consists of three essays on different aspects of water management. The first essay focuses on the sustainability of freshwater use by introducing the notion that altruistic parents do bequeath economic assets for their offspring. Constructing a two-period, over-lapping generational model, an optimal ratio of consumption and pollution for old and young generations in each period is determined. Optimal levels of water consumption and pollution change according to different parameters, such as, altruistic degree, natural recharge rate, and population growth. The second essay concerns water sharing between countries in the case of trans-boundary river basins. The paper recognizes that side payments fail to forge water-sharing agreement among the international community and that downstream countries have weak bargaining power. An interconnected game approach is developed by linking the water allocation issue with other non-water issues such as trade or border security problems, creating symmetry between countries in bargaining power. An interconnected game forces two countries to at least partially cooperate under some circumstances. The third essay introduces the concept of virtual water (VW) into a traditional international trade model in order to estimate water savings for a water scarce country. A two country, two products and two factors trade model is developed, which includes not only consumers and producer’s surplus, but also environmental externality of water use. The model shows that VW trade saves water and increases global and local welfare. This study should help policy makers to design appropriate subsidy or tax policy to promote water savings especially in water scarce countries.

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This symposium describes a multi-dimensional strategy to examine fidelity of implementation in an authentic school district context. An existing large-district peer mentoring program provides an example. The presentation will address development of a logic model to articulate a theory of change; collaborative creation of a data set aligned with essential concepts and research questions; identification of independent, dependent, and covariate variables; issues related to use of big data that include conditioning and transformation of data prior to analysis; operationalization of a strategy to capture fidelity of implementation data from all stakeholders; and ways in which fidelity indicators might be used.

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Recent debate on the quality of arts events has concentrated on the requirement to deliver against a complex range of political, social, and cultural criteria with an emphasis on the external partnerships that are forged. Yet those aspects of quality over which event organizers have more direct control have been accorded minor examination. The authors believe that operational effectiveness is key to service quality in the cultural context, and seek to demonstrate that a balanced consideration of both process and product is vital to fully deliver quality arts events. This article identifies areas of emergent research and practice and focuses on issues in the front-of-house environment where the breakdown of service quality is a real concern, using the experience of one UK not-for-profit arts organization as a case study to illustrate potential management responses.

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Diese Arbeit beschäftigt sich mit nicht in Rechnung stellbaren Wasserverlusten in städtischen Versorgungsnetzen in Entwicklungsländern. Es soll das Wissen über diese Verluste erweitert und aufgezeigt werden, ob diese auf ein ökonomisch vertretbares Maß reduziert werden können. Die vorliegende Doktorarbeit untersucht solche unberechneten Wasserverluste und versucht, neben der Quantifizierung von Leckagen auch Entscheidungswerkzeuge für ein verbessertes Management der Versorgungsnetze in Entwicklungsländern zu erarbeiten. Als Fallstudie dient Harare, die Hauptstadt von Simbabwe. Wasserverluste in Verteilungsnetzen sind unvermeidbar, sollten aber auf ein ökonomisch tragbares Niveau reduziert werden, wenn ein nachhaltiger Betrieb erreicht werden soll. Wasserverluste können sowohl durch illegale und ungenehmigte Anschlüsse oder durch Undichtigkeiten im Verteilnetz, als auch durch mangelhafte Mess- und Berechnungssysteme entstehen. Es sind bereits viele Ansätze zur Verringerung von Verlusten in Wasserverteilsystemen bekannt geworden, entsprechend existieren dazu auch zahlreiche Methoden und Werkzeuge. Diese reichen von computergestützten Verfahren über gesetzliche und politische Vorgaben sowie ökonomische Berechnungen bis hin zu Maßnahmen der Modernisierung der Infrastruktur. Der Erfolg dieser Anstrengungen ist abhängig von der Umsetzbarkeit und dem Umfeld, in dem diese Maßnahmen durchgeführt werden. Die Bewertung der Arbeitsgüte einer jeden Wasserversorgungseinheit basiert auf der Effektivität des jeweiligen Verteilungssystems. Leistungs- und Bewertungszahlen sind die meist genutzten Ansätze, um Wasserverteilsysteme und ihre Effizienz einzustufen. Weltweit haben sich zur Bewertung als Indikatoren die finanzielle und die technische Leistungsfähigkeit durchgesetzt. Die eigene Untersuchung zeigt, dass diese Indikatoren in vielen Wasserversorgungssystemen der Entwicklungsländer nicht zur Einführung von Verlust reduzierenden Managementstrategien geführt haben. Viele durchgeführte Studien über die Einführung von Maßnahmen zur Verlustreduzierung beachten nur das gesamte nicht in Rechnung stellbare Wasser, ohne aber den Anteil der Leckagen an der Gesamthöhe zu bestimmen. Damit ist keine Aussage über die tatsächliche Zuordnung der Verluste möglich. Aus diesem Grund ist ein Bewertungsinstrument notwendig, mit dem die Verluste den verschiedenen Ursachen zugeordnet werden können. Ein solches Rechenwerkzeug ist das South African Night Flow Analysis Model (SANFLOW) der südafrikanischen Wasser-Forschungskommission, das Untersuchungen von Wasserdurchfluss und Anlagendruck in einzelnen Verteilbezirken ermöglicht. In der vorliegenden Arbeit konnte nachgewiesen werden, dass das SANFLOW-Modell gut zur Bestimmung des Leckageanteiles verwendet werden kann. Daraus kann gefolgert werden, dass dieses Modell ein geeignetes und gut anpassbares Analysewerkzeug für Entwicklungsländer ist. Solche computergestützte Berechnungsansätze können zur Bestimmung von Leckagen in Wasserverteilungsnetzen eingesetzt werden. Eine weitere Möglichkeit ist der Einsatz von Künstlichen Neuronalen Netzen (Artificial Neural Network – ANN), die trainiert und dann zur Vorhersage der dynamischen Verhältnisse in Wasserversorgungssystemen genutzt werden können. Diese Werte können mit der Wassernachfrage eines definierten Bezirks verglichen werden. Zur Untersuchung wurde ein Mehrschichtiges Künstliches Neuronales Netz mit Fehlerrückführung zur Modellierung des Wasserflusses in einem überwachten Abschnitt eingesetzt. Zur Bestimmung des Wasserbedarfes wurde ein MATLAB Algorithmus entwickelt. Aus der Differenz der aktuellen und des simulierten Wassernachfrage konnte die Leckagerate des Wasserversorgungssystems ermittelt werden. Es konnte gezeigt werden, dass mit dem angelernten Neuronalen Netzwerk eine Vorhersage des Wasserflusses mit einer Genauigkeit von 99% möglich ist. Daraus lässt sich die Eignung von ANNs als flexibler und wirkungsvoller Ansatz zur Leckagedetektion in der Wasserversorgung ableiten. Die Untersuchung zeigte weiterhin, dass im Versorgungsnetz von Harare 36 % des eingespeisten Wassers verloren geht. Davon wiederum sind 33 % auf Leckagen zurückzuführen. Umgerechnet bedeutet dies einen finanziellen Verlust von monatlich 1 Millionen Dollar, was 20 % der Gesamteinnahmen der Stadt entspricht. Der Stadtverwaltung von Harare wird daher empfohlen, aktiv an der Beseitigung der Leckagen zu arbeiten, da diese hohen Verluste den Versorgungsbetrieb negativ beeinflussen. Abschließend wird in der Arbeit ein integriertes Leckage-Managementsystem vorgeschlagen, das den Wasserversorgern eine Entscheidungshilfe bei zu ergreifenden Maßnahmen zur Instandhaltung des Verteilnetzes geben soll.

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MORAES, Maísa Suares Teixeira; ROLIM, Lariane Thays Albuquerque; ENDERS, Bertha Cruz; FARIAS, Glaucea Maciel de; DAVIM, Rejane Marie Barbosa. Applicability of non-pharmacological strategies for pain relief in parturient: integrative review. Revista de Enfermagem UFPE on line, v.4, n.especial, p.131-136, May/June 2010. Disponivel em:< http://www.ufpe.br/revistaenfermagem/index.php/revista/>.

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Transportation and land-use are independent, inter-active systems. Land-use patterns shape local transportation demand, but transportation systems in turn influence land-use patterns. In attempting to satisfy transportation demand created by existing land-use patterns, transportation planners directly, if not always consciously or intentionally, influence future land-use patterns. This study examines that complex relationship. The purpose of the study was threefold: to compile the body of knowledge already existing; to apply this body of knowledge to the context of midsize cities in the Midwest; and, to make the knowledge accessible both to transportation planners and to public officials who make key decisions about land use.

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Performance improvements subsequent to the implementation of a pay-for-performance plan can result because more productive employees self-select into the firm (selection effect) and/or because employees allocate effort to become more effective (effort effect). We analyze individual performance data for 3,776 sales employees of a retail firm to evaluate these alternative sources of continuing performance improvement. The incentive plan helps the firm attract and retain more productive sales employees, and motivates these employees to further improve their productivity. In contrast, the less productive sales employees’ performance declines before they leave the firm.

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Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention’s potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers’ behaviors or clinical practice at the units. Future interventions directed towards managers should have a stronger focus on developing leadership skills and behaviors to tailor implementation plans and support implementation of CPG recommendations.

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Thesis (Ph.D.)--University of Washington, 2016-06

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This thesis examines the impact on child and adolescent psychotherapists within CAMHS of the introduction of routine outcome measures (ROMs) associated with the Children and Young People’s Improving access to Psychological Therapies programme (CYP-IAPT). All CAMHS therapists working within a particular NHS mental health Trust1 were required to trial CYP-IAPT ROMs as part of their everyday clinical practice from October 2013-September 2014. During this period considerable freedom was allowed as to which of the measures each therapist used and at what frequency. In order to assess the impact of CYP-IAPT ROMs on child psychotherapy, I conducted semi-structured interviews with eight psychotherapists within a particular CAMHS partnership within one NHS Trust. Each statement was coded and grouped according to whether it related to initial (generic) assessment, goal setting / monitoring, monitoring on-going progress, therapeutic alliance, or to issues concerning how data might be used or interpreted by managers and commissioners. Analysis of interviews revealed greatest concern about session-by session ROMs, as these are felt to impact most significantly on psychotherapy; therapists felt that session-by-session ROMs do not take account of negative transference relationships, they are overly repetitive and used to reward / punish the therapist. Measures used at assessment and review were viewed as most compatible with psychotherapy, although often experienced as excessively time consuming. The Goal Based Outcome Measure was generally experienced as compatible with psychotherapy so long as goals are formed collaboratively between therapist and young person. There was considerable anxiety about how data may be (mis)used and (mis)interpreted by managers and commissioners, for example to end treatment prematurely, trigger change of therapist in the face of negative ROMs data, or to damage psychotherapy. Use of ROMs for short term and generic work was experienced as less intrusive and contentious.

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Background: Athletic groin pain (AGP) is prevalent in sports involving repeated accelerations, decelerations, kicking and change-of-direction movements. Clinical and radiological examinations lack the ability to assess pathomechanics of AGP, but three-dimensional biomechanical movement analysis may be an important innovation. Aim: The primary aim was to describe and analyse movements used by patients with AGP during a maximum effort change-of-direction task. The secondary aim was to determine if specific anatomical diagnoses were related to a distinct movement strategy. Methods: 322 athletes with a current symptom of chronic AGP participated. Structured and standardised clinical assessments and radiological examinations were performed on all participants. Additionally, each participant performed multiple repetitions of a planned maximum effort change-of-direction task during which whole body kinematics were recorded. Kinematic and kinetic data were examined using continuous waveform analysis techniques in combination with a subgroup design that used gap statistic and hierarchical clustering. Results: Three subgroups (clusters) were identified. Kinematic and kinetic measures of the clusters differed strongly in patterns observed in thorax, pelvis, hip, knee and ankle. Cluster 1 (40%) was characterised by increased ankle eversion, external rotation and knee internal rotation and greater knee work. Cluster 2 (15%) was characterised by increased hip flexion, pelvis contralateral drop, thorax tilt and increased hip work. Cluster 3 (45%) was characterised by high ankle dorsiflexion, thorax contralateral drop, ankle work and prolonged ground contact time. No correlation was observed between movement clusters and clinically palpated location of the participant's pain. Conclusions: We identified three distinct movement strategies among athletes with long-standing groin pain during a maximum effort change-of-direction task. These movement strategies were not related to clinical assessment findings but highlighted targets for rehabilitation in response to possible propagative mechanisms. Trial registration number NCT02437942, pre results.