Improving the management of behaviour that challenges associated with dementia in care homes:protocol for pharmacy-health psychology intervention feasibility study

INTRODUCTION: The inappropriate use of antipsychotics in people with dementia for behaviour that challenges is associated with an estimated 1800 deaths annually. However, solely focusing on antipsychotics may transfer prescribing to other equally dangerous psychotropics. Little is known about the role of pharmacists in the management of psychotropics used to treat behaviours that challenge. This research aims to determine whether it is feasible to implement and measure the effectiveness of a combined pharmacy-health psychology intervention incorporating a medication review and staff training package to limit the prescription of psychotropics to manage behaviour that challenges in care home residents with dementia. METHODS/ANALYSIS: 6 care homes within the West Midlands will be recruited. People with dementia receiving medication for behaviour that challenges, or their personal consultee, will be approached regarding participation. Medication used to treat behaviour that challenges will be reviewed by the pharmacist, in collaboration with the general practitioner (GP), person with dementia and carer. The behavioural intervention consists of a training package for care home staff and GPs promoting person-centred care and treating behaviours that challenge as an expression of unmet need. The primary outcome measure is the Neuropsychiatric Inventory-Nursing Home version (NPI-NH). Other outcomes include quality of life (EQ-5D and DEMQoL), cognition (sMMSE), health economic (CSRI) and prescribed medication including whether recommendations were implemented. Outcome data will be collected at 6 weeks, and 3 and 6 months. Pretraining and post-training interviews will explore stakeholders' expectations and experiences of the intervention. Data will be used to estimate the sample size for a definitive study. ETHICS/DISSEMINATION: The project has received a favourable opinion from the East Midlands REC (15/EM/3014). If potential participants lack capacity, a personal consultee will be consulted regarding participation in line with the Mental Capacity Act. Results will be published in peer-reviewed journals and presented at conferences.

The complements towards developing a new risk management framework and Its applicability to the Nigerian power sector

The availability of regular supply has been identified as one of the major stimulants for the growth and development of any nation and is thus important for the economic well-being of a nation. The problems of the Nigerian power sector stems from a lot of factors culminating in her slow developmental growth and inability to meet the power demands of her citizens regardless of the abundance of human and natural resources prevalent in the nation. The research therefore had the main aim of investigating the importance and contributions of risk management to the success of projects specific to the power sector. To achieve this aim it was pertinent to examine the efficacy of risk management process in practice and elucidate the various risks typically associated with projects (Construction, Contractual, Political, Financial, Design, Human resource and Environmental risk factors) in the power sector as well as determine the current situation of risk management practice in Nigeria. To address this factors inhibiting the proficiency of the overarching and prevailing issue which have only been subject to limited in-depth academic research, a rigorous mixed research method was adopted (quantitative and qualitative data analysis). A review of the Nigeria power sector was also carried out as a precursor to the data collection stage. Using purposive sampling technique, respondents were identified and a questionnaire survey was administered. The research hypotheses were tested using inferential statistics (Pearson correlation, Chi-square test, t-test and ANOVA technique) and the findings revealed the need for the development of a new risk management implementation Framework. The proposed Framework was tested within a company project, for interpreting the dynamism and essential benefits of risk management with the aim of improving the project performances (time), reducing the level of fragmentation (quality) and improving profitability (cost) within the Nigerian power sector in order to bridge a gap between theory and practice. It was concluded that Nigeria’s poor risk management practices have prevented it from experiencing strong growth and development. The study however, concludes that the successful implementation of the developed risk management framework may help it to attain this status by enabling it to become more prepared and flexible, to face challenges that previously led to project failures, and thus contributing to its prosperity. The research study provides an original contribution theoretically, methodologically and practically which adds to the project risk management body of knowledge and to the Nigerian power sector.

CloudMPL:a domain specific language for describing management policies for an autonomic cloud infrastructure

To benefit from the advantages that Cloud Computing brings to the IT industry, management policies must be implemented as a part of the operation of the Cloud. Among others, for example, the specification of policies can be used for the management of energy to reduce the cost of running the IT system or also for security policies while handling privacy issues of users. As cloud platforms are large, manual enforcement of policies is not scalable. Hence, autonomic approaches for management policies have recently received a considerable attention. These approaches allow specification of rules that are executed via rule-engines. The process of rules creation starts by the interpretation of the policies drafted by high-rank managers. Then, technical IT staff translate such policies to operational activities to implement them. Such process can start from a textual declarative description and after numerous steps terminates in a set of rules to be executed on a rule engine. To simplify the steps and to bridge the considerable gap between the declarative policies and executable rules, we propose a domain-specific language called CloudMPL. We also design a method of automated transformation of the rules captured in CloudMPL to the popular rule-engine Drools. As the policies are changed over time, code generation will reduce the time required for the implementation of the policies. In addition, using a declarative language for writing the specifications is expected to make the authoring of rules easier. We demonstrate the use of the CloudMPL language into a running example extracted from a management energy consumption case study.

Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings:protocol for a systematic review of qualitative studies

Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

Analysis of purchasing activity with discounted cash flow inventory models = Beszerzési tevékenység elemzése diszkontált pénzáramlású készletmodellel

A klasszikus tételnagyság probléma két fontosabb készletezési költséget ragad meg: rendelési és készlettartási költségek. Ebben a dolgozatban a vállalatok készpénz áramlásának a beszerzési tevékenységre gyakorolt hatását vizsgáljuk. Ebben az elemzésben a készpénzáramlási egyenlőséget használjuk, amely nagyban emlékeztet a készletegyenletekre. Eljárásunkban a beszerzési és rendelési folyamatot diszkontálva vizsgáljuk. A költségfüggvény lineáris készpénztartási, a pénzkiadás haszonlehetőség és lineáris kamatköltségből áll. Bemutatjuk a vizsgált modell optimális megoldását. Az optimális megoldást egy számpéldával illusztráljuk. = The classical economic order quantity model has two types of costs: ordering and inventory holding costs. In this paper we try to investigate the effect of purchasing activity on cash flow of a firm. In the examinations we use a cash flow identity similar to that of in inventory modeling. In our approach we analyze the purchasing and ordering process with discounted costs. The cost function of the model consists of linear cash holding, linear opportunity cost of spending cash, and linear interest costs. We show the optimal solution of the proposed model. The optimal solutions will be presented by numerical examples.

Initial inventory levels for a book publishing firm = Kezdőkészletek egy könyvkiadó vállalatnál

Egy könyvkiadó vállalatot vizsgálunk. A kiadó kiadványait a szokásos értékesítési láncon (kis- és nagykereskedelem) keresztül értékesíti. A kérdés az, hogy egy új könyv példányait hogyan allokálja az értékesítési láncban. Feltételezzük, hogy a kereslet ismert, Poisson-eloszlású. A készletezés költségeit szintén ismertnek tételezzük fel. Cél a költségek minimalizálása. = The aim of the paper is to analyze a practical real world problem. A publishing house is given. The publishing firm has contacts to a number of wholesaler / retailer enterprises and direct contact to customers to satisfy the market demand. The book publishers work in a project industry. The publisher faces with the problem to allocate the stocks of a given, newly published book to the wholesaler and retailer, and to hold some copies to satisfy the customers direct from the publisher. The distribution of the demand is unknown, but it can be estimated. The costs consist of inventory holding and shortage, backorder costs. The decision maker wants to minimize these relevant costs. The problem can be modeled as a one-warehouse and N-retailer supply chain with not identical demand distribution. The problem structure is similar that of a newsvendor model. It is assumed that the demand distribution follows a Poisson distribution.

The calculation of dynamic ecological footprint on the basis of the dynamic input-output model

The Leontief input-output model is widely used to determine the ecological footprint of consumption in a region or a country. It is able to capture spillover environmental effects along the supply change, thus its popularity is increasing in ecology related economic research. These studies are static and the dynamic investigations are neglected. The dynamic Leontief model makes it possible to involve the capital and inventory investment in the footprint calculation that projects future growth of GDP and environmental impacts. We show a new calculation method to determine the effect of capital accumulation on ecological footprint. Keywords: Dynamic Leontief model, Dynamic ecological footprint, Environmental management, Allocation method

Inventory investment and sectoral characteristics in some OECD countries

This paper discusses the effects of sectoral structure on the long run macroeconomic inventory behaviour of national economies. Data on 15 OECD countries are included in the analysis, which is based on correlation and cluster analysis methodologies. The study is part of a long-term research project exploring factors influencing the inventory behaviour of national economies. First, we introduce some basic characteristics of macroeconomic inventory formation in the 15 OECD countries. We argue that our previous results on the existence of specific characteristic features of macroeconomic inventory investment are justified, hence it makes sense to study the factors influencing these features. We then examine the contribution of various sectors to the production of in the countries involved and the relationship between sectoral structure and inventory intensity (annual inventory change/Gross Value Added). We find that the high share of agriculture and manufacturing increases inventory intensity, that the increasing share of services has a negative effect and that the role of construction and trade is not obvious. The relatively low stability of the statistical results warns us to be cautious with our judgements. Further, case-by-case analysis would be required to obtain more solid results.

Inventory investment and GDP characteristics in OECD countries

There are very few research studies on macroeconomic inventory behaviour of various countries. It is clear that macro inventories are the results of a large number of individual microdecisions. However, we believe that it is worth analysing how inventories develop in the individual countries and why we can see different tendencies. This paper is the newest piece in a series of studies on the above subject. We use the OECD database to analyse inventory trends between 1987 and 2004 in nine of the most developed economies of the world. Annual inventory investment data are used and their connections with other components of GDP expenditure (governmental and private consumption, investment in fixed assets and foreign trade balance as well as the annual growth rate of GDP) are examined by multi-variable statistical analysis. Conclusions include the steadily decreasing tendency of inventory fluctuations, the varying periods of higher and lower rates of inventory investments and the differences of main influencing factors by country.

Macroeconomic characteristics and inventory investment: a multi-country study

The paper is a new element in a series of studies analyzing macroeconomic inventory behavior by use of multi-country data. In this paper, seven hypotheses are tested with positive result. These hypotheses include subjects like relations of inventories with growth and with some other macroeconomic indicators of the use of GDP and the long-term tendencies of global inventory formations. Multivariate statistical analysis is used for evaluation.

The impact of lean practices on inventory turnover

Lean manufacturing (LM) is currently enjoying its second heyday. Companies in several industries are implementing leanpractices to keep pace with the competition and achieve better results. In this article, we will concentrate on how companies can improve their inventoryturnover performance through the use ofleanpractices. According to our main proposition, firms that widely apply leanpractices have higher inventoryturnover than those that do not rely on LM. However, there may be significant differences in inventoryturnover even among lean manufacturers depending on their contingencies. Therefore, we also investigate how various contingency factors (production systems, order types, product types) influence theinventoryturnoveroflean manufacturers. We use cluster and correlation analysis to separate manufacturers based onthe extent of their leanness and to examine the effect of contingencies. We acquired the data from the International Manufacturing Strategy Survey (IMSS) in ISIC sectors 28–35.

A vállalati likviditásmenedzsment számviteli támogatása (Accounting support for company’s liquidity management)

A cikk kiindulópontja, hogy a kettős könyvvitelt vezető vállalkozások által kötelezően elkészítendő éves pénzügyi kimutatások (számviteli beszámolók) olyan információbázist jelentenek, amelyek segítséget nyújthatnak egyrészről a vállalati likviditásmenedzsment támogatásához, másrészről a vállalkozások likviditási helyzetének megítéléséhez. A cikk első fele felvázolja a vállalkozások pénzügyi helyzetét bemutató adatok számviteli kereteit, bemutatja a likviditás fogalmának egyes értelmezéseit, majd részletesen kitér arra, hogy a likviditás utólagos vizsgálatához, illetve előrejelzéséhez milyen korrekciókat kell (lehet) végezni a számviteli beszámoló adatain. A cikk második fele az elemzés lehetséges módjait és eszközeit veszi számba, kitérve a statikus és dinamikus elemzés közötti különbségek bemutatására, az egyes mutatók számításának lehetséges módjaira és értelmezésükre, mindvégig szem előtt tartva az alkalmazás korlátait. ________ The study examines how information provided by accounting information systems could support companies’ liquidity management. The starting point is that compulsory financial statements prepared by economic entities embody an adequate information basis, which could help liquidity management as well as the judgement of liquidity. The first part of the study introduces the various interpretations of liquidity and gives a detailed description of the adjustments that need to be made on accounting data for an a posteriori examination of liquidity and to be able to forecast liquidity. The second part discusses the possible means and tools of analysis, including the differences between static and dynamic methods and the calculation and interpretation of the various ratios widely used by professionals. The conclusion is that there is no best-practice method or ratio, but rather a wide range of tools is to be used when one is willing to gain a complex and comprehensive insight about an entity’s liquidity.

Fenntarthatósági szempontok beépítése a beszállító értékelésébe a DEA/CI összetett indikátorok módszere alkalmazásával (Integrating sustainability criteria in supplier evaluation with application of the method of of DEA/CI complex indicators)

A környezeti hatások rendszerint túlmutatnak egy vállalat határain, éppen ezért az ellátási lánc kontextusban a környezeti szempontok érvényesítése során fontos szerep jut a beszerzési döntéseknek is. Számos olyan példát lehetne említeni, amikor egy adott szempont szerint egy alternatíva környezetileg előnyös, de az ellátási lánc egészét nézve már környezetterhelő. A környezeti hatások ellátási lánc szinten való mérése azonban komoly kihívásokat jelent. Ezzel jelentős kutatásokat és fejlesztéseket inspirált a téma. Az egyik olyan terület, amelyben komoly kutatási eredmények születtek, az a környezeti szempontok beszállítói értékelésbe való beépítése. A kutatások ezen irányához csatlakozva a szerzők tanulmányunkban azt keresik, hogyan lehet meghatározni az egyik legáltalánosabban használt szállítóértékelési módszerben, a súlyozott pontrendszerben egy adott szemponthoz azt a súlyt, amely mellett az adott szempont már döntésbefolyásoló tényezővé válik. Ehhez a DEA (Data Envelopment Analysis) összetett indikátorok (Composite Indicators, CI) módszerét alkalmazzák. A szempontok közös súlyának fontossága megállapításához a lineáris programozás elméletét használják. _____ Management decisions often have an environmental effect not just within the company, but outside as well, this is why supply chain context is highlighted in literature. Measuring environmental issues of supply decisions raise a lot of problems from methodological and practical point of view. This inspires a rapidly growing literature as a lot of studies were published focusing on how to incorporate environmental issues into supplier evaluation. This paper contributes to this stream of research as it develops a method to help weight selection. In the authors’ paper the method of Data Envelope Analysis (DEA) is used to study the extension of traditional supplier selection methods with environmental factors. The selection of the weight system can control the result of the selection process.

Kultúraközi szolgáltatásélmények vizsgálata a megalapozott elmélet módszerével (Examination of the intercultural service experiences with grounded theory method)

A cikk fókuszában az interkulturális szolgáltatással való találkozás áll. A téma jelentősége kétségen kívül áll, hiszen a szolgáltatások egyre növekvő térhódítása, valamint a globalizáció terjedése fontossá teszi annak ismeretét, hogy a különböző nemzeti kultúrából érkező szolgáltató és fogyasztó számára hogyan érhető el a legfőbb cél, az elégedettség. A szerzők jelen kutatásukban annak megértését helyezték a középpontba, hogy melyek azok a tényezők, amelyek befolyásolják a felek erőfeszítéseit a találkozás során fellépő problémák megoldásában. Kutatásuk során mélyinterjúkat folytattak mind a szolgáltatói, mind a fogyasztói oldallal, majd a megalapozott elmélet (grounded theory) konstruktivista irányzatának segítségével elemezték ezen interjúkat, és azonosították azokat a tényezőket, amelyek fontossá válhatnak egy kultúraközi szolgáltatásélmény során. A kutatás eredményei rámutatnak, hogy melyek azok a kommunikációs és kulturális korlátok, amelyek problémát okozhatnak, s hogy az e problémák megoldására tett erőfeszítések visszavezethetők az interakció résztvevőinek személyes jellemzőire, tapasztalataira, kulturális nyitottságára és ismereteire. A kutatás eredményeinek egyik fontos menedzseri következtetése, hogy a szállodákban a probléma jelentősége ellenére nem helyeznek elegendő hangsúlyt a kommunikációs és kulturális korlátok leküzdésére irányuló képzésekre, tréningekre. _____ This paper presents an attempt to analyse the possible solutions to problems that can occur during intercultural service encounters (ICSE). Using grounded theory the authors provide a theoretical framework that identifies the factors that lead to ICSE barriers. Based on in-depth interviews with service providers and clients they have defined the relevant characteristics that influence intercultural competence. Intercultural competence with communication and cultural differences lead to problems during ICSE that can be handled by both parties: the service provider and the client, as well. An important finding is that service companies should provide adequate training that concentrates not only on the cultural knowledge but it should create capability in understanding and adapting to cultural differences.