Primary care physicians' perceptions of barriers and facilitators to management of chronic kidney disease: A mixed methods study.

BackgroundGiven the high prevalence of chronic kidney disease (CKD), primary care physicians (PCPs) frequently manage early stage CKD. Nonetheless, there are challenges in providing optimal CKD care in the primary care setting. This study sought to understand PCPs' perceptions of barriers and facilitators to the optimal management of CKD.Study designMixed methods study.Settings and participantsCommunity-based PCPs in four US cities: Baltimore, MD; St. Louis, MO; Raleigh, NC and San Francisco, CA.MethodologyWe used a self-administered questionnaire and conducted 4 focus groups of PCPs (n = 8 PCPs/focus group) in each city to identify key barriers and facilitators to management of patients with CKD in primary care.Analytic approachWe conducted descriptive analyses of the survey data. Major themes were identified from audio-recorded interviews that were transcribed and coded by the research team.ResultsOf 32 participating PCPs, 31 (97%) had been in practice for >10 years, and 29 (91%) practiced in a non-academic setting. PCPs identified multiple barriers to managing CKD in primary care including at the level of the patient (e.g., low awareness of CKD, poor adherence to treatment recommendations), the provider (e.g., staying current with CKD guidelines), and the health care system (e.g., inflexible electronic medical record, limited time and resources). PCPs desired electronic prompts and lab decision support, concise guidelines, and healthcare financing reform to improve CKD care.ConclusionsPCPs face substantial but modifiable barriers in providing care to patients with CKD. Interventions that address these barriers and promote facilitative tools may improve PCPs' effectiveness and capacity to care for patients with CKD

Synchromodal logistics: An overview of critical success factors, enabling technologies, and open research issues

Abstract As supply chain management is becoming demand driven, logistics service providers need to use real-time information efficiently and integrate new technologies into their business. Synchromodal logistics has emerged recently to improve flexibility in supply chains, cooperation among stakeholders, and utilization of resources. We survey the existing scientific literature and real-life developments on synchromodality. We focus on the critical success factors of synchromodality and six categories of enabling technologies. We identify open research issues and propose the introduction of a new stakeholder, which takes on the role of orchestrator to coordinate and provide services through a technology-based platform

Forum Session at the First International Conference on Service Oriented Computing (ICSOC03)

The First International Conference on Service Oriented Computing (ICSOC) was held in Trento, December 15-18, 2003. The focus of the conference ---Service Oriented Computing (SOC)--- is the new emerging paradigm for distributed computing and e-business processing that has evolved from object-oriented and component computing to enable building agile networks of collaborating business applications distributed within and across organizational boundaries. Of the 181 papers submitted to the ICSOC conference, 10 were selected for the forum session which took place on December the 16th, 2003. The papers were chosen based on their technical quality, originality, relevance to SOC and for their nature of being best suited for a poster presentation or a demonstration. This technical report contains the 10 papers presented during the forum session at the ICSOC conference. In particular, the last two papers in the report ere submitted as industrial papers

Adaptive fog service placement for real-time topology changes in Kubernetes clusters

Recent trends have caused a shift from services deployed solely in monolithic data centers in the cloud to services deployed in the fog (e.g. roadside units for smart highways, support services for IoT devices). Simultaneously, the variety and number of IoT devices has grown rapidly, along with their reliance on cloud services. Additionally, many of these devices are now themselves capable of running containers, allowing them to execute some services previously deployed in the fog. The combination of IoT devices and fog computing has many advantages in terms of efficiency and user experience, but the scale, volatile topology and heterogeneous network conditions of the fog and the edge also present problems for service deployment scheduling. Cloud service scheduling often takes a wide array of parameters into account to calculate optimal solutions. However, the algorithms used are not generally capable of handling the scale and volatility of the fog. This paper presents a scheduling algorithm, named "Swirly", for large scale fog and edge networks, which is capable of adapting to changes in network conditions and connected devices. The algorithm details are presented and implemented as a service using the Kubernetes API. This implementation is validated and benchmarked, showing that a single threaded Swirly service is easily capable of managing service meshes for at least 300.000 devices in soft real-time

HealthPartners: Consumer-Focused Mission and Collaborative Approach Support Ambitious Performance Improvement Agenda

Presents a case study of a nonprofit healthcare organization that exhibits the six attributes of an ideal healthcare delivery system as defined by the Fund, including information continuity, care coordination and transitions, and system accountability

Emerging priorities for HIV service delivery

Nathan Ford and co-authors discuss global priorities in the provision of HIV prevention and treatment services

A Proposal for Supply Chain Management Research That Matters: Sixteen High Priority Research Projects for the Future

On May 4th, 2016 in Milton, Ontario, the World Class Supply Chain 2016 Summit was held in partnership between CN Rail and Wilfrid Laurier University’s Lazaridis School of Business & Economics to realize an ambitious goal: raise knowledge of contemporary supply chain management (SCM) issues through genuine peer-­‐to-­‐peer dialogue among practitioners and scholars. A principal element of that knowledge is an answer to the question: to gain valid and reliable insights for attaining SCM excellence, what issues must be researched further? This White Paper—which is the second of the summit’s two White Papers—addresses the question by proposing a research agenda comprising 16 research projects. This research agenda covers the following: The current state of research knowledge on issues that are of the highest priority to today’s SCM professionals Important gaps in current research knowledge and, consequently, the major questions that should be answered in sixteen future research projects aimed at addressing those gaps Ways in which the research projects can be incorporated into student training and be supported by Canada’s major research funding agencies That content comes from using the summit’s deliberations to guide systematic reviews of both the SCM research literature and Canadian institutional mechanisms that are geared towards building knowledge through research. The major conclusions from those reviews can be summarized as follows: While the research literature to date has yielded useful insights to inform the pursuit of SCM excellence, several research questions of immense practical importance remain unanswered or, at best, inadequately answered The body of research required to answer those questions will have to focus on what the summit’s first White Paper presented as four highly impactful levers that SCM executives must expertly handle to attain excellence: collaboration; information; technology; and talent The proposed research agenda can be pursued in ways that achieve the two inter-­‐related goals of creating new actionable knowledge and building the capacity of today’s students to become tomorrow’s practitioners and contributors to ongoing knowledge growth in the SCM field This White Paper’s details underlying these conclusions build on the information presented in the summit’s first White Paper. That is, while the first White Paper (White Paper 1) identified general SCM themes for which the research needs are most urgent, this White Paper goes further along the path of industry-academia knowledge co-creation. It does so by examining and articulating those needs against the backdrop of available research findings, translating the needs into specific research projects that should be pursued, and providing guidelines for how those projects can be carried out