The interaction of lean and building information modeling in construction

Lean construction and Building Information Modeling are quite different initiatives, but both are having profound impacts on the construction industry. A rigorous analysis of the myriad specific interactions between them indicates that a synergy exists which, if properly understood in theoretical terms, can be exploited to improve construction processes beyond the degree to which it might be improved by application of either of these paradigms independently. Using a matrix that juxtaposes BIM functionalities with prescriptive lean construction principles, fifty-six interactions have been identified, all but four of which represent constructive interaction. Although evidence for the majority of these has been found, the matrix is not considered complete, but rather a framework for research to explore the degree of validity of the interactions. Construction executives, managers, designers and developers of IT systems for construction can also benefit from the framework as an aid to recognizing the potential synergies when planning their lean and BIM adoption strategies

The enhanced cognitive interview: expressions of uncertainty, motivation and its relation with report accuracy

The Enhanced Cognitive Interview (ECI) is one of the most widely studied and used methods to interview witnesses. However, ECI research has mainly focused on increasing report size and somewhat overlooked how to improve and evaluate report accuracy. No study evaluated if witnesses’ spontaneous expressions of uncertainty are accurate metacognitive judgments, nor if witnesses’ motivation during the interview affects report accuracy. This study examined how witnesses’ judgments of recall ‘uncertainty’ and their motivation perception could relate to report accuracy. Forty-four psychology students watched a mock robbery video recording and were interviewed 48 hours later with either the Portuguese version of the ECI or a Structured Interview (SI). Afterward, participants’ motivation was assessed and items of information were classified as ‘certainties’ or ‘uncertainties’. Results suggest that our ECI protocol was effective, since participants interviewed with the ECI produced more information without compromising accuracy. ‘Uncertainties’ were less accurate than ‘certainties’, and their exclusion raised overall, ECI, and SI, accuracy. More motivated participants had better recall accuracy. Accounting for witnesses’ motivation and spontaneous verbal expressions of uncertainty may be effective and time-saving procedures to increase accuracy. These are key points that professionals and researchers should consider

Definition of medical event is to be based on the total source strength for evaluation of permanent prostate brachytherapy: A report from the American Society for Radiation Oncology

AbstractPurposeThe Nuclear Regulatory Commission deems it to be a medical event (ME) if the total dose delivered differs from the prescribed dose by 20% or more. A dose-based definition of ME is not appropriate for permanent prostate brachytherapy as it generates too many spurious MEs and thereby creates unnecessary apprehension in patients, and ties up regulatory bodies and the licensees in unnecessary and burdensome investigations. A more suitable definition of ME is required for permanent prostate brachytherapy.Methods and MaterialsThe American Society for Radiation Oncology (ASTRO) formed a working group of experienced clinicians to review the literature, assess the validity of current regulations, and make specific recommendations about the definition of an ME in permanent prostate brachytherapy.ResultsThe working group found that the current definition of ME in §35.3045 as “the total dose delivered differs from the prescribed dose by 20 percent or more” was not suitable for permanent prostate brachytherapy since the prostate volume (and hence the resultant calculated prostate dose) is dependent on the timing of the imaging, the imaging modality used, the observer variability in prostate contouring, the planning margins used, inadequacies of brachytherapy treatment planning systems to calculate tissue doses, and seed migration within and outside the prostate. If a dose-based definition for permanent implants is applied strictly, many properly executed implants would be improperly classified as an ME leading to a detrimental effect on brachytherapy. The working group found that a source strength-based criterion, of >20% of source strength prescribed in the post-procedure written directive being implanted outside the planning target volume is more appropriate for defining ME in permanent prostate brachytherapy.ConclusionsASTRO recommends that the definition of ME for permanent prostate brachytherapy should not be dose based but should be based upon the source strength (air-kerma strength) administered

Understanding the UK hospital supply chain in an era of patient choice

Author Posting © Westburn Publishers Ltd, 2011. This is a post-peer-review, pre-copy-edit version of an article which has been published in its definitive form in the Journal of Marketing Management, and has been posted by permission of Westburn Publishers Ltd for personal use, not for redistribution. The article was published in Journal of Marketing Management, 27(3-4), 401 - 423, doi:10.1080/0267257X.2011.547084 http://dx.doi.org/10.1080/0267257X.2011.547084The purpose of this paper is to investigate the UK hospital supply chain in light of recent government policy reform where patients will have, inter alia, greater choice of hospital for elective surgery. Subsequently, the hospital system should become far more competitive with supply chains having to react to these changes as patient demand becomes less predictable. Using a qualitative case study methodology, hospital managers are interviewed on a range of issues. Views on the development of the hospital supply chain in different phases are derived, and are used to develop a map of the current hospital chain. The findings show hospital managers anticipating some significant changes to the hospital supply chain and its workings as Patient Choice expands. The research also maps the various aspects of the hospital supply chain as it moves through different operational phases and highlights underlying challenges and complexities. The hospital supply chain, as discussed and mapped in this research, is original work given there are no examples in the literature that provide holistic representations of hospital activity. At the end, specific recommendations are provided that will be of interest to service to managers, researchers, and policymakers

Escrevendo em aulas de Ciências

Neste artigo, apresentamos uma análise dos registros escritos dos alunos do 3° ano do Ensino Fundamental nas aulas de Ciências, em que a professora utilizou as atividades de conhecimento físico, criadas pelo Laboratório de Pesquisa e Ensino de Física da Faculdade de Educação da Universidade de São Paulo. Os registros analisados foram coletados na Escola de Aplicação da Feusp, no ano de 2001, durante o acompanhamento de três aulas de Ciências: o problema do submarino, o problema do barquinho e o problema da pressão. O artigo procura mostrar um panorama de como aparecem os registros realizados pelos alunos, após uma aula de Ciências em que eles são levados a resolver situações problemáticas por meio da experimentação, argumentar e escrever sobre os fenômenos físicos. Durante a análise, levou-se em consideração os tipos de textos que os alunos escrevem, o uso da primeira pessoa, o uso de verbos de ação, o respeito à ordem cronológica dos eventos e quais os tipos de explicações os alunos atribuem aos fenômenos trabalhados

Reflections on using a community-based and multisystem approach to transforming school-based intervention for children with developmental motor disorders

Evidence-based management of Developmental Coordination Disorder (DCD) in school-age children requires putting into practice the best and most current research findings, including evidence that early identification, self-management, prevention of secondary disability, and enhanced participation are the most appropriate foci of school-based occupational therapy. Partnering for Change (P4C) is a new school-based intervention based upon these principles that has been developed and evaluated in Ontario, Canada over an 8-year period. Our experience to date indicates that its implementation in schools is highly complex with involvement of multiple stakeholders across health and education sectors. In this paper, we describe and reflect upon our team’s experience in using community-based participatory action research, knowledge translation, and implementation science to transform evidence-informed practice with children who have DCD

Sulfur degassing at Erta Ale (Ethiopia) and Masaya (Nicaragua) volcanoes: Implications for degassing processes and oxygen fugacities of basaltic systems

We investigate the relationship between sulfur and oxygen fugacity at Erta Ale and Masaya volcanoes. Oxygen fugacity was assessed utilizing Fe3+/∑Fe and major element compositions measured in olivine‐hosted melt inclusions and matrix glasses. Erta Ale melts have Fe3+/∑Fe of 0.15–0.16, reflecting fO2 of ΔQFM 0.0 ± 0.3, which is indistinguishable from fO2 calculated from CO2/CO ratios in high‐temperature gases. Masaya is more oxidized at ΔQFM +1.7 ± 0.4, typical of arc settings. Sulfur isotope compositions of gases and scoria at Erta Ale (δ34Sgas − 0.5‰; δ34Sscoria + 0.9‰) and Masaya (δ34Sgas + 4.8‰; δ34Sscoria + 7.4‰) reflect distinct sulfur sources, as well as isotopic fractionation during degassing (equilibrium and kinetic fractionation effects). Sulfur speciation in melts plays an important role in isotope fractionation during degassing and S6+/∑S is 0.67 in Masaya melt inclusions. No change is observed in Fe3+/∑Fe or S6+/∑S with extent of S degassing at Erta Ale, indicating negligible effect on fO2, and further suggesting that H2S is the dominant gas species exsolved from the S2−‐rich melt (i.e., no redistribution of electrons). High SO2/H2S observed in Erta Ale gas emissions is due to gas re‐equilibration at low pressure and fixed fO2. Sulfur budget considerations indicate that the majority of S injected into the systems is emitted as gas, which is therefore representative of the magmatic S isotope composition. The composition of the Masaya gas plume (+4.8‰) cannot be explained by fractionation effects but rather reflects recycling of high δ34S oxidized sulfur through the subduction zone

Prescription dose evaluation for APBI with noninvasive image-guided breast brachytherapy using equivalent uniform dose

ABSTRACT PURPOSE: Noninvasive image-guided breast brachytherapy (NIBB) is an attractive novel approach to deliver accelerated partial breast irradiation (APBI). Calculations of equivalent uniform dose (EUD) were performed to identify the appropriate APBI dose for this technique. METHODS AND MATERIALS: APBI plans were developed for 15 patients: five with threedimensional conformal APBI (3D-CRT), five with multi-lumen intracavitary balloons (m-IBB), and five simulating NIBB treatment. Prescription doses of 34.0 and 38.5 Gy were delivered in 10 fractions for m-IBB and 3D-CRT, respectively. Prescription doses ranging from 34.0 to 38.5 Gy were considered for NIBB. Dose-volume histogram data from all 3D-CRT, m-IBB, and NIBB plans were used to calculate the biologically effective EUD and corresponding EUD to the PTV_eval using the following equation: ). An a/b value of 4.6 Gy was assumed for breast tumor. EUD for varying NIBB prescription doses were compared with EUD values for the other APBI techniques. RESULTS: Mean PTV_eval volume was largest for 3D-CRT (372.9 cm 3 ) and was similar for NIBB and m-IBB (88.7 and 87.2 cm 3 , respectively). The EUD value obtained by prescribing 38.5 Gy with 3D-CRT APBI was 38.6 Gy. The EUD value of 34.0 Gy prescribed with m-IBB was 34.4 Gy. EUD values for NIBB ranged from 33.9 to 38.2 Gy for prescription doses ranging from 34.0 to 38.5 Gy. CONCLUSIONS: Using EUD calculations to compare APBI techniques and treatment doses, a prescription dose of 36.0 Gy in 10 fractions using NIBB has a comparable biologic equivalent dose to other established brachytherapy techniques.