Model based integration of management systems (MSs) – case study

Abstract Purpose – The purpose of this paper is to present a case study regarding the deployment of a previously developed model for the integration of management systems (MSs). The case study is developed at a manufacturing site of an international enterprise. The implementation of this model in a real business environment is aimed at assessing its feasibility. Design/methodology/approach – The presented case study takes into account different management systems standards (MSSs) progressively implemented, along the years, independently. The implementation of the model was supported by the results obtained from an investigation performed according to a structured diagnosis that was conducted to collect information related to the organizational situation of the enterprise. Findings – The main findings are as follows: a robust integrated management system (IMS), objectively more lean, structured and manageable was found to be feasible; this study provided an holistic view of the enterprise’s global management; clarifications of job descriptions and boundaries of action and responsibilities were achieved; greater efficiency in the use of resources was attained; more coordinated management of the three pillars of sustainability – environmental, economic and social, as well as risks, providing confidence and added value to the company and interested parties was achieved. Originality/value – This case study is pioneering in Portugal in respect to the implementation, at the level of an industrial organization, of the model previously developed for the integration of individualized MSs. The case study provides new insights regarding the implementation of IMSs including the rationalization of several resources and elimination of several types of organizational waste leveraging gains of efficiency. Due to its intrinsic characteristics, the model is able to support, progressively, new or revised MSSs according to the principles of annex SL (normative) – proposals for MSSs – of the International Organization for Standardization and the International Electrotechnical Commission, that the industrial organization can adopt beyond the current ones.

Beyond the numbers of maternal near-miss in Rwanda - a qualitative study on women's perspectives on access and experiences of care in early and late stage of pregnancy.

BACKGROUND: Rwanda has made remarkable progress in decreasing the number of maternal deaths, yet women still face morbidities and mortalities during pregnancy. We explored care-seeking and experiences of maternity care among women who suffered a near-miss event during either the early or late stage of pregnancy, and identified potential health system limitations or barriers to maternal survival in this setting. METHODS: A framework of Naturalistic Inquiry guided the study design and analysis, and the 'three delays' model facilitated data sorting. Participants included 47 women, who were interviewed at three hospitals in Kigali, and 14 of these were revisited in their homes, from March 2013 to April 2014. RESULTS: The women confronted various care-seeking barriers depending on whether the pregnancy was wanted, the gestational age, insurance coverage, and marital status. Poor communication between the women and healthcare providers seemed to result in inadequate or inappropriate treatment, leading some to seek either traditional medicine or care repeatedly at biomedical facilities. CONCLUSION: Improved service provision routines, information, and amendments to the insurance system are suggested to enhance prompt care-seeking. Additionally, we strongly recommend a health system that considers the needs of all pregnant women, especially those facing unintended pregnancies or complications in the early stages of pregnancy.

Continuity of care in older adults with multiple chronic conditions

Thesis (Ph.D.)--University of Washington, 2016-08

Automated generic integration of flight logbook data into aircraft maintenance systems

The automated transfer of flight logbook information from aircrafts into aircraft maintenance systems leads to reduced ground and maintenance time and is thus desirable from an economical point of view. Until recently, flight logbooks have not been managed electronically in aircrafts or at least the data transfer from aircraft to ground maintenance system has been executed manually. Latest aircraft types such as the Airbus A380 or the Boeing 787 do support an electronic logbook and thus make an automated transfer possible. A generic flight logbook transfer system must deal with different data formats on the input side – due to different aircraft makes and models – as well as different, distributed aircraft maintenance systems for different airlines as aircraft operators. This article contributes the concept and top level distributed system architecture of such a generic system for automated flight log data transfer. It has been developed within a joint industry and applied research project. The architecture has already been successfully evaluated in a prototypical implementation.

A cross-sectional study assessing the association between online ratings and structural and quality of care measures : results from two German physician rating websites

BACKGROUND: Even though physician rating websites (PRWs) have been gaining in importance in both practice and research, little evidence is available on the association of patients' online ratings with the quality of care of physicians. It thus remains unclear whether patients should rely on these ratings when selecting a physician. The objective of this study was to measure the association between online ratings and structural and quality of care measures for 65 physician practices from the German Integrated Health Care Network "Quality and Efficiency" (QuE). METHODS: Online reviews from two German PRWs were included which covered a three-year period (2011 to 2013) and included 1179 and 991 ratings, respectively. Information for 65 QuE practices was obtained for the year 2012 and included 21 measures related to structural information (N = 6), process quality (N = 10), intermediate outcomes (N = 2), patient satisfaction (N = 1), and costs (N = 2). The Spearman rank coefficient of correlation was applied to measure the association between ratings and practice-related information. RESULTS: Patient satisfaction results from offline surveys and the patients per doctor ratio in a practice were shown to be significantly associated with online ratings on both PRWs. For one PRW, additional significant associations could be shown between online ratings and cost-related measures for medication, preventative examinations, and one diabetes type 2-related intermediate outcome measure. There again, results from the second PRW showed significant associations with the age of the physicians and the number of patients per practice, four process-related quality measures for diabetes type 2 and asthma, and one cost-related measure for medication. CONCLUSIONS: Several significant associations were found which varied between the PRWs. Patients interested in the satisfaction of other patients with a physician might select a physician on the basis of online ratings. Even though our results indicate associations with some diabetes and asthma measures, but not with coronary heart disease measures, there is still insufficient evidence to draw strong conclusions. The limited number of practices in our study may have weakened our findings.

Clinical Research and Standard of Care — An Unresolved Question?

Ever since the 1996 revision of the Declaration of Helsinki, the World Medical Association has attempted to address ethical and scientific concerns of its diverse stakeholders for Articles 33 (use of placebo) and 34 (posttrial provisions), most recently in 2013. Both are inextricably linked to standard of care, an essential element of any comparative, interventional clinical trial. But has this now 20-year-long ethical debate truly been put to rest? The choice of standard of care in clinical trials remains a complex issue, particularly for comparative trials conducted in emerging countries.

Integration of learning and practice as part of the educational system development in Eritrea. "School Management" - a distance learning program by technical university of Kaiserslautern

The distance learning program "School Management" supports decision makers at the school and ministerial levels in the shaping of formal and informal learning processes at different levels in schools and curricula in Eritrea. This paper examines how the distance learning program is interconnected to educational system development. (DIPF/Orig.)

The Silent Majority: an Exploration of the Integration of Voting Software within Theatre in Education programmes

I wanted to explore whether traditional Forum Theatre approaches can be enhanced by the use of integrated voting software to empower young people. My research is based on two of a series of widening participation interactive TiE programmes focused on the decisions young people make on educational progression. I worked as a director alongside students studying Drama and Performance at The University of Worcester and the programmes have toured widely to schools across Worcestershire and Herefordshire. ‘It’s Up to You!’ (2013 – 2014) was aimed at years 8 and 9 choosing their GCSE options and ‘Move on Up!’ (2014 - 2015) looked at the hopes and fears of year 6 pupils about to go up to secondary school. Finding a voice in Boal’s framework as a ‘specactor’ does not always appeal to a pupil who does not want to stand out from the crowd or is not familiar with a classroom where drama conventions are practised or understood. The anonymity of the voting software with results of decisions made appearing instantly on screen is certainly appealing to some pupils: ‘I also loved the keypads they gave us so that we could answer the questions without having to put our hand up and wait..’ This paper aims to interrogate the idea that empowering needs to not simply be about giving voice to a few confident group members but allowing the silent majority to be able to experiment with decision making in an educational and social context.

Design, modelling, simulation and integration of cyber physical systems: methods and applications

The main drivers for the development and evolution of Cyber Physical Systems (CPS) are the reduction of development costs and time along with the enhancement of the designed products. The aim of this survey paper is to provide an overview of different types of system and the associated transition process from mechatronics to CPS and cloud-based (IoT) systems. It will further consider the requirement that methodologies for CPS-design should be part of a multi-disciplinary development process within which designers should focus not only on the separate physical and computational components, but also on their integration and interaction. Challenges related to CPS-design are therefore considered in the paper from the perspectives of the physical processes, computation and integration respectively. Illustrative case studies are selected from different system levels starting with the description of the overlaying concept of Cyber Physical Production Systems (CPPSs). The analysis and evaluation of the specific properties of a sub-system using a condition monitoring system, important for the maintenance purposes, is then given for a wind turbine.

ASSESSING THE LEVEL OF TECHNOLOGY INTEGRATION OF TITLE I TEACHERS IN A LARGE URBAN SCHOOL DISTRICT

By law, Title I schools employ teachers who are both competent in their subject knowledge and State certified. In addition, Title I teachers receive ongoing professional development in technology integration and are equipped with the latest innovative resources to integrate technology in the classroom. The aim is higher academic achievement and the effective use of technology in the classroom. The investment to implement technology in this large urban school district to improve student achievement has continued to increase. In order to infuse current and emerging technology throughout the curriculum, this school district needs to know where teachers have, and have not, integrated technology. Yet the level of how technology is integrated in Title I schools is unknown. This study used the Digital-Age Survey Levels of Teaching Innovation (LoTi) to assess 508 Title I teachers’ technology integration levels using three major initiatives purchased by Title I— the iPads program, the Chromebook initiative, and the interactive whiteboards program. The study used a quantitative approach. Descriptive statistics, regression analysis, and statistical correlations were used to examine the relationship between the level of technology integration and the following dependent variables: personal computer use (PCU), current instructional practices (CIP), and levels of teaching innovation (LoTi). With this information, budgetary decisions and professional development can be tailored to the meet the technology implementation needs of this district. The result of this study determined a significant relationship between the level of teaching innovation, personal computer use, and current instructional practices with teachers who teach with iPad, Chromebook, and/or interactive whiteboard. There was an increase in LoTi, PCU, and CIP scores with increasing years of experience of Title I teachers. There was also a significant relationship between teachers with 20 years or more teaching experience and their LoTi score.

The impacts of environmental and anthropogenic stressors on largemouth bass: an integration of field and laboratory studies

Several environmental stressors can impact the physiology and survival of fishes. Fish experience natural fluctuations in temperature and dissolved oxygen, but variations in these parameters due to anthropogenic sources are typically greater in magnitude and duration. Changes in temperature and oxygen of anthropogenic origins may therefore have larger negative impacts on fish than those occurring during natural events. Physiological parameters are sensitive indicators of the impacts of stressors by providing insight into the manner in which fish are disturbed by the stressor. Fish may display cumulative physiological responses to successive stressors, but the concept of synergy among multiple thermal stressors is poorly understood. Further, some fish species can be subjected to competitive angling events, which expose fish to an array of additional stressors that can increase mortality. The impacts of these events may change over seasons as fish display seasonal changes in behavior and physiology. Latitudinal origin may also affect the physiological response and mortality of fish exposed to common environmental stressors as individual populations are adapted to local environmental conditions. This thesis focuses on addressing these potential impacts on physiological parameters and mortality of largemouth bass (Micropterus salmoides) and provides implications for management and conservation. Largemouth bass were relatively robust to abrupt changes in temperature and oxygen, but were perturbed from physiological homeostasis during large (12°C) temperature shocks and low (< 4 mg O2/L) levels of dissolved oxygen. Cumulative physiological impacts of multiple cold shocks were only slightly greater than the disturbances sustained during a single cold shock, suggesting largemouth bass are able to tolerate successive thermal stressors. Largemouth bass exhibited seasonal changes in physiological parameters but the responses of fish to angling tournaments were relatively similar across seasons when compared with seasonal controls. Mortality was low during angling tournaments held during four seasons and no apparent seasonal trends were observed. Lastly, largemouth bass from two latitudinally separated populations exhibited differences in their physiological responses to acute cold stressors and overwinter mortality, characterized by greater mortality and physiological disturbances of southern fish than northern fish. Knowledge gained from this study can be used to make management and conservation decisions regarding a host of environmental factors and provides insight into the mechanisms by which fish species can persist over large latitudinal ranges.

Reuse and integration of specification logics: the hybridisation perspective

Hybridisation is a systematic process along which the characteristic features of hybrid logic, both at the syntactic and the semantic levels, are developed on top of an arbitrary logic framed as an institution. It also captures the construction of first-order encodings of such hybridised institutions into theories in first-order logic. The method was originally developed to build suitable logics for the specification of reconfigurable software systems on top of whatever logic is used to describe local requirements of each system’s configuration. Hybridisation has, however, a broader scope, providing a fresh example of yet another development in combining and reusing logics driven by a problem from Computer Science. This paper offers an overview of this method, proposes some new extensions, namely the introduction of full quantification leading to the specification of dynamic modalities, and exemplifies its potential through a didactical application. It is discussed how hybridisation can be successfully used in a formal specification course in which students progress from equational to hybrid specifications in a uniform setting, integrating paradigms, combining data and behaviour, and dealing appropriately with systems evolution and reconfiguration.

Exploring Health in Military Families: Does Continuity of Care Influence Patient Satisfaction?

To ensure mission-readiness for military members, support for their families is essential. Military family health and health care satisfaction has been a neglected area of study in this population. Satisfaction can be defined in terms of patient-, provider-, and practice-level factors and is influenced by continuity of care, which is often poor in transient military populations. Using a modified patient satisfaction survey, this study found that both the number of moves and assigned providers were significantly associated with continuity of care in military spouses. Further, continuity of care was a significant predictor of satisfaction with military health care.