An investigation into using SAP-PS as a multidimensional project control system (MPCS)

This paper investigates the effectiveness of using a corporate enterprise resource planning (ERP) system as a multi-dimensional project control system (MPCS) to monitor and control the work performed on projects, meet the needs and expectations of the project managers and support the requirements of other key stakeholders. A qualitative approach i.e. case study interviews and literature review accompanied by a quantitative computer system validation test approach was deployed. The results from this study suggest that the corporate ERP system is effective at monitoring and controlling the project stakeholder success criteria within a fully integrated environment. The system does however need to be setup and configured for the purpose of MPCS. This study contributes to the field by providing empirical evidence that corporate ERP systems are likely one of the only systems truly capable of solving the age old problem of how to expand the traditional singular dimensional approaches commonly used in project control, thus multiple control dimensions are integrated with each other and other business systems to form a multi-dimensional project control system

The role of organizational and professional cultures in medication safety: a scoping review of the literature

Purpose: This scoping review explores what is known about the role of organizational and professional cultures in medication safety. The aim is to increase our understanding of ‘cultures’ within medication safety and provide an evidence base to shape governance arrangements. / Data sources: Databases searched are ASSIA, CINAHL, EMBASE, HMIC, IPA, MEDLINE, PsycINFO and SCOPUS. / Study selection: Inclusion criteria were original research and grey literature articles written in English and reporting the role of culture in medication safety on either organizational or professional levels, with a focus on nursing, medical and pharmacy professions. Articles were excluded if they did not conceptualize what was meant by ‘culture’ or its impact was not discussed. / Data extraction: Data were extracted for the following characteristics: author(s), title, location, methods, medication safety focus, professional group and role of culture in medication safety. / Results of data synthesis: A total of 1272 citations were reviewed, of which, 42 full-text articles were included in the synthesis. Four key themes were identified which influenced medication safety: professional identity, fear of litigation and punishment, hierarchy and pressure to conform to established culture. At times, the term ‘culture’ was used in a non-specific and arbitrary way, for example, as a metaphor for improving medication safety, but with little focus on what this meant in practice. / Conclusions: Organizational and professional cultures influence aspects of medication safety. Understanding the role these cultures play can help shape both local governance arrangements and the development of interventions which take into account the impact of these aspects of culture

Weight Loss and Illness Severity in Adolescents With Atypical Anorexia Nervosa.

BACKGROUND:Lower weight has historically been equated with more severe illness in anorexia nervosa (AN). Reliance on admission weight to guide clinical concern is challenged by the rise in patients with atypical anorexia nervosa (AAN) requiring hospitalization at normal weight. METHODS:We examined weight history and illness severity in 12- to 24-year-olds with AN (n = 66) and AAN (n = 50) in a randomized clinical trial, the Study of Refeeding to Optimize Inpatient Gains (www.clinicaltrials.gov; NCT02488109). Amount of weight loss was the difference between the highest historical percentage median BMI and admission; rate was the amount divided by duration (months). Unpaired t tests compared AAN and AN; multiple variable regressions examined associations between weight history variables and markers of illness severity at admission. Stepwise regression examined the explanatory value of weight and menstrual history on selected markers. RESULTS:Participants were 16.5 ± 2.6 years old, and 91% were of female sex. Groups did not differ by weight history or admission heart rate (HR). Eating Disorder Examination Questionnaire global scores were higher in AAN (mean 3.80 [SD 1.66] vs mean 3.00 [SD 1.66]; P = .02). Independent of admission weight, lower HR (β = -0.492 [confidence interval (CI) -0.883 to -0.100]; P = .01) was associated with faster loss; lower serum phosphorus was associated with a greater amount (β = -0.005 [CI -0.010 to 0.000]; P = .04) and longer duration (β = -0.011 [CI -0.017 to 0.005]; P = .001). Weight and menstrual history explained 28% of the variance in HR and 36% of the variance in serum phosphorus. CONCLUSIONS:Weight history was independently associated with markers of malnutrition in inpatients with restrictive eating disorders across a range of body weights and should be considered when assessing illness severity on hospital admission

Juniper Biology and Management in Texas

12 pp., 3 photos, 3 tables, 2 figuresJunipers (or cedars) are a major management concern on Texas rangelands. This publication discusses physical characteristics of the two major species in western Texas--ashe juniper and redberry juniper. Watershed management, juniper control methods, and the effect of juniper on wildlife and livestock are covered in depth

Exploration of synergistic and redundant information sharing in static and dynamical Gaussian systems

To fully characterize the information that two source variables carry about a third target variable, one must decompose the total information into redundant, unique, and synergistic components, i.e., obtain a partial information decomposition (PID). However, Shannon's theory of information does not provide formulas to fully determine these quantities. Several recent studies have begun addressing this. Some possible definitions for PID quantities have been proposed and some analyses have been carried out on systems composed of discrete variables. Here we present an in-depth analysis of PIDs on Gaussian systems, both static and dynamical. We show that, for a broad class of Gaussian systems, previously proposed PID formulas imply that (i) redundancy reduces to the minimum information provided by either source variable and hence is independent of correlation between sources, and (ii) synergy is the extra information contributed by the weaker source when the stronger source is known and can either increase or decrease with correlation between sources. We find that Gaussian systems frequently exhibit net synergy, i.e., the information carried jointly by both sources is greater than the sum of information carried by each source individually. Drawing from several explicit examples, we discuss the implications of these findings for measures of information transfer and information-based measures of complexity, both generally and within a neuroscience setting. Importantly, by providing independent formulas for synergy and redundancy applicable to continuous time-series data, we provide an approach to characterizing and quantifying information sharing amongst complex system variables

Emergency ambulance service involvement with residential care homes in the support of older people with dementia : an observational study

© 2014 Amador et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BACKGROUND: Older people resident in care homes have a limited life expectancy and approximately two-thirds have limited mental capacity. Despite initiatives to reduce unplanned hospital admissions for this population, little is known about the involvement of emergency services in supporting residents in these settings.METHODS: This paper reports on a longitudinal study that tracked the involvement of emergency ambulance personnel in the support of older people with dementia, resident in care homes with no on-site nursing providing personal care only. 133 residents with dementia across 6 care homes in the East of England were tracked for a year. The paper examines the frequency and reasons for emergency ambulance call-outs, outcomes and factors associated with emergency ambulance service use. RESULTS: 56% of residents used ambulance services. Less than half (43%) of all call-outs resulted in an unscheduled admission to hospital. In addition to trauma following a following a fall in the home, results suggest that at least a reasonable proportion of ambulance contacts are for ambulatory care sensitive conditions. An emergency ambulance is not likely to be called for older rather than younger residents or for women more than men. Length of residence does not influence use of emergency ambulance services among older people with dementia. Contact with primary care services and admission route into the care home were both significantly associated with emergency ambulance service use. The odds of using emergency ambulance services for residents admitted from a relative's home were 90% lower than the odds of using emergency ambulance services for residents admitted from their own home. CONCLUSIONS: Emergency service involvement with this vulnerable population merits further examination. Future research on emergency ambulance service use by older people with dementia in care homes, should account for important contextual factors, namely, presence or absence of on-site nursing, GP involvement, and access to residents' family, alongside resident health characteristics.Peer reviewedFinal Published versio

A High-Value, Low-Cost Bubble Continuous Positive Airway Pressure System for Low-Resource Settings: Technical Assessment and Initial Case Reports

Acute respiratory infections are the leading cause of global child mortality. In the developing world, nasal oxygen therapy is often the only treatment option for babies who are suffering from respiratory distress. Without the added pressure of bubble Continuous Positive Airway Pressure (bCPAP) which helps maintain alveoli open, babies struggle to breathe and can suffer serious complications, and frequently death. A stand-alone bCPAP device can cost $6,000, too expensive for most developing world hospitals. Here, we describe the design and technical evaluation of a new, rugged bCPAP system that can be made in small volume for a cost-of-goods of approximately$350. Moreover, because of its simple designﾗconsumergrade pumps, medical tubing, and regulators—it requires only the simple replacement of a ,$1 diaphragm approximately every 2 years for maintenance. The low-cost bCPAP device delivers pressure and flow equivalent to those of a reference bCPAP system used in the developed world. We describe the initial clinical cases of a child with bronchiolitis and a neonate with respiratory distress who were treated successfully with the new bCPAP device