Facets of operational performance in an emergency room (ER)

This paper, using detailed time measurements of patients complemented by interviews with hospital management and staff, examines three facets of an emergency room's (ER) operational performance: (1) effectiveness of the triage system in rationing patient treatment; (2) factors influencing ER's operational performance in general and the trade-offs in flow times, inventory levels (that is the number of patients waiting in the system), and resource utilization; (3) the impacts of potential process and staffing changes to improve the ER's performance. Specifically, the paper discusses four proposals for streamlining the patient flow: establishing designated tracks (fast track, diagnostic track), creating a holding area for certain type of patients, introducing a protocol that would reduce the load on physicians by allowing a registered nurse to order testing and treatment for some patients, and potentially and in the longer term, moving from non-ER specialist physicians to ER specialists. The paper's findings are based on analyzing the paths and flow times of close to two thousand patients in the emergency room of the Medical Center of Leeuwarden (MCL), The Netherlands. Using exploratory data analysis the paper presents generalizable findings about the impacts of various factors on ER's lead-time performance and shows how the proposals fit with well-documented process improvement theories. © 2010 Elsevier B.V. All rights reserved.

Engineering access control for distributed enterprise applications

Access control (AC) is a necessary defense against a large variety of security attacks on the resources of distributed enterprise applications. However, to be effective, AC in some application domains has to be fine-grain, support the use of application-specific factors in authorization decisions, as well as consistently and reliably enforce organization-wide authorization policies across enterprise applications. Because the existing middleware technologies do not provide a complete solution, application developers resort to embedding AC functionality in application systems. This coupling of AC functionality with application logic causes significant problems including tremendously difficult, costly and error prone development, integration, and overall ownership of application software. The way AC for application systems is engineered needs to be changed. ^ In this dissertation, we propose an architectural approach for engineering AC mechanisms to address the above problems. First, we develop a framework for implementing the role-based access control (RBAC) model using AC mechanisms provided by CORBA Security. For those application domains where the granularity of CORBA controls and the expressiveness of RBAC model suffice, our framework addresses the stated problem. ^ In the second and main part of our approach, we propose an architecture for an authorization service, RAD, to address the problem of controlling access to distributed application resources, when the granularity and support for complex policies by middleware AC mechanisms are inadequate. Applying this architecture, we developed a CORBA-based application authorization service (CAAS). Using CAAS, we studied the main properties of the architecture and showed how they can be substantiated by employing CORBA and Java technologies. Our approach enables a wide-ranging solution for controlling the resources of distributed enterprise applications. ^

An improved framework for dynamic origin-destination (O-D) matrix estimation

This dissertation aims to improve the performance of existing assignment-based dynamic origin-destination (O-D) matrix estimation models to successfully apply Intelligent Transportation Systems (ITS) strategies for the purposes of traffic congestion relief and dynamic traffic assignment (DTA) in transportation network modeling. The methodology framework has two advantages over the existing assignment-based dynamic O-D matrix estimation models. First, it combines an initial O-D estimation model into the estimation process to provide a high confidence level of initial input for the dynamic O-D estimation model, which has the potential to improve the final estimation results and reduce the associated computation time. Second, the proposed methodology framework can automatically convert traffic volume deviation to traffic density deviation in the objective function under congested traffic conditions. Traffic density is a better indicator for traffic demand than traffic volume under congested traffic condition, thus the conversion can contribute to improving the estimation performance. The proposed method indicates a better performance than a typical assignment-based estimation model (Zhou et al., 2003) in several case studies. In the case study for I-95 in Miami-Dade County, Florida, the proposed method produces a good result in seven iterations, with a root mean square percentage error (RMSPE) of 0.010 for traffic volume and a RMSPE of 0.283 for speed. In contrast, Zhou's model requires 50 iterations to obtain a RMSPE of 0.023 for volume and a RMSPE of 0.285 for speed. In the case study for Jacksonville, Florida, the proposed method reaches a convergent solution in 16 iterations with a RMSPE of 0.045 for volume and a RMSPE of 0.110 for speed, while Zhou's model needs 10 iterations to obtain the best solution, with a RMSPE of 0.168 for volume and a RMSPE of 0.179 for speed. The successful application of the proposed methodology framework to real road networks demonstrates its ability to provide results both with satisfactory accuracy and within a reasonable time, thus establishing its potential usefulness to support dynamic traffic assignment modeling, ITS systems, and other strategies.

The Caribbean Court of Justice: An investigation of the impact of elites on its creation and present structure as it relates to original jurisdiction

The primary focus of this dissertation is to determine the degree to which political, economic, and socio-cultural elites in Jamaica and Trinidad & Tobago influenced the development of the Caribbean Court of Justice's (CCJ) original jurisdiction. As members of the Caribbean Community (CARICOM), both states replaced their protectionist model with open regionalism at the end of the 1980s. Open regionalism was adopted to make CARICOM member states internationally competitive. Open regionalism was also expected to create a stable regional trade environment. To ensure a stable economic environment, a regional court with original jurisdiction was proposed. A six member Preparatory Committee on the Caribbean Court of Justice (PREPCOM), on which Jamaica and Trinidad & Tobago sat, was formed to draft the Agreement Establishing the Caribbean Court of Justice that would govern how the Court would interpret the Revised Treaty of Chaguaramas (RTC) and enforce judgments. ^ Through the use of qualitative research methods, namely elite interviews, document data, and text analysis, and a focus on three levels of analysis, that is, the international, regional, and domestic, three major conclusions are drawn. First, changes in the international economic environment caused Jamaica and Trinidad & Tobago to support the establishment of a regional court. Second, Jamaica had far greater influence on the final structure of the CCJ than Trinidad & Tobago. Third, it was found that in both states the political elite had the greatest influence on the development and structure of the CCJ. The economic elite followed by the socio-cultural elite were found to have a lesser impact. These findings are significant because they account for the impact of elites and elite behavior on institutions in a much-neglected category of states: the developing world.^

Analysis of fractured terrain using remote sensing and geographic information systems : establishing a correlation between fracture network properties and vegetation

This research analyzed the spatial relationship between a mega-scale fracture network and the occurrence of vegetation in an arid region. High-resolution aerial photographs of Arches National Park, Utah were used for digital image processing. Four sets of large-scale joints were digitized from the rectified color photograph in order to characterize the geospatial properties of the fracture network with the aid of a Geographic Information System. An unsupervised landcover classification was carried out to identify the spatial distribution of vegetation on the fractured outcrop. Results of this study confirm that the WNW-ESE alignment of vegetation is dominantly controlled by the spatial distribution of the systematic joint set, which in turn parallels the regional fold axis. This research provides insight into the spatial heterogeneity inherent to fracture networks, as well as the effects of jointing on the distribution of surface vegetation in desert environments.

Shi'a women's participatory roles in the establishing and sustaining Shi'a religious identity in South Florida : Islamic Jaffaria Association

The research on the Muslim American community is largely Sunni specific and the purpose of this thesis is to add upon the limited scholarly work concerning the Shi'a Muslim American community. This study looks into the American Shi'a Muslim education experience at the Islamic Jaffaria Education Center (IJEC) and how it establishes and sustains a Pakistani Shiite Muslim identity. In addition, research on widespread American Muslim education shows high female participation on all levels, including, but not limited to, board and teaching positions. To see if this situation exists inside the Shi'ite communities an ethnographic study was conducted over the course of about 4 months at the IJEC. The findings show that there is also high female participation at that Shi'ite education center on all levels. The study links the high female participation with the education and how it established and is currently sustaining a Pakistani Shi'ite Muslim American identity in South Florida.

Engineering access control for distributed enterprise applications

Access control (AC) is a necessary defense against a large variety of security attacks on the resources of distributed enterprise applications. However, to be effective, AC in some application domains has to be fine-grain, support the use of application-specific factors in authorization decisions, as well as consistently and reliably enforce organization-wide authorization policies across enterprise applications. Because the existing middleware technologies do not provide a complete solution, application developers resort to embedding AC functionality in application systems. This coupling of AC functionality with application logic causes significant problems including tremendously difficult, costly and error prone development, integration, and overall ownership of application software. The way AC for application systems is engineered needs to be changed. In this dissertation, we propose an architectural approach for engineering AC mechanisms to address the above problems. First, we develop a framework for implementing the role-based access control (RBAC) model using AC mechanisms provided by CORBA Security. For those application domains where the granularity of CORBA controls and the expressiveness of RBAC model suffice, our framework addresses the stated problem. In the second and main part of our approach, we propose an architecture for an authorization service, RAD, to address the problem of controlling access to distributed application resources, when the granularity and support for complex policies by middleware AC mechanisms are inadequate. Applying this architecture, we developed a CORBA-based application authorization service (CAAS). Using CAAS, we studied the main properties of the architecture and showed how they can be substantiated by employing CORBA and Java technologies. Our approach enables a wide-ranging solution for controlling the resources of distributed enterprise applications.

High accuracy mobile robot positioning using an external large volume metrology instrument

A method of accurately controlling the position of a mobile robot using an external Large Volume Metrology (LVM) instrument is presented in this paper. Utilizing a LVM instrument such as the laser tracker in mobile robot navigation, many of the most difficult problems in mobile robot navigation can be simplified or avoided. Using the real- Time position information from the laser tracker, a very simple navigation algorithm, and a low cost robot, 5mm repeatability was achieved over a volume of 30m radius. A surface digitization scan of a wind turbine blade section was also demonstrated, illustrating possible applications of the method for manufacturing processes. © Springer-Verlag Berlin Heidelberg 2010.

Taking risks in the face of uncertainty:an exploratory analysis of green innovation

The relationship between uncertainty and firms’ risk-taking behaviour has been a focus of investigation since early discussion of the nature of enterprise activity. Here, we focus on how firms’ perceptions of environmental uncertainty and their perceptions of the risks involved impact on their willingness to undertake green innovation. Analysis is based on a cross-sectional survey of UK food companies undertaken in 2008. The results reinforce the relationship between perceived environmental uncertainty and perceived innovation risk and emphasise the importance of macro-uncertainty in shaping firms’ willingness to undertake green innovation. The perceived (market-related) riskiness of innovation also positively influences the probability of innovating, suggesting either a proactive approach to stimulating market disruption or an opportunistic approach to innovation leadership.

Design of an information system for metrology contents

Dimensional and form inspections are key to the manufacturing and assembly of products. Product verification can involve a number of different measuring instruments operated using their dedicated software. Typically, each of these instruments with their associated software is more suitable for the verification of a pre-specified quality characteristic of the product than others. The number of different systems and software applications to perform a complete measurement of products and assemblies within a manufacturing organisation is therefore expected to be large. This number becomes even larger as advances in measurement technologies are made. The idea of a universal software application for any instrument still appears to be only a theoretical possibility. A need for information integration is apparent. In this paper, a design of an information system to consistently manage (store, search, retrieve, search, secure) measurement results from various instruments and software applications is introduced. Two of the main ideas underlying the proposed system include abstracting structures and formats of measurement files from the data so that complexity and compatibility between different approaches to measurement data modelling is avoided. Secondly, the information within a file is enriched with meta-information to facilitate its consistent storage and retrieval. To demonstrate the designed information system, a web application is implemented. © Springer-Verlag Berlin Heidelberg 2010.

Enterprise management and ERP development:case study of Zoomlion using dynamic enterprise reference grid

The enterprise management approach provides a holistic view of organizations and their related information systems. In order to cope with the globalization, virtualization, and volatile competitive environment, traditional firms are seeking to reconstruct their organizational structures and establish new IS architectures to transform from single autonomous entities into more open enterprises supported by new Enterprise Resource Planning (ERP) systems. This paper reports on ERP engage-abilities within three different enterprise management patterns based on the theoretical foundations of the "Dynamic Enterprise Reference Grid". An exploratory inductive study in Zoomlion using the narrative research approach has been conducted. Also, this research delivers a conceptual framework to demonstrate the adoption of ERP in the three enterprise management structures and points to a new architectural type (ERPIII) for operating in the virtual enterprise paradigm. © 2010 Springer-Verlag.

Social sustainability initiatives in cocoa supply chains in Africa:an analysis of sustainability reporting of world's major chocolatiers

This research paper focuses on the self-declared initiatives of the four largest chocolate companies to tackle social problems within the context of establishing a sustainable supply chain. After the literature review of sustainability, supply chain management, and cocoa farming, this paper gives an assessment of the extant practices of the chocolatiers and makes a comparative analysis based on Corporate Social Responsibility (CSR) and Sustainability Reports. This paper uses a case study approach based on secondary-data. A roadmap and benchmarking of social sustainability initiatives were conducted for the supply chain management activities of the world's four largest chocolatiers. This paper analyses the extant sustainability practices of the chocolatiers and offers a model framework for comparison of the measures taken. This paper is based on self-declared secondary data. There is a chance that some practices were not documented by the case companies; or that companies claim what they don't actually do. This paper provides a framework for agricultural businesses to compare their sustainability efforts and improve the performance of their supply chains. Originality and value of this research reside in terms of both literature and methodology. The framework for analysing the social sustainability aspects of agricultural supply chains is original and gives an up-to-date view of sustainability practices. The use of secondary data to compare self-declared initiatives is also a novel approach to business sustainability research.

Mobile Clinics & Bundled Healthcare: An Exploration of Patient Perceptions of the SughaVazhvu Approach to Chronic Care Management

As the burden of non-communicable diseases increases worldwide, it is imperative that health systems adopt delivery approaches that will enable them to provide accessible, high-quality, and low-cost care to patients that need consistent management of their lifelong conditions. This is especially true in low- and middle-income country settings, such as India, where the disease burden is high and the health sector resources to address it are limited. The subscription-based, managed care model that SughaVazhvu Healthcare—a non-profit social enterprise operating in rural Thanjavur, Tamil Nadu—has deployed demonstrates potential for ensuring continuity of care among chronic care patients in resource-strained areas. However, its effectiveness and sustainability will depend on its ability to positively impact patient health status and patient satisfaction with the care management they are receiving. Therefore, this study is not only a program appraisal to aid operational quality improvement of the SughaVazhvu Healthcare model, but also an attempt to identify the factors that affect patient satisfaction among individuals with chronic conditions actively availing services.

The contribution of community enterprise to British urban regeneration in a period of state retrenchment

This chapter discusses the growth and nature of community enterprise and in particular the sub-set of asset-based community development trusts and reviews their contribution to urban regeneration in Britain. Three models are presented and illustrated with case studies.

An exploration of students’ perceptions and attitudes towards creativity in engineering education

This study used a mixed methods approach to develop a broad and deep understanding of students’ perceptions towards creativity in engineering education. Studies have shown that students’ attitudes can have an impact on their motivation to engage in creative behavior. Using an ex-post facto independent factorial design, attitudes of value towards creativity, time for creativity, and creativity stereotypes were measured and compared across gender, year of study, engineering discipline, preference for open-ended problem solving, and confidence in creative abilities. Participants were undergraduate engineering students at Queen’s University from all years of study. A qualitative phenomenological methodology was adopted to study students’ understandings and experiences with engineering creativity. Eleven students participated in oneon- one interviews that provided depth and insight into how students experience and define engineering creativity, and the survey included open-ended items developed using the 10 Maxims of Creativity in Education as a guiding framework. The findings from the survey suggested that students had high value for creativity, however students in fourth year or higher had less value than those in other years. Those with preference for open-ended problem solving and high confidence valued creative more than their counterparts. Students who preferred open-ended problem solving and students with high confidence reported that time was less of a hindrance to their creativity. Males identified more with creativity stereotypes than females, however overall they were both low. Open-ended survey and interview results indicated that students felt they experienced creativity in engineering design activities. Engineering creativity definitions had two elements: creative action and creative characteristic. Creative actions were associated with designing, and creative characteristics were predominantly associated with novelty. Other barriers that emerged from the qualitative analysis were lack of opportunity, lack of assessment, and discomfort with creativity. It was concluded that a universal definition is required to establish clear and aligned understandings of engineering creativity. Instructors may want to consider demonstrating value by assessing creativity and establishing clear criteria in design projects. It is recommended that students be given more opportunities for practice through design activities and that they be introduced to design and creative thinking concepts early in their engineering education.