64,335 research outputs found

    Developments in hospital management: a proposal for a new hospital management model for Malta

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    The management of hospitals has changed considerably over the last two decades. The business processes and patient treatment regimes are unrecognisable from those of ten years ago. Health care in general faces unprecedented challenges internationally as the demand for more medical treatment and services increases together with a parallel emphasis on quality and cost containment1. Furthermore external factors such as the 'greying' population and growing patients' expectations increase the burden upon hospital management and staff to provide a quality hospital service. Hospitals are expensive enterprises. Huge investments go into the construction and equipping of hospitals. In the UK the cost of building a hospital is ÂŁ1000 /square metre2, whilst in Malta new construction costs around Lm430 /square metre. Medical equipment accounts for an additional 20%. Furthermore hospitals invariably take the lion's share of health care expenditure, averaging around 8% of GDP in Western Europe3 . It is therefore incumbent upon the authorities to ensure that the populace gets an appropriate return on its investment. This paper reviews developments in hospital care and management, including the increasing importance of focusing care and management decisions around the patient. It will explore the role clinicians should play in management, itself still a topic of controversy. The role of information technology and its indissoluble link with the proper administration of resources will also be critically appraised. These will be reviewed in the local context where a model for the future management of Malta's hospitals is proposed.peer-reviewe

    A Call to Action: Los Angeles' Quest to Achieve Community Safety

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    "A Call To Action: Los Angeles' Quest To Achieve Community Safety" is a report and policy brief telling the story of L.A.'s extraordinary experiment to keep kids safe in the City of Los Angeles' worst gang zones, and laying out a new comprehensive set of recommendations. The document also explains Advancement Project's comprehensive violence reduction strategy and shows how it could be used in other communities suffering from gang violence. The report, assembled by Advancement Proejct's Urban Peace and Healthy City programs, highlights progress the City of L.A. has made toward greater public safety, and how to build on those successes to achieve comprehensive community safety in places where children are still exposed to chronic trauma and violence.Five Years of ProgressIn 2007 Advancement Project released "A Call to Action: A Case for a Comprehensive Solution to L.A.'s Gang Violence Epidemic", a roadmap that explained why Los Angeles' 30-year "war on gangs" was failing to quell gangs and gang violence and laid out a comprehensive set of recommendations to reverse course. Since then, Advancement Project has worked closely with City officials to put these recommendations into place.Los Angeles has seen greater success in decreasing gang violence with gang-related crime reduced by over 15% and 35% fewer gang-related homicides surrounding neighborhoods served by the Mayor's Gang Reduction & Youth Development (GRYD) Office and by Summer Night Lights, a summer violence reduction strategy. In 2010 the homicide rate was at its lowest since the 1960s.Success in significantly reducing violence can be attributed in part to the following:Catalyst to City's new approach to gang violence: Based on the 2007 report recommendations to create a central entity that manages gang violence prevention in areas where violence was concentrated, the City of L.A. created the GRYD Office to focus public resources where it is needed the most -- on 12 gang violence hot zones identified in conjunction with community leaders.Transformation of L.A. Police Department: The LAPD has transformed the way it deals with gangs, from an overbroad suppression strategy to relationship-based, problem-solving policing.Training gang interventionists: The Urban Peace Academy was established to train gang interventionists, the only publicly funded training program in the nation for gang interventionists. The academy has trained more than 1,200 gang interventionists and more than 400 police officers to work together, which has resulted in collaboration and shared accountability to achieve public safety.In fact, efforts in Los Angeles have been so successful that other cities across the nation are working to adopt some of the strategies that have succeeded in Los Angeles.Time for a New Call to ActionDespite amazing gains in violence reduction for the City of Los Angeles as a whole, there is still much left to do. We are not yet fully cured of this complex epidemic -- the conditions that spawn and sustain gang violence remain largely unchanged in L.A.'s most vulnerable communities. We continue to require holistic, systemic, and politically difficult solutions."A Call to Action: Los Angeles' Quest to Achieve Community Safety"explains why, despite these significant accomplishments, the City faces a number of ongoing challenges and opportunities for investment.The Urban Peace program advocates for the leadership of the City and County of Los Angeles to publicly commit to achieving the following goals:GOVERNMENT AND COMMUNITY ACCOUNTABILITY: Government at every level must be held accountable for the basic safety of every child.SCALING UP PREVENTION, INTERVENTION, AND TARGETED SUPPRESSION: The City and County of Los Angeles must bring up to scale prevention and intervention efforts to meet the need in the hot zones in a culturally competent way.ACHIEVE FEAR-FREE SCHOOLS: Beyond Safe Passages to and from school, all students should attend public schools free of bullying, gang intimidation, and all forms of fear.REGIONALLY COORDINATED COUNTY AGENCIES: County agencies must cooperate with each other and with the City to achieve reductions in violence, trauma, and crime.BUILD A REENTRY NETWORK: The County must seize realignment as an opportunity to make coordinated, seamless reintegration a reality for its citizens returning from incarceration.EQUITABLE COMMUNITY BUILDING: These neighborhoods must receive the same capital, business, educational, and infrastructure investment from which affluent Los Angeles already benefits.CREATE VIABLE EMPLOYMENT: There needs to be an immediate economic and employment plan for the hot zone communities of Los Angeles.Ending the public safety inequity that renders gang violence hot zone communities invisible to the rest of Los Angeles means we must provide youth greater alternatives that preempt gang joining. Political will is necessary to pull together a truly comprehensive solution with real government-community partnerships at both the City and County level, tailored to yield and sustain results for each individual neighborhood. Los Angeles cannot rest until every family and every child enjoy the first of all civil rights -- safety -- and the first of all freedoms -- freedom from violence

    Global Grids and Software Toolkits: A Study of Four Grid Middleware Technologies

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    Grid is an infrastructure that involves the integrated and collaborative use of computers, networks, databases and scientific instruments owned and managed by multiple organizations. Grid applications often involve large amounts of data and/or computing resources that require secure resource sharing across organizational boundaries. This makes Grid application management and deployment a complex undertaking. Grid middlewares provide users with seamless computing ability and uniform access to resources in the heterogeneous Grid environment. Several software toolkits and systems have been developed, most of which are results of academic research projects, all over the world. This chapter will focus on four of these middlewares--UNICORE, Globus, Legion and Gridbus. It also presents our implementation of a resource broker for UNICORE as this functionality was not supported in it. A comparison of these systems on the basis of the architecture, implementation model and several other features is included.Comment: 19 pages, 10 figure

    INSPIRAL: investigating portals for information resources and learning. Final project report

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    INSPIRAL's aims were to identify and analyse, from the perspective of the UK HE learner, the nontechnical, institutional and end-user issues with regard to linking VLEs and digital libraries, and to make recommendations for JISC strategic planning and investment. INSPIRAL's objectives -To identify key stakeholders with regard to the linkage of VLEs, MLEs and digital libraries -To identify key stakeholder forum points and dissemination routes -To identify the relevant issues, according to the stakeholders and to previous research, pertaining to the interaction (both possible and potential) between VLEs/MLEs and digital libraries -To critically analyse identified issues, based on stakeholder experience and practice; output of previous and current projects; and prior and current research -To report back to JISC and to the stakeholder communities, with results situated firmly within the context of JISC's strategic aims and objectives

    Construction IT in 2030: a scenario planning approach

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    Summary: This paper presents a scenario planning effort carried out in order to identify the possible futures that construction industry and construction IT might face. The paper provides a review of previous research in the area and introduces the scenario planning approach. It then describes the adopted research methodology. The driving forces of change and main trends, issues and factors determined by focusing on factors related to society, technology, environment, economy and politics are discussed. Four future scenarios developed for the year 2030 are described. These scenarios start from the global view and present the images of the future world. They then focus on the construction industry and the ICT implications. Finally, the preferred scenario determined by the participants of a prospective workshop is presented

    An Institutional Analysis of European Systems for Impact Assessment

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    Agricultural and Food Policy, Environmental Economics and Policy, Farm Management, Land Economics/Use,

    Skills Academy research report

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    "This research was commissioned by the Welsh Assembly Government in July 2009 in order to review the development, operation and sustainability of Skills Academy networks across the UK and other relevant countries, to determine the strengths and weaknesses of such networks and to make recommendations to support the policy development of a Skills Academy network in Wales." - overview
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