Effects Comparison of Different Resilience Enhancing Strategies for Municipal Water Distribution Network: A Multidimensional Approach

Water distribution network (WDN) is critical to the city service, economic rehabilitation, public health, and safety. Reconstructing the WDN to improve its resilience in seismic disaster is an important and ongoing issue. Although a considerable body of research has examined the effects of different reconstruction strategies on seismic resistance, it is still hard for decision-makers to choose optimal resilience enhancing strategy. Taking the pipeline ductile retrofitting and network meshed expansion as demonstration, we proposed a feasible framework to contrast the resilience enhancing effects of two reconstruction strategies—units retrofitting strategy and network optimization strategy—in technical and organizational dimension. We also developed a new performance response function (PRF) which is based on network equilibrium theory to conduct the effects comparison in integrated technical and organizational dimension. Through the case study of municipal WDN in Lianyungang, China, the comparison results were thoroughly shown and the holistic decision-making support was provided

Developing minimum clinical standards for physiotherapy in South African ICUs: A qualitative study

Rationale, aims, and objectives: Physiotherapists are integral members of the intensive care unit (ICU) team. Clinicians working in ICU are dependent on their own experience when making decisions regarding individual patient management thus resulting in variation in clinical practice. No formalized clinical practice guidelines or standards exist for the educational profile or scope of practice requirements for ICU physiotherapy. This study explored perceptions of physiotherapists on minimum clinical standards that ICU physiotherapists should adhere to for delivering safe, effective physiotherapy services to critically ill patients. Method: Experienced physiotherapists offering a service to South African ICUs were purposively sampled. Three focus group sessions were held in different parts of the country to ensure national participation. Each was audio recorded. The stimulus question posed was “What is the minimum standard of clinical practice needed by physiotherapists to ensure safe and independent practice in South African ICUs?” Three categories were explored, namely, knowledge, skill, and attributes. Themes and subthemes were developed using the codes identified. An inductive approach to data analysis was used to perform conventional content analysis. Results: Twenty-five physiotherapists participated in 1 of 3 focus group sessions. Mean years of ICU experience was 10.8 years (±7.0; range, 3-33). Three themes emerged from the data namely, integrated medical knowledge, multidisciplinary teamwork, and physiotherapy practice. Integrated medical knowledge related to anatomy and physiology, conditions that patients present with in ICU, the ICU environment, pathology and pathophysiology, and pharmacology. Multidisciplinary teamwork encompassed elements related to communication, continuous professional development, cultural sensitivity, documentation, ethics, professionalism, safety in ICU, and technology. Components related to physiotherapy practice included clinical reasoning, handling skills, interventions, and patient care. Conclusions: The information obtained will be used to inform the development of a list of standards to be presented to the wider national physiotherapy and ICU communities for further consensus-building activities

Pragmatic but Principled: Background report on Integrated Water Resource Management

IWRM is about integrated and "joined-up" management. It is about promoting integration across sectors, applications, groups in society and time, based upon an agreed set of principles. IWRM has been widely applied and aims for more coordinated use of land and water and is divided into full (wholly integrated activities) and light (applying the principles at the local level). The main criticisms of IWRM are the failure to translate the theory into action and the lack of change on the ground. There is a need for both light and full IWRM, but future projects need to increase participation and engagement.Water and Sanitation for the Urban Poo

Cleaning Up the Nuclear Weapons Complex: Exploring New Approaches

In recent years, policy experts have increasingly decried the "piecemeal" approach to environmental protection embodied in existing laws and regulations. This paper analyzes one aspect of the call for more integration: the feasibility and advisability of developing an integrated approach to regulating the cleanup of the nation's nuclear weapons complex. The Cold War has left an unprecedented set of difficulties at sites across the country where vast quantities of hazardous and radioactive materials must be properly managed. Regulatory fragmentation�particularly the phenomenon of multiple regulators and regulations driving the allocation of resources in an uncoordinated fashion�is nowhere more evident than in the current statutory and regulatory framework governing environmental management activities at this array of sites�the nuclear weapons complex. The objective of an integrated approach is to give regulators and the regulated community incentives to look holistically at environmental hazards, both existing and future, and to develop creative ways of setting priorities such that risk, cost effectiveness, and public concerns are taken into account. This paper describes recent efforts to achieve integration in the environmental arena, surveys the unique technical, regulatory, and political circumstances surrounding cleanup of the weapons complex, and offers some preliminary thoughts on how integration might be attained in this vital area. While administrative and regulatory changes could achieve some important steps in this direction, the authors conclude that legislative change is necessary for implementation of a truly integrated approach.

Corporate motivation for integrated management system implementation : why do firms engage in integration of management systems: a literature review & research agenda\ud

Integration of management systems such as for quality, environment, occupational health and safety, risk management, and corporate social responsibilities is a viable organisational approach to cost reduction, efficient utilization of resources, greater motivation of employees, and better compliance to social obligations and stakeholders‘ requirements. Identification of drivers for corporate motivation for IMS decision making and its implementation is a matter of interest for academicians, practitioners, industry, and government regulatory agencies; paradoxically literature on this subject is pretty thin. This paper describes the literature review and research agenda for the exploration of drivers of IMS implementation and factors influencing IMS implementation. The exploratory research is meant to be executed by an inductive approach through case studies in Pakistani manufacturing firms

What does it take to make integrated care work? A ‘cookbook’ for large-scale deployment of coordinated care and telehealth

The Advancing Care Coordination & Telehealth Deployment (ACT) Programme is the first to explore the organisational and structural processes needed to successfully implement care coordination and telehealth (CC&TH) services on a large scale. A number of insights and conclusions were identified by the ACT programme. These will prove useful and valuable in supporting the large-scale deployment of CC&TH. Targeted at populations of chronic patients and elderly people, these insights and conclusions are a useful benchmark for implementing and exchanging best practices across the EU. Examples are: Perceptions between managers, frontline staff and patients do not always match; Organisational structure does influence the views and experiences of patients: a dedicated contact person is considered both important and helpful; Successful patient adherence happens when staff are engaged; There is a willingness by patients to participate in healthcare programmes; Patients overestimate their level of knowledge and adherence behaviour; The responsibility for adherence must be shared between patients and health care providers; Awareness of the adherence concept is an important factor for adherence promotion; The ability to track the use of resources is a useful feature of a stratification strategy, however, current regional case finding tools are difficult to benchmark and evaluate; Data availability and homogeneity are the biggest challenges when evaluating the performance of the programmes

International Guidelines for Securing Sustainable Small-scale Fisheries

The 'Zero Draft' of the International Guidelines for Securing Sustainable Small-scale Fisheries(SSF Guidelines) has been prepared based on the outcomes of the extensive consultation process that has taken place during the last few years. This preliminary draft text draws in particular on the Discussion Document: Towards Voluntary Guidelines on Securing Sustainable Small-scale Fisheries–prepared as a stock-taking exercise by the FAO SSF Guidelines Secretariat in July 2011 and the contributions to and the outcomes of the FAO Workshop on International Guidelines for Securing Sustainable Small-scale Fisheries held on 7-10 February 2012 in FAO, Rome. It has been prepared to stimulate further consultations among all concerned parties. The outcomes of these additional consultations will provide guidance to the FAO Secretariat when preparing the text of the SSF Guidelines that will be submitted as a draft to the formal inter-governmental negotiation process tentatively scheduled for May 2013

A holistic multi-methodology for sustainable renovation

A review of the barriers for building renovation has revealed a lack of methodologies, which can promote sustainability objectives and assist various stakeholders during the design stage of building renovation/retrofitting projects. The purpose of this paper is to develop a Holistic Multi-methodology for Sustainable Renovation, which aims to deal with complexity of renovation projects. It provides a framework through which to involve the different stakeholders in the design process to improve group learning and group decision-making, and hence make the building renovation design process more robust and efficient. Therefore, the paper discusses the essence of multifaceted barriers in building renovation regarding cultural changes and technological/physical changes. The outcome is a proposal for a multi-methodology framework, which is developed by introducing, evaluating and mixing methods from Soft Systems Methodologies (SSM) with Multiple Criteria Decision Making (MCDM). The potential of applying the proposed methodology in renovation projects is demonstrated through a case study

A Call to Action: An Integrated Approach to Youth Permanency and Preparation for Adulthood

Addresses the unique needs of adolescents in foster care, and highlights efforts to ensure that youth in the foster system benefit from the most strategic preparation and supports for entering adulthood