Using system dynamics for collaborative design : a case study

Background  In order to facilitate the collaborative design, system dynamics (SD) with a group modelling approach was used in the early stages of planning a new stroke unit. During six workshops a SD model was created in a multiprofessional group. Aim To explore to which extent and how the use of system dynamics contributed to the collaborative design process. Method A case study was conducted using several data sources. Results SD supported a collaborative design, by facilitating an explicit description of stroke care process, a dialogue and a joint understanding. The construction of the model obliged the group to conceptualise the stroke care and experimentation with the model gave the opportunity to reflect on care. Conclusion SD facilitated the collaborative design process and should be integrated in the early stages of the design process as a quality improvement tool.

Facilitators and barriers to applying a national quality registry for quality improvement in stroke care

BACKGROUND: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. METHODS: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. RESULTS: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. CONCLUSION: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.

Local politico-administrative perspectives on quality improvement based on national registry data in Sweden : a qualitative study using the Consolidated Framework for Implementation Research.

Background. Through a national policy agreement, over 167 million Euros will be invested in the Swedish National Quality Registries (NQRs) between 2012 and 2016. One of the policy agreement¿s intentions is to increase the use of NQR data for quality improvement (QI). However, the evidence is fragmented as to how the use of medical registries and the like lead to quality improvement, and little is known about non-clinical use. The aim was therefore to investigate the perspectives of Swedish politicians and administrators on quality improvement based on national registry data. Methods. Politicians and administrators from four county councils were interviewed. A qualitative content analysis guided by the Consolidated Framework for Implementation Research (CFIR) was performed. Results. The politicians and administrators perspectives on the use of NQR data for quality improvement were mainly assigned to three of the five CFIR domains. In the domain of intervention characteristics, data reliability and access in reasonable time were not considered entirely satisfactory, making it difficult for the politico-administrative leaderships to initiate, monitor, and support timely QI efforts. Still, politicians and administrators trusted the idea of using the NQRs as a base for quality improvement. In the domain of inner setting, the organizational structures were not sufficiently developed to utilize the advantages of the NQRs, and readiness for implementation appeared to be inadequate for two reasons. Firstly, the resources for data analysis and quality improvement were not considered sufficient at politico-administrative or clinical level. Secondly, deficiencies in leadership engagement at multiple levels were described and there was a lack of consensus on the politicians¿ role and level of involvement. Regarding the domain of outer setting, there was a lack of communication and cooperation between the county councils and the national NQR organizations. Conclusions. The Swedish experiences show that a government-supported national system of well-funded, well-managed, and reputable national quality registries needs favorable local politico-administrative conditions to be used for quality improvement; such conditions are not yet in place according to local politicians and administrators.

Newly Automated System For Integrated Assessment Of The Conditions Of Underwater Gas Pipelines

An underwater gas pipeline is the portion of the pipeline that crosses a river beneath its bottom. Underwater gas pipelines are subject to increasing dangers as time goes by. An accident at an underwater gas pipeline can lead to technological and environmental disaster on the scale of an entire region. Therefore, timely troubleshooting of all underwater gas pipelines in order to prevent any potential accidents will remain a pressing task for the industry. The most important aspect of resolving this challenge is the quality of the automated system in question. Now the industry doesn't have any automated system that fully meets the needs of the experts working in the field maintaining underwater gas pipelines. Principle Aim of this Research: This work aims to develop a new system of automated monitoring which would simplify the process of evaluating the technical condition and decision making on planning and preventive maintenance and repair work on the underwater gas pipeline. Objectives: Creation a shared model for a new, automated system via IDEF3; Development of a new database system which would store all information about underwater gas pipelines; Development a new application that works with database servers, and provides an explanation of the results obtained from the server; Calculation of the values MTBF for specified pipelines based on quantitative data obtained from tests of this system. Conclusion: The new, automated system PodvodGazExpert has been developed for timely and qualitative determination of the physical conditions of underwater gas pipeline; The basis of the mathematical analysis of this new, automated system uses principal component analysis method; The process of determining the physical condition of an underwater gas pipeline with this new, automated system increases the MTBF by a factor of 8.18 above the existing system used today in the industry.

Development Of Water Pollution Early Warning System For Oyster Harvesting Areas

The objective of this study is to develop a Pollution Early Warning System (PEWS) for efficient management of water quality in oyster harvesting areas. To that end, this paper presents a web-enabled, user-friendly PEWS for managing water quality in oyster harvesting areas along Louisiana Gulf Coast, USA. The PEWS consists of (1) an Integrated Space-Ground Sensing System (ISGSS) gathering data for environmental factors influencing water quality, (2) an Artificial Neural Network (ANN) model for predicting the level of fecal coliform bacteria, and (3) a web-enabled, user-friendly Geographic Information System (GIS) platform for issuing water pollution advisories and managing oyster harvesting waters. The ISGSS (data acquisition system) collects near real-time environmental data from various sources, including NASA MODIS Terra and Aqua satellites and in-situ sensing stations managed by the USGS and the NOAA. The ANN model is developed using the ANN program in MATLAB Toolbox. The ANN model involves a total of 6 independent environmental variables, including rainfall, tide, wind, salinity, temperature, and weather type along with 8 different combinations of the independent variables. The ANN model is constructed and tested using environmental and bacteriological data collected monthly from 2001 – 2011 by Louisiana Molluscan Shellfish Program at seven oyster harvesting areas in Louisiana Coast, USA. The ANN model is capable of explaining about 76% of variation in fecal coliform levels for model training data and 44% for independent data. The web-based GIS platform is developed using ArcView GIS and ArcIMS. The web-based GIS system can be employed for mapping fecal coliform levels, predicted by the ANN model, and potential risks of norovirus outbreaks in oyster harvesting waters. The PEWS is able to inform decision-makers of potential risks of fecal pollution and virus outbreak on a daily basis, greatly reducing the risk of contaminated oysters to human health.

The brazilian education quality index (Ideb): measurement and incentives upgrades

The increasing availability of social statistics in Latin America opens new possibilities in terms of accountability and incentive mechanisms for policy makers. This paper addresses these issues within the institutional context of the Brazilian educational system. We build a theoretical model based on the theory of incentives to analyze the role of the recently launched Basic Education Development Index (Ideb) in the provision of incentives at the sub-national level. The first result is to demonstrate that an education target system has the potential to improve the allocation of resources to education through conditional transfers to municipalities and schools. Second, we analyze the local government’s decision about how to allocate its education budget when seeking to accomplish the different objectives contemplated by the index, which involves the interaction between its two components, average proficiency and the passing rate. We discuss as well policy issues concerning the implementation of the synthetic education index in the light of this model arguing that there is room for improving the Ideb’s methodology itself. In addition, we analyze the desirable properties of an ideal education index and we argue in favor of an ex-post relative learning evaluation system for different municipalities (schools) based on the value added across different grades

The impact of structured teaching methods on the quality of education

This paper estimates the impact of the use of structured methods on the quality of education of the students in primary public school in Brazil. Structure methods encompass a range of pedagogical and managerial instruments applied to the education system. In recent years, several municipalities in the State of São Paulo have contracted out private educational providers to implement these structured methods in their schooling system. Their pedagogical proposal involves structuring curriculum contents, elaboration and use of teachers and students textbooks, and training and supervision of the teachers and instructors. Using a difference in differences estimation strategy, we find that the fourth and eighth grader students in the municipalities with structured methods performed better in Portuguese and Math than students in municipalities not exposed to the methods. We find no differences in approval rates. However, a robustness check is not able to discard the possibility that unobserved municipal characteristics may affect the results.

Ecotoxicological assessment of sediments from the Santos and São Vicente estuarine system- Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Development of site-specific sediment quality guidelines for North and South Atlantic littoral zones: Comparison against national and international sediment quality benchmarks

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Eutrophization process in a system used for rearing the nile tilapia (Oreochromis niloticus), São Paulo State, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Computed tomographic-dacryocystography (CT-DCG) of the normal canine nasolacrimal drainage system with three-dimensional reconstruction

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Microbiology quality in continuous water flow fish ponds

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Stress responses of juvenile matrinxã (Brycon amazonicus) after transport in a closed system under different loading densities

Neste estudo, foram investigadas as densidades de carga adequadas para transporte de matrinxãs juvenis em sistema fechado com sacos plásticos. O transporte de 4h foi feito com peixes (23,5±0,4g; 11,6 (0,08cm) em jejum por 24h, em densidades de 83g L-1 (D1), 125g L-1 (D2), 168g L-1 (D3) e 206g L-1 (D4). Os peixes foram amostrados antes do transporte (AT), logo após o transporte (chegada) (DT) e 24h depois. A qualidade da água foi monitorada antes da captura dos peixes nos tanques de depuração, após o transporte nos sacos plásticos e nos tanques de recuperação. O oxigênio da água diminuiu para valores inferiores a 4mg L-1 em D2, D3 e D4, a temperatura esteve em torno de 32°C, pH 6,5-6,78, a amônia total foi de 1,09-1,7mg L-1, a amônia não-ionizada foi de 3,58-9,33 x 10³mg L-1 e alcalinidade 134-165mg CaCO3 L-1. O cortisol plasmático e a glicose sanguínea aumentaram após o transporte nos peixes em todas as densidades ensaiadas, voltando aos valores controle 24h depois. Os valores de osmolaridade não mudaram logo após o transporte, mas aumentaram 24h depois de modo igual em todas as densidades. O cloreto plasmático diminuiu na chegada, de modo inversamente proporcional à densidade de carga. O hematócrito diminuiu 24h depois da chegada dos peixes, em todas as densidades testadas, mas não houve diferença no número de eritrócitos. Não houve mortalidade até uma semana após o transporte. O matrinxã mostrou ser uma espécie tolerante a altas densidades de carga em embalagens para transporte além de suportar baixos níveis de oxigênio na água.

Automated system of seedling image analysis (SVIS) and electrical conductivity to assess sun hemp seed vigor

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Physical quality of an Oxisol cultivated with maize submited to cover crops in the pre-cropping period

The intensive use of land alters the distribution of the pore size which imparts consequences on the soil physical quality. The Least Limiting Water Range (LLWR) allows for the visualization of the effects of management systems upon either the improvement or the degradation of the soil physical quality. The objective of this study was to evaluate the physical quality of a Red Latosol (Oxisol) submited to cover crops in the period prior to the maize crop in a no-tillage and conventional tillage system, using porosity, soil bulk density and the LLWR as attributes. The treatments were: conventional tillage (CT) and a no-tillage system with the following cover crops: sunn hemp (Crotalaria juncea L.) (NS), pearl millet (Pennisetum americanum (L.) Leeke) (NP) and lablab (Dolichos lablab L.) (NL). The experimental design was randomized blocks in subdivided plots with six replications, with the plots being constituted by the treatments and the subplots by the layers analyzed. The no-tillage systems showed higher total porosity and soil organic matter at the 0-0.5 m layer for the CT. The CT did not differ from the NL or NS in relation to macroporosity. The NP showed the greater porosity, while CT and NS presented lower soil bulk density. No <= 10 % airing porosity was found for the treatments evaluated, and value for water content where soil aeration is critical (theta(PA)) was found above estimated water content at field capacity (theta(FC)) for all densities. Critical soil bulk density was of 1.36 and 1.43 Mg m(-3) for NP and CT, respectively. The LLWR in the no-tillage systems was limited in the upper part by the theta(FC), and in the bottom part, by the water content from which soil resistance to penetration is limiting (theta(PR)). By means of LLWR it was observed that the soil presented good physical quality.