Prospective case review of a global e-health system for doctors in developing countries

The Swinfen Charitable Trust has managed email consultations for doctors in developing countries since 1999. The process was handled manually for the first three years and then subsequently using an automatic message-handling system. We conducted a prospective review of email consultations between referring doctors and consulting specialists during six months of automatic operation (December 2003 to May 2004). During the study period 125 consultations took place. These concerned a wide range of specialties (e.g. orthopaedics 17%, dermatology 16%, obstetrics and gynaecology 11%, radiology 10%). Of these referrals, 33% (41) were for paediatric cases. Consulting specialists, who were based in five countries, were volunteers. Referring doctors were from 24 hospitals in 12 developing countries. The median time from referral to definitive reply was 1.5 days (interquartile range 0.6-4.9). There was an 85% response rate (n = 106) to a survey concerning the value of the consultation to the referring doctor. All the referring doctors who responded made positive comments about the service and half said that it improved their management of the case. The second-opinion consultation system operated by the Swinfen Charitable Trust represents an example of a global e-health system operated for altruistic, rather than commercial, reasons.

Referral patterns in a global store-and-forward telemedicine system

We examined the nature of the referral patterns in the email telemedicine network operated by the Swinfen Charitable Trust with a view to informing long-term resource planning. Over the first six years of operation, 62 hospitals from 19 countries registered with the Trust in order to be able to refer cases for specialist advice; 55 of these hospitals (89%) actually referred cases during this period. During the first six years of operation, nearly 1000 referrals were submitted and answered, from a wide range of specialty areas. Between July 2002 and March 2005 the referral rate rose from 127 to 318 cases per year. The median length of time required to provide a specialist's response was 2.3 days during the first 12 months and 1.8 days during the last 12 months. Five hospitals submitted cases for more than four years (together sending a total of 493 cases). Their activity data showed a trend to declining referral rates over the four-year period, which may represent successful knowledge transfer. There is some evidence that over the last three years the growth in demand has been exponential, while the growth in resources available (i.e. specialists) has been linear, a situation which cannot continue for very long before demand outstrips supply.

Positioning hierarchy in enterprise system change

There is a widening gulf in change literature between theoretical notions of evolving organisational form and the emerging reality that old and new organisational structures coexist. This paper explores this dichotomy in Enterprise Resource Planning change. It develops a cellular hierarchy framework to explain how different types of hierarchy coexist within the same organisation during the implementation of Enterprise Resource Planning. © 2006 The Author; Journal compilation © 2006 Blackwell Publishing Ltd.

Functional neuroimaging and behavioural studies on global form processing in the human visual system

Magnetoencephalography (MEG), functional magnetic resonance imaging (fMRI) and behavioural experiments were used to investigate the neural processes underlying global form perception in human vision. Behavioural studies using Glass patterns examined sensitivity for detecting radial, rotational and horizontal structure. Neuroimaging experiments using either Glass patterns or arrays of Gabor patches determined the spatio-temporal neural responseto global form. MEG data were analysed using synthetic aperture magnetometry (SAM) to spatially map event-related cortical oscillatory power changes: the temporal sequencing of activity within a discrete cortical area was determined using a Morlet wavelet transform. A case study was conducted to determine the effects of strbismic amblyopia on global form processing: all other observers were normally-sighted. The main findings from normally-sighted observers were: 1) sensitivity to horizontal structure was less than for radial or rotational structure; 2) the neural response to global structure was a reduction in cortical oscillatory power (10-30 Hz) within a network of extrastriate areas, including V4 and V3a; 3) the extend of reduced cortical power was least for horizontal patters; 4) V1 was not identified as a region of peak activity with either MEG or fMRI. The main findings with the strabismic amblyope were: 1) sensitivity for detection of radial, rotational, and horizontal structure was reduced when viewed with the amblyopic- relative to the fellow- eye; 2) cortical power changes within V4 to the presentation of rotational Glass patterns were less when viewed with the amblyopic- compared with the fellow- eye. The main conclusions are: 1) a network of extrastriate cortical areas are involved in the analysis of global form, with the most prominent change in neural activity being a reduction in oscillatory power within the 10-30 Hz band; 2) in strabismic amblyopia, the neuronal assembly associated with form perception in extrastriate cortex may be dysfunctional, the nature of this dysfunction may be a change in the normal temporal pattern of neuronal discharges; 3) MEG, fMRI and behavioural measures support the notion that different neural processes underlie the perception of horizontal as opposed to radial or rotational structure.

Strategic positioning of manufacturing operations within global supply chains

In global environment, a company has to make many decisions that impact upon its position in global supply chain networks such as outsourcing, offshoring, joint venture, vertical/horizontal integration, etc. All these decisions impact on the company’s strategic position, and hence on competitive space and performance. Therefore, it is important for a company to carefully manage strategic positioning by making careful decisions about the adoption of alternative manufacturing and supply chain activities. Unfortunately, there is no complete process studied in strategic positioning of manufacturing operations within global supply chain. Therefore, the work presented in this paper has investigated leading research and industrial practices to create a formal and rational decision process. An analysis of previous literature, industrial practices, and the resulting decision process are all presented in this paper.

Success factors in a forming strategic positioning of manufacturing operations within global supply chains

Managing supply chains effectively has become a critical element in enhancing company profitability and has been identified as the new frontier of competitive advantage. An important element of effective supply chain management is the strategic positioning of the company. The strategic positioning process is concerned with the choice of production-centred activities a company carries out internally and those provided externally. Strategic positioning within manufacturing supply chains however is a relatively recent research topic with apparently few articles currently available that explicitly address associated issues directly. Moreover there is no previous research working strategic positioning of manufacturing operations in global context. Therefore the purpose of this paper is to explore strategic positioning within global supply chains. This paper is based on three cases drawn from the cross industry sector manufacturing companies. It describes an exploratory analysis which is aimed at gaining insight into the success factor to form a strategic positioning within global supply chains.

Strategic positioning of manufacturing operations within global supply chains

This paper describes research that has sought to create a structured and integrated methodology that guides manufacturers through the decision of strategic positioning within global supply chains. The position of a company is concerned with deciding a boundary and configuration of internal and external business activities to the company and is directly related to initiatives such as outsourcing, make or buy, and offshoring. This paper provides an in-depth description of this concept, describes work carried out to form a methodology for strategic positioning within the global supply chain, and presents the details of the methodology. This research has made a significant contribution to the knowledge on how manufacturing companies can form a strategic positioning within global supply chains.

Tsunami simulation and detection using global navigation satellite system reflectometry

In this thesis, research for tsunami remote sensing using the Global Navigation Satellite System-Reflectometry (GNSS-R) delay-Doppler maps (DDMs) is presented. Firstly, a process for simulating GNSS-R DDMs of a tsunami-dominated sea sur- face is described. In this method, the bistatic scattering Zavorotny-Voronovich (Z-V) model, the sea surface mean square slope model of Cox and Munk, and the tsunami- induced wind perturbation model are employed. The feasibility of the Cox and Munk model under a tsunami scenario is examined by comparing the Cox and Munk model- based scattering coefficient with the Jason-1 measurement. A good consistency be- tween these two results is obtained with a correlation coefficient of 0.93. After con- firming the applicability of the Cox and Munk model for a tsunami-dominated sea, this work provides the simulations of the scattering coefficient distribution and the corresponding DDMs of a fixed region of interest before and during the tsunami. Fur- thermore, by subtracting the simulation results that are free of tsunami from those with presence of tsunami, the tsunami-induced variations in scattering coefficients and DDMs can be clearly observed. Secondly, a scheme to detect tsunamis and estimate tsunami parameters from such tsunami-dominant sea surface DDMs is developed. As a first step, a procedure to de- termine tsunami-induced sea surface height anomalies (SSHAs) from DDMs is demon- strated and a tsunami detection precept is proposed. Subsequently, the tsunami parameters (wave amplitude, direction and speed of propagation, wavelength, and the tsunami source location) are estimated based upon the detected tsunami-induced SSHAs. In application, the sea surface scattering coefficients are unambiguously re- trieved by employing the spatial integration approach (SIA) and the dual-antenna technique. Next, the effective wind speed distribution can be restored from the scat- tering coefficients. Assuming all DDMs are of a tsunami-dominated sea surface, the tsunami-induced SSHAs can be derived with the knowledge of background wind speed distribution. In addition, the SSHA distribution resulting from the tsunami-free DDM (which is supposed to be zero) is considered as an error map introduced during the overall retrieving stage and is utilized to mitigate such errors from influencing sub- sequent SSHA results. In particular, a tsunami detection procedure is conducted to judge the SSHAs to be truly tsunami-induced or not through a fitting process, which makes it possible to decrease the false alarm. After this step, tsunami parameter estimation is proceeded based upon the fitted results in the former tsunami detec- tion procedure. Moreover, an additional method is proposed for estimating tsunami propagation velocity and is believed to be more desirable in real-world scenarios. The above-mentioned tsunami-dominated sea surface DDM simulation, tsunami detection precept and parameter estimation have been tested with simulated data based on the 2004 Sumatra-Andaman tsunami event.

The transition movement and food sovereignty: from local resilience to global engagement in food system transformation

The emergence of grassroots social movements variously preoccupied with a range of external threats, such as diminishing supplies of fossil energy or climate change, has led to increased interest in the production of local food. Drawing upon the notion of cognitive praxis, this article utilises transition as a trajectory guided by an overarching cosmology that brings together a broad social movement seeking a more resilient future. This ‘grand narrative’ is reinforced by ‘transition movement intellectuals’ who serve to shape an agenda of local preparedness in the face of uncertainty, rather than structural analysis of the global system. In this context, growing and producing food offers important multi-functional synergies by reconnecting people to place and its ecological endowments and serves to provide a vital element in civic mobilisation. Yet, local food could also become a means to build international solidarity in defence of food sovereignty and establish a global coalition opposed to the corporate agri-food agenda of biotechnologies, land grabbing and nutritional impoverishment.

Expanding a Global Company Management System to An Integrated Coverage of Several Standards

This Master’s thesis examines the implementation of management system standard requirements as integrated in the organization. The aim is to determine how requirements from management system standards ISO 14001:2015 and ISO 9001:2015 can be integrated and implemented into the existing ISO 9001:2008 compliant management system. Research was executed as action research by utilizing an operating model about the integrated use of management system standards created by the International Organization for Standardization. Phases of the operating model were applied to the target organization. The similarity and integration potential of relevant standards were assessed by using comparative matrices. Allocation of the requirements and conformity assessment of the processes was executed by gap analysis. The main results indicate that the requirements of the relevant standards are principally equivalent or have the same kind of purpose. The results also show the most important processes of the target organization in terms of requirement compliance, as well as the requirements which affect the process the most. Prioritizing the compliance achievement of the most important processes and implementation of those requirements that have the most effect create an opportunity for organizations to implement the integrated requirements effectively.

How essential are Argo observations to constrain a global ocean data assimilation system?

Observing system experiments (OSEs) are carried out over a 1-year period to quantify the impact of Argo observations on the Mercator Ocean 0.25° global ocean analysis and forecasting system. The reference simulation assimilates sea surface temperature (SST), SSALTO/DUACS (Segment Sol multi-missions dALTimetrie, d'orbitographie et de localisation précise/Data unification and Altimeter combination system) altimeter data and Argo and other in situ observations from the Coriolis data center. Two other simulations are carried out where all Argo and half of the Argo data are withheld. Assimilating Argo observations has a significant impact on analyzed and forecast temperature and salinity fields at different depths. Without Argo data assimilation, large errors occur in analyzed fields as estimated from the differences when compared with in situ observations. For example, in the 0–300 m layer RMS (root mean square) differences between analyzed fields and observations reach 0.25 psu and 1.25 °C in the western boundary currents and 0.1 psu and 0.75 °C in the open ocean. The impact of the Argo data in reducing observation–model forecast differences is also significant from the surface down to a depth of 2000 m. Differences between in situ observations and forecast fields are thus reduced by 20 % in the upper layers and by up to 40 % at a depth of 2000 m when Argo data are assimilated. At depth, the most impacted regions in the global ocean are the Mediterranean outflow, the Gulf Stream region and the Labrador Sea. A significant degradation can be observed when only half of the data are assimilated. Therefore, Argo observations matter to constrain the model solution, even for an eddy-permitting model configuration. The impact of the Argo floats' data assimilation on other model variables is briefly assessed: the improvement of the fit to Argo profiles do not lead globally to unphysical corrections on the sea surface temperature and sea surface height. The main conclusion is that the performance of the Mercator Ocean 0.25° global data assimilation system is heavily dependent on the availability of Argo data.