The development and testing of a contextual model for healthcare quality improvement using Lean and the Model for Understanding Success in Quality (MUSIQ) : a thesis presented in partial fulfilment of the requirements for the degree of Master of Quality Systems at Massey University, Palmerston North, New Zealand

This study developed a new theoretical model of quality improvement (QI) contextual factors, for QI activity undertaken at the healthcare microsystem level. The Model for Understanding Success in Quality (MUSIQ) (Kaplan, Provost, Froehle, & Margolis, 2012), was aligned with Lean improvement activity using the Toyota Way framework. The aim of the research was to improve the effectiveness of healthcare quality improvement initiatives by providing more understanding of the associations, relative importance and precise functioning of critical contextual factors. A new survey instrument, based on the literature, was developed to collect data and the hypothesised theoretical relationships were tested using the partial least squares path modelling (PLSPM) technique. QI practitioners at a large New Zealand District Health Board were surveyed on a range of contextual factors hypothesised to influence improvement outcomes. All survey participants had recently completed a small-scale improvement project using Lean, or were participants in training programmes that introduced them to Lean thinking and methods. Some participants worked autonomously on improvements of their own selection; others were part of a wider training programme derived from the National Health Service’s (UK) ‘productive ward’ programme. In the healthcare organisational context, the majority of these improvement initiatives were carried out at the microsystem level – initiated and delivered by the teams responsible for the work processes being modified. Survey responses were first analysed via principal components analysis (to examine the dimensionality of the scales) and then PLSPM. The defined contextual factors for ‘Teamwork’, ‘Respect for People’, ‘Lean Actions’ and the influence of negatively motivating factors all reached significance. Defined contextual factors for ‘Previous Experience’ and the influence of positive motivating factors did not reach significance at 5% level. The final model showed a statistically significant, moderate predictive strength, with an overall adjusted R2 of 0.58. This result was an encouraging validation of the microsystem-level layer of the MUSIQ model using Lean as the QI method (context). The relative influence of ‘Teamwork’, ‘Respect for People’, ‘Motivation’, and a mediating mechanism for making process changes (in this instance, Lean) were measured and found to be consistent with the MUSIQ model. Identifying more detailed causal mechanisms (the present model was intentionally parsimonious due to the time frame allowed and the resources available for the research), refining the operational definitions, and developing and testing predictive models for the defined contextual factors are the proposed next steps in the research

Prediction of remaining life of power transformers based on left truncated and right censored lifetime data

Prediction of the remaining life of high-voltage power transformers is an important issue for energy companies because of the need for planning maintenance and capital expenditures. Lifetime data for such transformers are complicated because transformer lifetimes can extend over many decades and transformer designs and manufacturing practices have evolved. We were asked to develop statistically-based predictions for the lifetimes of an energy company's fleet of high-voltage transmission and distribution transformers. The company's data records begin in 1980, providing information on installation and failure dates of transformers. Although the dataset contains many units that were installed before 1980, there is no information about units that were installed and failed before 1980. Thus, the data are left truncated and right censored. We use a parametric lifetime model to describe the lifetime distribution of individual transformers. We develop a statistical procedure, based on age-adjusted life distributions, for computing a prediction interval for remaining life for individual transformers now in service. We then extend these ideas to provide predictions and prediction intervals for the cumulative number of failures, over a range of time, for the overall fleet of transformers.Comment: Published in at http://dx.doi.org/10.1214/00-AOAS231 the Annals of Applied Statistics (http://www.imstat.org/aoas/) by the Institute of Mathematical Statistics (http://www.imstat.org

Deep Learning as a Parton Shower

We make the connection between certain deep learning architectures and the renormalisation group explicit in the context of QCD by using a deep learning network to construct a toy parton shower model. The model aims to describe proton-proton collisions at the Large Hadron Collider. A convolutional autoencoder learns a set of kernels that efficiently encode the behaviour of fully showered QCD collision events. The network is structured recursively so as to ensure self-similarity, and the number of trained network parameters is low. Randomness is introduced via a novel custom masking layer, which also preserves existing parton splittings by using layer-skipping connections. By applying a shower merging procedure, the network can be evaluated on unshowered events produced by a matrix element calculation. The trained network behaves as a parton shower that qualitatively reproduces jet-based observables.Comment: 26 pages, 13 figure

HOW to Facilitate or Stifle Economic Development: The Role of Agriculture in Indonesia and the Philippines

Strikingly different patterns of agricultural growth and widely divergent results in terlnsof rural income. poverty. and employment have cmcrged in Southeast Asia. In the Philippiies, with someregional variations, a patterns of declining red farm wages,increasing landlessness in worsening poverty and diminishing employmctlt relative to demand for jobs has emerged despite some brief periods of improvcment since 1960. Sincc 1980, the employment and poverty situation has deteriorated sharply,particularly in areas concentrating on single traditional export crops (lkc sugar or coconuts) but also in amore general context. Indonesia (particularly in Java, which contains over 60 pcrcent of the population) succeeded in reversing a seemingly inevitable worsening of poverty and inequality in the rural economy with strong evidence indicating that rural real wages and income of small farmers rose substantially between the mid-1970sand late 1980s. Why such divergent patterns of rural development exist and the lessons that can be extracted from thc varied cxperiences of 1ndoncsia and the Philippines are subjects of this papcr.agriculture, economic develoment, Indonesia, the Philippines

Deliberation and global civil society : agency, arena, affect

The article provides a critical analysis of the role and function of global civil society within deliberative approaches to global governance. It critiques a common view that global civil society can/should act as an agent for democratising global governance and seeks to explore the importance of global civil society as an arena of deliberation. This more reconstructive aim is supplemented by an empirically focused discussion of the affective dimensions of global civil society, in general, and the increasingly important use of film, in particular. Ultimately, this then yields an image of the deliberative politics of global civil society that is more reflective of the differences, ambiguities and contests that pervade its discourses about global governance. This is presented as a quality that debates about deliberative global governance might learn from as well as speak to

Physical Activity and Psychological Well-Being: Testing Alternative Sociological Interpretations

This study examines the relationship between physical activity in sport and feelings of well-being, testing alternative interpretations of the relationship between these two variables. It was expected that there would be positive relationships between physical activity on the one hand and physical fitness, feelings of well-being, social interaction in the sport and exercise environment, and socioeconomic status on the other hand. It was also expected that physical fitness, social interaction, and socioeconomic status would be positively related to psychological well-being. Further, it was expected that any positive zero-order relationship of physical activity and well-being would be at least in part a result of the conjoint effects of the other variables. The analyses were conducted separately for the male and female subsamples of a large survey study of Canadian adults. The results, after controls, show a modest positive relationship of physical activity and well-being for males but no such relationship for females. The predicted independent effects of the control factors obtained for both males and females. Interpretations of the results are discussed