Developing a Lean Based Model for a Hospital Pharmacy Environment

Lean strategies have become necessary in healthcare due primarily to two factors: a demand for efficiency and a need to reduce medical error. The case for the necessity of a lean program is based on trends of increasing costs and decreasing revenues resulting from government intervention. Profit margin per patient has been reduced, and therefore more patients per time period must be seen in order to meet profitability goals. Preventable medical error is shown to be a leading cause of death. Current research in the area of hospital and healthcare efficiency proves that a parallel exists between healthcare efficiency today and the state of efficiency in manufacturing during the late 70’s and early 80’s. In the 70’s and 80’s, MRP technology came into vogue as a means for attacking complicated problems with expensive, complicated, technology-based solutions. Today, many hospitals hope to solve their efficiency and human error problems by implementing computer based delivery, order-filling, and data systems. Better manufacturers made a move away from complicated solutions, toward lean practices focused on instead of simplifying the problems; healthcare should then do the same. A generic lean methodology geared toward the differing nuances of healthcare is developed. Lean is offered as a solution to both efficiency and medical error (on the basis that visual systems reduce error and that lean reduces stress, a major contributor to human error). A connection between stress and lean has been found by prior research and is taken a step further and connected with human error. This is based on research showing that stress cases the potential for human error in skilled workers to increase by 2-5 times

A Song Cycle on Mortality: Reimagining Four Sonnets of Sor Juana Inés de la Cruz as Four Songs on Life and Death

Sor Juana Inés de la Cruz (1648? – 1695) was revered during her lifetime as a major intellectual force in the Spanish Golden Age. Today Sor Juana remains a central public figure in Mexican culture and is most remembered for the enormous body of poetry she created, notably her sonnets, of which there are over 65. In this paper, the author, after an analysis of the sonnet, and the life of Sor Juana, selects four sonnets written by Sor Juana. The sonnets are discussed, and then set to music composed by the author

Iron speciation in coastal rainwater : oxidation kinetics and organic complexation

The redox kinetics and organic complexation of iron were investigated in rainwater collected from a coastal site in Wilmington, NC between September 2001 and September 2003. A series of authentic rain samples was irradiated with simulated sunlight to photoproduce Fe(II) and the kinetics of its reoxidation back to Fe(III) was monitored. The oxidation of Fe(II) by hydrogen peroxide during dark storage followed second order kinetics with an average rate constant of 0.024mM-1h-1. Using sequential regression analysis the rate loss could be predicted accurately by the following equation (given that H2O2 is in mM and Fe(II) is in nM units): rate loss = -16.6 + 1.1[H2O2] + .28[Fe(II)]. In addition to studying the redox kinetics of photoproduced Fe(II) in rainwater the importance of organic complexation on Fe speciation was also evaluated. After approximately 2 h the concentration of photochemically produced Fe(II) decreased until it reached levels at or near pre-irradiation values. A series of experiments demonstrated that the photochemically produced Fe(II) rapidly returned to initial concentrations, suggesting that essentially all the Fe(II) and most of the Fe(III) in rainwater in the absence of sunlight occurs organically complexed. When rainwater was UV oxidized the Fe(II) concentration declined to much lower concentrations than before irradiation, because the organic Fe(II) complex stabilizing Fe(II) in rainwater was destroyed. A second series of experiments demonstrated that Fe(II) present in authentic rainwater was stabilized for up to four hours once added to seawater. When the rain was UV oxidized prior to addition to seawater, the Fe(II) was oxidized almost immediately in the seawater again, suggesting essentially all the Fe(II) in rain is organically complexed. In summary, the results presented in this study suggests that during the daytime when sunlight is present there is a dynamic interconversion between inorganic Fe(II) and Fe(III) species. Once solar irradiation is removed, there is a organically complexed form of Fe(II) which is stabilized against oxidation. Therefore, the concentrations of Fe(II) and Fe(III) measured in rainwater at any given time depends on the photochemical history of the sample

Metal ion complexing and fluorescence properties of the novel hemicycle, dipyridoacridine, with computational studies on metal ion selectivity

The novel hemicycle dipyridoacridine (DPA) was studied using UV/Vis spectrophotometric and 3D-fluorometric methods. The UV/Vis spectrophotometric methods resulted in a pKa2 for DPA of 4.52 + 0.06, and a pKa1 of 2.22 + 0.03. Formation constants were also found for a series of ten metals, the highest of which were Hg2+ and Sr2+, with log K values of 8.16 + 0.06 and 8.02 + 0.01, respectively. The lanthanides analyzed included La3+, Gd3+, and Lu3+, which had log K values with DPA of 6.43 + 0.04, 6.49 + 0.06, and 6.33 + 0.02, respectively. Other metals analyzed include In3+, Mn2+, and Zn2+, which had log K values with DPA of 7.55 + 0.03, 7.57 + 0.02, 7.69 + 0.12, respectively. Formation constants were also found for Na+ and Ca 2+, which were 1.95 + 0.04 and 5.48 + 0.07, respectively. DPA was found to show enhanced fluorescence with Ca 2+, Na+, and Cd2+, and was found to have quenched fluorescence in the presence of mercury, lead, and zinc. MM+ studies yielded an ideal ionic radius for a metal to complex to DPA of 1.12 Å, and an ideal M-N bond length for DPA complexes of 2.38 Å. This ideal M-N bond length supports the chelate ring size theory prediction of DPA preferring larger metal ions and having a geometrically preferred metalnitrogen bond length of 2.5. This ideal ionic radius of 1.12 Å partly explains the largest log K values with DPA belonging to strontium and mercury, which have respective ionic radii of 1.12 and 1.10. MM+ studies also revealed a linear relationship between ionic radius of a complexed metal and the steric energy for the transfer of a metal ion from a 5-membered ring to a 6- membered ring. Further computational studies using DFT revealed a correlation between higher log K values for F- with more negative calculated Gibb’s free energies for a theoretical reaction involving the transfer of an F- to a metal ion

USING AUDIENCE-CENTRIC DESIGN AND COMMUNITY FEEDBACK TO MANAGE COMPLEX PRIVACY SETTINGS

Today, technology is enabling people to share information on an unprecedented scale. Although much of this information is intended to be shared with a large group of people or even the public, some disclosure is intended for smaller audiences—a subset of a larger group. People may want to limit information visibility because the information is private or sensitive, or they may feel others would not be interested in the content. When people want to selectively share to different audiences, many technologies fail to provide usable mechanisms to manage these more complex sharing situations. In many cases, people lack understanding about which audiences are able to see what items of information. Additionally, the effort to manage audiences and control access to information adds some extra physical and cognitive burden. This research suggests two methods to help people better understand and control sharing. The first examines audience-centric design: using mechanisms that integrate with the primary task and allow sharing to multiple audiences to improve understanding of how information flows to multiple groups of people. The second method examines using community feedback to enhance privacy/sharing default settings thereby lessening the user’s configuration burden. This knowledge contributes to existing research by understanding the extent of how users share information to multiple audiences and react to community feedback mechanisms designed to ease configuration burden

Police Technology: An Investigation into the Benefits for Law Enforcement

The police must perform their duties every hour of each day during the year. While they have been able to complete their responsibilities in the past, they have become more efficient due to technological advancements. Such technological advancements as fingerprinting, the 911 system, or vehicle location systems have revolutionized policing in the modern era. Other forms of technology have been a benefit to police as this paper will prove

GrowingChange: Media Products as Therapy for Adjudicated Youth

GrowingChange is a grassroots organization dedicated to improving the futures of teenage males in the juvenile justice system. The group is working to reclaim an abandoned prison in Wagram, North Carolina in order to convert it into a sustainable farm and agricultural center for the local community. If successful, GrowingChange hopes to institute a national model for converting closed prison sites into community centers across the country. Youth involved in the program undergo unique forms of therapy to reset their paths toward more promising futures. A core therapeutic component of GrowingChange is teaching youth in the program about ways to provide food and food-related products to impoverished populations in surrounding communities. As the fledgling organization grows, its founder, Noran Sanford, has discovered that promotional media endeavors provide additional therapeutic benefits for the adjudicated youth of GrowingChange

Standardized distraction : why the emphasis on high-stakes testing can't resolve educational inequality

Standardized testing has exploded into nearly every grade level and subject area in public education over the past two decades. Attaching high stakes to standardized test results was intended to improve education for all students, but especially for those who belong to consistently low-performing groups. Theory and experience, however, show that privileged groups maintain their advantages even in the face of education reforms. Tracking practices in particular have the potential to worsen the inequalities associated with high-stakes testing. This study uses a unique longitudinal dataset to observe the existence, growth, and harm of achievement gaps through high-stakes testing in North Carolina. The study demonstrates that high-stakes standardized tests predict college performance for students whose high school experiences were in in the top academic tracks, but not for students in lower academic tracks. Findings suggest that standardized test scores of lower track students reflect less learning of the kinds of substance and higher order thinking skills needed to excel in college

Three essays in market efficiency : an examination of market reaction to information

The efficient market hypothesis (EMH) examines how quickly and accurately information is reflected in a security price, and as a result, it has become one of the primary areas of focus in financial literature. I explore three problems regarding the release of information and the impact it has on price. First, I show that securities? prices are influenced by the introduction of other securities. The offering of betting lines does influence the accuracy of pricing; however, the unbiasedness seems unaffected. Additionally, I find evidence of the linear relationship between the money line and sides line, similar to the security market line, ends up breaking down as a result of the bookmaker offering a higher payout in the money line to the favorite team in order to entice bettors. Next, I examine if winning or losing influences sports clubs? financial performance. While there is literature, with mixed results, that examine the market reaction to winning and losing for publicly-traded clubs, the question; does winning influence the clubs? financial performance has been sidestepped. Results from English soccer clubs suggest that match performance does impact a club?s operating income, but the impact differs for “elite” and “non-elite” clubs. Lastly, utilizing English soccer club data again, I reexamine market reaction to good and bad news by looking at matches where both clubs were publicly-traded – seeing the market?s reaction to the win and the loss simultaneously. While my results contradict previous literature, that the market reacts to good news faster, this is because I find that losing is a stronger signal