Doctor’s knowledge and practices of traumatic brain injury management in Chinese prehospital settings

Objectives: The incidence and mortality of traumatic brain injury (TBI) has increased rapidly in the last decade in China. Appropriate ambulance service can reduce case-fatality rates of TBI significantly. This study aimed to explore the factors (age, gender, education level, clinical experience, professional title, organization, specialty before prehospital care, and training frequency) that could influence prehospital doctors’ knowledge level and practices in TBI management in China, Hubei Province. Methods: A cross-sectional questionnaire survey was conducted in two cities in Hubei Province. The self-administered questionnaire consisted of demographic information and questions about prehospital TBI management. Independent samples t-test and one-way ANOVA were used to analyze group differences in the average scores in terms of demographic character. General linear regression was used to explore associated factors in prehospital TBI management. Results: A total of 56 questionnaires were handed out and 52 (93%) were returned. Participants received the lowest scores in TBI treatment (0.64; SD=0.08) and the highest scores in TBI assessment (0.80; SD=0.14). According to the regression model, the education level was associated positively with the score of TBI identification (P=.019); participants who worked in the emergency department (ED; P=.011) or formerly practiced internal medicine (P=.009) tended to get lower scores in TBI assessment; participants’ scores in TBI treatment were associated positively with the training frequency (P=.011); and no statistically significant associated factor was found in the overall TBI management. Conclusion: This study described the current situation of prehospital TBI management. The prehospital doctors’ knowledge level and practices in TBI management were quantified and the influential factors hidden underneath were explored. The results indicated that an appropriate continuing medical education (CME) program enables improvement of the quality of ambulance service in China.

The process for implementation of a Quality Management System within a multi-functional cereal laboratory

The intent of this study was to design, document and implement a Quality Management System (QMS) into a laboratory that incorporated both research and development (R&D) and routine analytical activities. In addition, it was necessary for the QMS to be easily and efficiently maintained to: (a) provide documented evidence that would validate the system's compliance with a certifiable standard, (b) fit the purpose of the laboratory, (c) accommodate prevailing government policies and standards, and (d) promote positive outcomes for the laboratory through documentation and verification of the procedures and methodologies implemented. Initially, a matrix was developed that documented the standards' requirements and the necessary steps to be made to meet those requirements. The matrix provided a check mechanism on the progression of the system's development. In addition, it was later utilised in the Quality Manual as a reference tool for the location of full procedures documented elsewhere in the system. The necessary documentation to build and monitor the system consisted of a series of manuals along with forms that provided auditable evidence of the workings of the QMS. Quality Management (QM), in one form or another, has been in existence since the early 1900's. However, the question still remains: is it a good thing or just a bugbear? Many of the older style systems failed because they were designed by non-users, fiercely regulatory, restrictive and generally deemed to be an imposition. It is now considered important to foster a sense of ownership of the system by the people who use the system. The system's design must be tailored to best fit the purpose of the operations of the facility if maximum benefits to the organisation are to be gained.

Implementation costs of Agricultural Management Practices for Water Quality Improvement in the Great Barrier Reef Catchments. CSIRO: Water for Healthy Country National Research Flagship

Executive summary. In this report we analyse implementation costs and benefits for agricultural management practices, grouped into farming systems. In order to do so, we compare plot scale gross margins for the dominant agricultural production systems (sugarcane, grazing and banana cultivation) in the NRM regions Wet Tropics, Burdekin Dry Tropics and Mackay Whitsundays. Furthermore, where available, we present investment requirements for changing to improved farming systems. It must be noted that transaction costs are not captured within this project. For sugarcane, this economic analysis shows that there are expected benefits to sugarcane growers in the different regions through transitions to C and B class farming systems. Further transition to A-class farming systems can come at a cost, depending on the capital investment required and the length of the investment period. Obviously, the costs and benefits will vary for each individual grower and will depend on their starting point and individual property scenario therefore each circumstance needs to be carefully considered before making a change in management practice. In grazing, overall, reducing stocking rates comes at a cost (reduced benefits). However, when operating at low utilisation rates in wetter country, lowering stocking rates can potentially come at a benefit. With win-win potential, extension is preferred to assist farmer in changing management practices to improve their land condition. When reducing stocking rates comes at a cost, incentives may be applicable to support change among farmers. For banana cultivation, the results indicate that the transition to C and B class management practices is a worthwhile proposition from an economic perspective. For a change from B to A class farming systems however, it is not worthwhile from a financial perspective. This is largely due to the large capital investment associated with the change in irrigation system and negative impact in whole of farm gross margin. Overall, benefits will vary for each individual grower depending on their starting point and their individual property scenario. The results presented in this report are one possible set of figures to show the changes in profitability of a grower operating in different management classes. The results in this report are not prescriptive of every landholder. Landholders will have different costs and benefits from transitioning to improved practices, even if similar operations are practiced, hence it is recommended that landholders that are willing to change management undertake their own research and analysis into the expected costs and benefits for their own soil types and property circumstances.

Chickpeas! Varietal performance, wet feet and root rot, virus and salinity effects in 2012, Ascochyta management, seed quality, issues in central Queensland and effects of desiccating too early with glyphosate on seed germination

Take home messages: Plant only high quality seed that has been germ and vigour tested and treated with a registered seed dressing Avoid poorly drained paddocks and those with a history of lucerne, medics or chickpea Phytophthora root rot, PRR; do not grow Boundary if you even suspect a PRR risk Select best variety suited to soil type, farming system and disease risk Beware Ascochyta: follow recommendations for your variety and district Minimise risk of virus by retaining stubble, planting on time and at optimal rate, controlling weeds and ensuring adequate plant nutrition Test soil to determine risk of salinity and sodicity – do not plant chickpeas if ECe > 1.0-1.3 dS/m. Beware early desiccation of seed crops – know how to tell when 90-95% seeds are mature

Organisational culture and quality management system implementation in Indonesian construction companies

The study of the organisational culture in the construction industry is still in the stage of debate (Oney-Yazıcı et al., 2007). Despite the complexities involved in measuring the culture of the construction industry (Tijhuis and Fellows, 2012), this culture is regarded as being worthy of research, especially in relation to the organisational culture needed to support quality management systems (Koh and Low, 2008; Watson and Howarth, 2011) and to improve organisational effectiveness, and therefore, organisational performance (Coffey, 2010; Cheung et al., 2011). A number of recent studies have examined the construction companies’ organisational culture within the context of the use of Cameron and Quinn’s Competing Value Framework (CVF), as well as the use of their Organizational Culture Assessment Instrument (OCAI) as the conceptual paradigm for the analyses (Thomas et al., 2002; Nummelin, 2006; Oney- Yazıcı et al., 2007; Koh and Low, 2008). However, there has been little research based on the use of Cameron and Quinn’s CVF-OCAI tool for identifying types of construction companies’ organisational culture and their influences on the implementation of QMS-ISO 9001. Research output and information is also very limited relating to the strength of the companies’ organisational culture driving an effective QMS-ISO 9001 implementation, affecting the companies’ effectiveness. To rectify these research gaps, the research has been aimed to study organisational culture types (based on CVF) and their influences on the implementation of QMS-ISO 9001:2008 principles and elements, which eventually lead to improved companies’ quality performance. In order to fully examine the status of the QMS being implemented, the research has studied the relationships of the barriers of QMS implementation with the implementation of QMS-ISO 9001:2008 principles and elements and with the business performance of the companies, as well as the examination of the relationships of the implementation of QMS-ISO 9001:2008 principles and elements with the companies’ business performance. The research output has been the development of fundamental and original studies on the study topics, to provide the knowledge for improvements in Indonesian construction companies’ quality performance and quality outcomes.

Curvature Management in Buffer Layer for Device Quality GaN Growth on Si (111)

An efficient buffer layer scheme has been designed to address the issue of curvature management during metalorganic chemical vapour deposition growth of GaN on Si (111) substrate. This is necessary to prevent cracking of the grown layer during post-growth cooling down from growth temperature to room temperature and to achieve an allowable bow (<40 m) in the wafer for carrying out lithographic processes. To meet both these ends simultaneously, the stress evolution in the buffer layers was observed carefully. The reduction in precursor flow during the buffer layer growth provided better control over curvature evolution in the growing buffer layers. This has enabled the growth of a suitable high electron mobility transistor (HEMT) stack on 2'' Si (111) substrate of 300 m thickness with a bow as low as 11.4 m, having a two-dimensional electron gas (2DEG) of mobility, carrier concentration, and sheet resistance values 1510 cm(2)/V-s, 0.96 x 10(13)/cm(2), and 444 /, respectively. Another variation of similar technique resulted in a bow of 23.4 m with 2DEG mobility, carrier concentration, and sheet resistance values 1960 cm(2)/V-s, 0.98 x 10(13)/cm(2), and 325 /, respectively.

Does Long-Term Macrophyte Management in Lakes Affect Biotic Richness and Diversity?

We hypothesize that the richness and diversity of the biota in Lake Moraine (42°50’47”N, 75°31’39”W) in New York have been negatively impacted by 60 years of macrophyte and algae management to control Eurasian watermilfoil ( Myriophyllum spicatum L.) and associated noxious plants. To test this hypothesis we compare water quality characteristics, richness and selected indicators of plant diversity, zooplankton, benthic macroinvertebrates and fish in Lake Moraine with those in nearby Hatch Lake (42°50’06”N, 75°40’67”W). The latter is of similar size and would be expected to have similar biota, but has not been subjected to management. Measurements of temperature, pH, oxygen, conductivity, Secchi transparency, calcium, total phosphorus and nitrites + nitrates are comparable. Taxa richness and the diversity indices applied to the aquatic macrophytes are similar in both lakes. (PDF has 8 pages.)

Process management in healthcare.Sant Camil Hospital case study

Nowadays due to the crisis, some government measures are aimed at reducing healthcare spending, affecting in some level or another the quality offered. Process management is said to be a useful tool for reducing healthcare costs by improving management without any additional economic investment. That is doing more with the same resources and without reducing the quality offered. In this study an empirical case of a Catalan hospital is presented. Overall, the usefulness of process management in the healthcare sector is shown and some tips are provided for those managers that want to implement this management system in their hospitals. This work is also interesting for those managers responsible for the National Healthcare System due to a big question is stated: what would happen if process management was implemented in the whole healthcare system?

Water quality management on the enhancement of shrimp (Penaeus monodon Fab.) production in the traditional and improved-traditional ghers of Bangladesh

On-farm research on enhancement of P. monodon production through water quality management was carried out in five ghers of Paikgacha, Khulna. Based on the prevailing condition of the ghers, lime in the form of CaCO(sub 3), urea and TSP were used as the major inputs to minimize the soil-water acidity and to ensure the availability of natural food particles in the water bodies. Exchange of water at required level also practiced for the qualitative improvement of culture water. Ghers of varying sizes showed that water quality management and fertilization have a positive impact on production performance of P. monodon (61.59% increment) that yielded an average production of 385.43 kg/ha/crop against the present traditional rate of 238.50 kg/ha/year.

HACCP based management system for improving quality of freshwater giant prawn, Macrobrachium rosenbergii

The study was conducted on the present status of HACCP based quality management system of golda, Macrobrachium rosenbergii farms in Fulpur region of Mymensingh. Information was collected on general condition of farms, culture systems and post-harvest quality management. In almost all farms, there is no or inadequate infrastructure facilities such as, road access, electric supply, telecommunications, ice, feed storage facility, vehicle for golda transportation, washing and toilet facilities. The problems associated with sanitation and hygiene was: widespread use of cow dung, poultry manure and construction of open toilet within the vicinity of prawn culture pond. Different grades of commercially available and locally prepared feeds were used for golda culture in the pond. Golda post-larvae (PL) of 40-50 days old were stocked with carp species. The price of golda PL ranged from Tk. 1.00 to Tk. 1.25/piece. The pond size varied from 50 decimal (0.2 ha) to 2.5 acre (1.0 ha) with an average depth of 2-2.5 m. The culture period of golda varied from April-May to November-December and survival rate ranged between 75 and 80%. Production of golda varied from 250-500 kg/acre (625-1,250 kg/ha). Harvested golda were transported to city market within 4 h. Two size grading were generally followed during pricing, e.g. Tk. 500 to 550/kg for >100 g size and Tk. 300/kg for <100 g size. The cost-benefit ratio was found to remain around 1:1.25 depending on availability of PL. Water quality parameters such as, water temperature, pH, dissolved oxygen, total alkalinity and chlorophyll a in five golda farms in Fulpur region were monitored. Water temperature ranged from 29°C to 33°C, dissolved oxygen from 2.28 to 4.13 mg/l, pH between 6.65 and 7.94, alkalinity from 44 to 70 mg/l and chlorophyll a concentration from 61.88 to 102.34 µg/l in the five investigated ponds. The Aerobic Plate Count (APC) of the water sample was within the range of 2.0x10^6 - 2.96x10^7 CFU/ml and of soil samples within the range of 6.9x10^6 - 7.73x10^6 CFU/g. Streptococcus sp., Bacillus sp., Escherichia coli, Staphylococcus sp., Pseudomonas sp. and Salmonella sp. were isolated from pond water and sediment. Different feed samples used for golda was analyzed for proximate composition. Moisture content ranged around 14.14-21.22%, crude protein 20.55-44.1%, lipid 4.67-12.54% and ash 9.7-27.69%. The TVB-N values and peroxide values of feeds used as starter, grower and fish meal were found within the acceptable ranges and samples were free from pathogenic organisms. A training was organized for the golda farmers on HACCP, water quality and post-harvest quality management of prawn.

The importance of quality fish feed and their proper management in ponds

The brochure explains the types of feeds needed by fish and how to detail with over feeding. Fish need to be provided enough nutritious food in order to attain big sizes in a short period of time under culture conditions.

Classifying data quality problems in asset management

© Springer International Publishing Switzerland 2015. Making sound asset management decisions, such as whether to replace or maintain an ageing underground water pipe, are critical to ensure that organisations maximise the performance of their assets. These decisions are only as good as the data that supports them, and hence many asset management organisations are in desperate need to improve the quality of their data. This chapter reviews the key academic research on data quality (DQ) and Information Quality (IQ) (used interchangeably in this chapter) in asset management, combines this with the current DQ problems faced by asset management organisations in various business sectors, and presents a classification of the most important DQ problems that need to be tackled by asset management organisations. In this research, eleven semi structured interviews were carried out with asset management professionals in a range of business sectors in the UK. The problems described in the academic literature were cross checked against the problems found in industry. In order to support asset management professionals in solving these problems, we categorised them into seven different DQ dimensions, used in the academic literature, so that it is clear how these problems fit within the standard frameworks for assessing and improving data quality. Asset management professionals can therefore now use these frameworks to underpin their DQ improvement initiatives while focussing on the most critical DQ problems.