866 resultados para Management evaluation
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During recent decades it has been possible to identify several problems in construction industry project management, related with to systematic failures in terms of fulfilling its schedule, cost and quality targets, which highlight a need for an evaluation of the factors that may cause these failures. Therefore, it is important to understand how project managers plan the projects, so that the performance and the results can be improved. However, it is important to understand if other areas beyond cost and time management that are mentioned on several studies as the most critical areas, receive the necessary attention from construction project managers. Despite the cost and time are the most sensitive areas/fields, there are several other factors that may lead to project failure. This study aims at understand the reasons that may cause the deviation in terms of cost, time and quality, from the project management point of view, looking at the knowledge areas mentioned by PMI (Project Management Institute).
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PURPOSE: To evaluate the technical quality and the diagnostic performance of a protocol with use of low volumes of contrast medium (25 mL) at 64-detector spiral computed tomography (CT) in the diagnosis and management of adult, nontraumatic subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: This study was performed outside the United States and was approved by the institutional review board. Intracranial CT angiography was performed in 73 consecutive patients with nontraumatic SAH diagnosed at nonenhanced CT. Image quality was evaluated by two observers using two criteria: degree of arterial enhancement and venous contamination. The two independent readers evaluated diagnostic performance (lesion detection and correct therapeutic decision-making process) by using rotational angiographic findings as the standard of reference. Sensitivity, specificity, and positive and negative predictive values were calculated for patients who underwent CT angiography and three-dimensional rotational angiography. The intraclass correlation coefficient was calculated to assess interobserver concordance concerning aneurysm measurements and therapeutic management. RESULTS: All aneurysms were detected, either ruptured or unruptured. Arterial opacification was excellent in 62 cases (85%), and venous contamination was absent or minor in 61 cases (84%). In 95% of cases, CT angiographic findings allowed optimal therapeutic management. The intraclass correlation coefficient ranged between 0.93 and 0.95, indicating excellent interobserver agreement. CONCLUSION: With only 25 mL of iodinated contrast medium focused on the arterial phase, 64-detector CT angiography allowed satisfactory diagnostic and therapeutic management of nontraumatic SAH.
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"Prepared for use by the Cooperative Extension System"--Cover.
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On cover: New horizons in long term care.
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The aims of this intervention are: To reduce adult obesity levels To improve access to weight management services in primary care. To improve access to weight management services for areas with high BME populations or poor access to commercial weight loss providers To improve diet and nutrition, promote healthy weight and increase levels of physical activity in overweight or obese patients. To support patients to make lifestyle changes to enable them to lose weight
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The main objective of this work was to evaluate the diversification of sorghum (Sorghum bicolor) populations as a way to manage resistance to the sorghum anthracnose fungus Colletotrichum graminicola. A total of 18 three-way hybrids were obtained by crossing six single cross male-sterile F1 hybrids, derived by crossing A (non restorer sterile cytoplasm) and B (non restorer normal cytoplasm) lines, with three fertile R (restorer) lines, previously evaluated for their differential reaction to the pathogen. Variation in the level of resistance was observed, as indicated by the values of the area under the disease progress curve (AUDPC) obtained for each hybrid. Lines contributed differently to the level of resistance of each hybrid. All hybrids in which CMSXS169R was the male progenitor were classified as highly resistant. Some hybrids had a level of resistance superior to the maximum levels of each line component individually.
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In recent approaches to the management of product development process (PDP), maturity levels have attracted the attention of practitioners and researchers. The CMMI model contributes to evaluate the maturity levels and improvement of the product development process management. This paper, based on CMMI model, analyzes the practices adopted in two companies of the capital goods industry, which develop and manufacture equipment upon request. It was observed that on account of market conditioning factors and different practices adapted to PDP management, these companies are at different maturity levels. One company is at the initial level of maturity while the other at the most advanced one. It was also noted that the application of CMMI model can provide improvement to PDP management, as well as present guidelines to achieve higher maturity levels, adequate to companies' needs.
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Prepared by Philip C. Mankin, Jeffery L. Van Orman, Bruce D. Taubert, David P. Philipp.
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In a dynamic atmosphere of competitiveness, customer satisfaction is a key factor in the long term success of a business relationship. From this perspective, the objective of the article was to evaluate the importance of attributes and customer satisfaction with Supermarkets in the Mid-Valley region of the ltajai/SC. Research methodology is characterized as descriptive, of the survey type, with a quantitative, cross section approach. The research instrument used was a questionnaire structured with open and closed questions, according to Lickert`s scale. By means of this, the degree of importance of supermarket attributes and the level of customer satisfaction with them were verified. In regard to the importance of the attributes, cleaning, parking, safety and variety of products are the most important, while the attributes Of purchase through the internet and taste samples are the least significant ones. The results of satisfaction point to the fact that the Supermarkets Big and Angeloni presented a greater degree of satisfaction in relation to the general average in practically all of the attributes, while Bistek presented the smallest degree of satisfaction, only surpassing the average in regard to the attribute of store lighting.
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La filière coordonnée "diabaide" a été mise en place à fin 2004 dans l'objectif d'améliorer la prise en charge des patients diabétiques par une organisation des soins fondée sur la collaboration, le partage de l'information et la coordination des prestations, afin de renforcer l'autonomie des patients (éducation et auto-prise en charge), d'améliorer la qualité des soins (recommandations thérapeutiques et protocoles de soins) et de maîtriser les coûts. La filière, à ses débuts, était constituée principalement de la cellule multidisciplinaire "diabaide", qui offrait des consultations ambulatoires et hospitalières par des professionnels spécialisés. Cette évaluation, intermédiaire, avait pour objectif d'estimer si le programme avait atteint ses objectifs après deux années d'activités. [....] Le développement de programmes de prise en charge des maladies chroniques est encore à ses débuts en Suisse et "diabaide" fait image de pionnier dans ce domaine. Après cette évaluation, le programme a été modifié en 2007 et ne correspond plus à la description fournie dans ce document. De nouveaux programmes ont également été mis en place en Suisse depuis 2007 (par exemple makora Diabetes-Disease Management Programm à Zürich). Dans le canton de Vaud, le département de la santé de l'action sociale a créé en 2010 un programme cantonal visant à réduire l'impact du diabète sur la population en agissant sur la prévention et sur l'amélioration de la prise en charge des personnes diabétiques. Le programme cantonal a pour objectif notamment de développer une prise en charge globale, inspirée en partie du programme "diabaide", qui sera stratifiée en fonction de la sévérité de la maladie et des besoins des patients, intégrera l'auto-gestion (self-management), sera organisée en filières interdisciplinaires, et sera fondée sur les preuves. [Auteurs, p. 5]
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Application of cervical collars may reduce cervical spine movements but render tracheal intubation with a standard laryngoscope difficult if not impossible. We hypothesised that despite the presence of a Philadelphia Patriot (R) cervical collar and with the patient's head taped to the trolley, tracheal intubation would be possible in 50 adult patients using the GlideScope (R) and its dedicated stylet. Laryngoscopy was attempted using a Macintosh laryngoscope with a size 4 blade, and the modified Cormack-Lehane grade was scored. Subsequently, laryngoscopy with the GlideScope was graded and followed by tracheal intubation. All patients' tracheas were successfully intubated with the GlideScope. The median (IQR) intubation time was 50 s (43-61 s). The modified Cormack-Lehane grade was 3 or 4 at direct laryngoscopy. It was significantly reduced with the GlideScope (p < 0.0001), reaching grade 2a in most patients. Tracheal intubation in patients wearing a semi-rigid collar and having their head taped to the trolley is possible with the help of the GlideScope.
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This book comprises two volumes and builds on the findings of the DISMEVAL project (Developing and validating DISease Management EVALuation methods for European health care systems), funded under the European Union's (EU) Seventh Framework Programme (FP7) (Agreement no. 223277). DISMEVAL was a three-year European collaborative project conducted between 2009 and 2011. It contributed to developing new research methods and generating the evidence base to inform decision-making in the field of chronic disease management evaluation (www.dismeval.eu). In this book, we report on the findings of the project's first phase, capturing the diverse range of contexts in which new approaches to chronic care are being implemented and evaluating the outcomes of these initiatives using an explicit comparative approach and a unified assessment framework. In this first volume, we describe the range of approaches to chronic care adopted in 12 European countries. By reflecting on the facilitators and barriers to implementation, we aim to provide policy-makers and practitioners with a portfolio of options to advance chronic care approaches in a given policy context.
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Tutkielman tavoitteena on tutkia, mikä olisi parhaiten case-yritykselle sopiva menetelmä tulla tekemään kauppaa ulkomaan markkinoille. Kaikki yleiset kansainvälisille markkinoilletulomenetelmät esitetään ja niiden edut ja haitat tuodaan esille. Selvittäessä tehtävänantajayrityksen resurssit, odotukset ja vaatimukset todetaan, että yhteistyössä tehtävä markkinoilletulo on pätevin vaihtoehto. Tämän jälkeen valitaan parhaiten tarkoitukseen sopiva yritys ennalta valitusta yritysvaihtoehtojen ryhmästä ja testataan tämän yrityksen yhteistyösopivuus case-yrityksen kanssa. Yritysten välinen yhteistyösopivuus arvioidaan analysoimalla yritykset haastattelujen avulla ja tutkielmassa esitettyjen teorioiden avulla. Sopivuus todetaan hyväksi, kattaen 71 prosenttia analysoiduista kohdista. Kaksikymmentäyhdeksän prosenttia kohdista todetaan kohdiksi, joissa yritysten välinen yhteisymmärrys ei ole toimeksiantajayrityksen minimivaatimukset täyttävää. Näitä kohtia tullaan käyttämään suunnittelun pohjana kun suunnitellaan jatkoneuvotteluja yhteistyön käynnistämiseksi.
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Due to the increase in water demand and hydropower energy, it is getting more important to operate hydraulic structures in an efficient manner while sustaining multiple demands. Especially, companies, governmental agencies, consultant offices require effective, practical integrated tools and decision support frameworks to operate reservoirs, cascades of run-of-river plants and related elements such as canals by merging hydrological and reservoir simulation/optimization models with various numerical weather predictions, radar and satellite data. The model performance is highly related with the streamflow forecast, related uncertainty and its consideration in the decision making. While deterministic weather predictions and its corresponding streamflow forecasts directly restrict the manager to single deterministic trajectories, probabilistic forecasts can be a key solution by including uncertainty in flow forecast scenarios for dam operation. The objective of this study is to compare deterministic and probabilistic streamflow forecasts on an earlier developed basin/reservoir model for short term reservoir management. The study is applied to the Yuvacık Reservoir and its upstream basin which is the main water supply of Kocaeli City located in the northwestern part of Turkey. The reservoir represents a typical example by its limited capacity, downstream channel restrictions and high snowmelt potential. Mesoscale Model 5 and Ensemble Prediction System data are used as a main input and the flow forecasts are done for 2012 year using HEC-HMS. Hydrometeorological rule-based reservoir simulation model is accomplished with HEC-ResSim and integrated with forecasts. Since EPS based hydrological model produce a large number of equal probable scenarios, it will indicate how uncertainty spreads in the future. Thus, it will provide risk ranges in terms of spillway discharges and reservoir level for operator when it is compared with deterministic approach. The framework is fully data driven, applicable, useful to the profession and the knowledge can be transferred to other similar reservoir systems.