BPR best practices for the healthcare domain

Healthcare providers are under pressure to work more efficiently and in a more patient-focused way. One possible way to achieve this is to launch Business Process Redesign (BPR) initiatives, which focus on changing the structure of the involved processes and using IT as an enabler for such changes. In this paper, we argue that a list of historically successful improvement tactics, the BPR best practices, are a highly suitable ingredient for such efforts in the healthcare domain. Our assessment is based on the analysis of 14 case studies. The insights obtained by the analysis also led to an extension of the original set of best practices

Dementia and guardianship: challenges in social work practice in a health care setting

This thesis critically examines social work practice in complex and disputed situations where an alternative legal decision-maker is perceived as necessary for a person with dementia. Australia has unique adult guardianship legislation and social workers are actively engaged in the process in a variety of ways, such as weighing the benefits against the possible harm and lodging applications. Yet within the profession this is an area where there is very little research. The purpose of this study is therefore to enable social workers to better understand the dynamics involved in adult guardianship proceedings for a person with dementia and provide knowledge that can be used for more effective practice. The theoretical approach is to use perspectives from social constructionism, with the links which can be made to modernism and postmodernism being taken into account. Five research case studies were investigated drawing from the caseload of social workers in an aged care service at a large metropolitan hospital in Australia. A thematic network analysis of the findings showed that the research case studies are constantly evolving, where different players participate by bringing their own perspectives, and in this process alliances are formed which reflect underlying dynamics of power. There are many diverse and contested issues, such as varied understandings of dementia and capacity and differing constructions of the notions of risk, protection and responsibility. The implications for social work practice are that in a contemporary health and welfare context social work is well placed to make an important contribution through its traditional roles of negotiation, interpretation and mediation between those who have discursive rights and those who do not

An improved vitrification protocol for equine immature oocytes, resulting in a first live foal

Background: The success rate for vitrification of immature equine oocytes is low. Although vitrified-warmed oocytes are able to mature, further embryonic development appears to be compromised. Objectives: The aim of this study was to compare two vitrification protocols, and to examine the effect of the number of layers of cumulus cells surrounding the oocyte during vitrification of immature equine oocytes. Study design: Experimental in vitro and in vivo trials. Methods: Immature equine oocytes were vitrified after a short exposure to high concentrations of cryoprotective agents (CPAs), or a long exposure to lower concentrations of CPAs. In Experiment 1, the maturation of oocytes surrounded by multiple layers of cumulus cells (CC oocytes) and oocytes surrounded by only corona radiata (CR oocytes) was investigated. In Experiment 2, spindle configuration was determined for CR oocytes vitrified using the two vitrification protocols. In Experiment 3, further embryonic development was studied after fertilisation and culture. Embryo transfer was performed in a standard manner. Results: Similar nuclear maturation rates were observed for CR oocytes vitrified using the long exposure and nonvitrified controls. Furthermore, a lower maturation rate was obtained for CC oocytes vitrified with the short exposure compared to control CR oocytes (P = 0.001). Both vitrification protocols resulted in significantly higher rates of aberrant spindle configuration than the control groups (P<0.05). Blastocyst development only occurred in CR oocytes vitrified using the short vitrification protocol, and even though blastocyst rates were significantly lower than in the control group (P<0.001), transfer of five embryos resulted in one healthy foal. Main limitations: The relatively low number of equine oocytes and embryo transfer procedures performed. Conclusions: For vitrification of immature equine oocytes, the use of 1) CR oocytes, 2) a high concentration of CPAs, and 3) a short exposure time may be key factors for maintaining developmental competence

VISUAL PPINOT: A Graphical Notation for Process Performance Indicators

Process performance indicators (PPIs) allow the quantitative evaluation of business processes, providing essential information for decision making. It is common practice today that business processes and PPIs are usually modelled separately using graphical notations for the former and natural language for the latter. This approach makes PPI definitions simple to read and write, but it hinders maintenance consistency between business processes and PPIs. It also requires their manual translation into lower-level implementation languages for their operationalisation, which is a time-consuming, error-prone task because of the ambiguities inherent to natural language definitions. In this article, Visual ppinot, a graphical notation for defining PPIs together with business process models, is presented. Its underlying formal metamodel allows the automated processing of PPIs. Furthermore, it improves current state-of-the-art proposals in terms of expressiveness and in terms of providing an explicit visualisation of the link between PPIs and business processes, which avoids inconsistencies and promotes their co-evolution. The reference implementation, developed as a complete tool suite, has allowed its validation in a multiple-case study, in which five dimensions of Visual ppinot were studied: expressiveness, precision, automation, understandability, and traceability

dierenfaculteit_NR02_2010:Dierenfaculteit

ABSTRACT This paper describes the birth of the first intracytoplasmic sperm injection (ICSI) foal in the Benelux. Oocytes were aspirated from ovaries from slaughtered mares. After in vitro maturation, the oocytes were fertilized by ICSI and cultured in vitro for 9 days. Two embryos reached the blastocyst stage and they were transferred to the uterus of a synchronized mare. Six days later a single embryonic vesicle was diagnosed by ultrasound. After a normal pregnancy a healthy foal was born on the 27 th of October 2009. Parentage testing via microsatellite genotyping confirmed that the foal originated from the transferred embryo

Birth of the first ICSI foal in the Benelux

This paper describes the birth of the first intracytoplasmic sperm injection (ICSI) foal in the Benelux. Oocytes were aspirated from ovaries from slaughtered mares. After in vitro maturation, the oocytes were fertilized by ICSI and cultured in vitro for 9 days. Two embryos reached the blastocyst stage and they were transferred to the uterus of a synchronized mare. Six days later a single embryonic vesicle was diagnosed by ultrasound. After a normal pregnancy a healthy foal was born on the 27(th) of October 2009. Parentage testing via microsatellite genotyping confirmed that the foal originated from the transferred embryo