Adoption Of Improvements Research Articles

Avaliação da eficiência do tratamento de lixiviado de um aterro sanitário

O lixiviado é um líquido altamente contaminante, gerado nos aterros sanitários, é um dos principais desafios ambientais, especialmente no que se refere ao seu tratamento, visto que sua composição variada dificulta a escolha de um tratamento continuamente eficiente. Sem o tratamento adequado, este pode ocasionar contaminação do solo e dos recursos hídricos superficiais e subterrâneos. Neste contexto, o presente trabalho realizou uma análise da eficiência do tratamento do lixiviado gerado no aterro sanitário da cidade de Maceió-AL, verificando o seu comportamento ao longo dos anos de operação, além de possíveis intercorrências em seu tratamento. As informações foram obtidas através de visitas in loco, bem como por meio de dados secundários disponibilizados pela Superintendência de Limpeza Urbana de Maceió (SLUM). Quanto ao tratamento do lixiviado gerado no aterro sanitário de Maceió, constatou-se muitas variações nas eficiências obtidas durante os períodos, o que demonstra a complexidade no tratamento do lixiviado, especialmente em um aterro em operação, necessitando da adoção de melhorias ao longo do tempo, a fim de obter melhores resultados. Os processos biológicos e de coagulação, floculação e decantação, proporcionaram melhor desempenho no tratamento do lixiviado, obtendo eficiência global média de 98,79%, 95,45% e 93,42% na remoção de demanda bioquímica de oxigênio (DBO), demanda química de Oxigênio (DQO) e Nitrogênio Amoniacal, respectivamente.

Procedural Economy at the International Court of Justice

Abstract In April 2016, the International Court of Justice held a colloquium to commemorate the 70th anniversary of its establishment. One of the principal themes of this event was the potential adoption of improvements to the procedures and working practices of the Court. Responses to a Counsel Survey revealed a general interest in procedural reform at the Court, particularly with respect to the areas of evidence and procedural efficiency. The purpose of this article is to set out a case for procedural reform at the ICJ, presenting multiple options, with supplementary reference to the ITLOS. Whereas the work of the Committee also addresses procedural integrity or “the sound administration of justice”, this contribution will focus upon the Court’s case management procedures to call for their reform in order to enhance procedural economy. This would enable the Court to improve its “throughput” to be able to cope with an expanded caseload.

Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients.

Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality.

Disruptive Innovation on Two Wheels: Chinese Urban Transportation and Electrification of the Humble Bike

This communication argues that the electrification of the conventional bicycle could perhaps be a solution to the issues surrounding urban transportation in emerging economies. As illustrated through the trajectory of E-Bike development and adoption in China, such innovations can be disruptive when implemented in untapped mass markets of the developing world. A historical as well as prospective lens was adopted to describe the socio-economic significance of E-bike expansion in China. Further, by simultaneously considering the current Chinese urban transport mix, the primary energy use in transport as well as projections of future E-Bikes sales, it is also asserted that that, although the E-Bike is not an entirely sustainable solution to urban transport; it however is a solution that has the potential to achieve high sustainability. The realization of any environmental co-benefits due to the adoption of the E-Bike hinges primarily upon the adoption of improvements in other sectors of the economy (electricity generation). Indeed, the E-Bike does exemplify that grass-root, inexpensive and sustainable solutions to our urban transportation problems do exist.

Assessing the Impact of Policy-Oriented Research: The Case of CIFOR’s Influence on the Indonesian Pulp and Paper Sector

Summary Qualitative and quantitative methods are applied to assess the impact of CIFOR’s political economy research on the Indonesian pulp and paper sector. Key-informant interviews triangulated by trend-series tests suggest important influence through advocacy intermediaries and counterfactuals of slower adoption of improvements. Effects on conservation set-asides, overcapacity, and plantation establishment are estimated to avert loss of 76,000–212,000 hectares of natural forest (135,000 under main assumptions). Application of an economic-surplus framework for environmental benefits of forest conservation and avoided implicit wood subsidies finds benefits of US$19 to US$583 million (US$133 million main estimate), compared with US$500,000 of direct research costs.

Does Comparative-Effectiveness Research Threaten Personalized Medicine?

Concerns have been raised that comparative-effectiveness research (CER) will not take adequate account of individual patient differences and may impede the development and adoption of improvements in medical care. Drs. Alan Garber and Sean Tunis argue that CER offers a way to hasten the discovery of the best approaches to personalization.

Different Paths to High-Quality Care: Three Archetypes of Top-Performing Practice Sites

Primary care practices use different approaches in their quest for high-quality care. Previous work in the Practice Partner Research Network (PPRNet) found that improved outcomes are associated with strategies to prioritize performance, involve staff, redesign elements of the delivery system, make patients active partners in guideline adherence, and use tools embedded in the electronic medical record. The aim of this study was to examine variations in the adoption of improvements among sites achieving the best outcomes. This study used an observational case study design. A practice-level measure of adherence to clinical guidelines was used to identify the highest performing practices in a network of internal and family medicine practices participating in a national demonstration project. We analyzed qualitative and quantitative information derived from project documents, field notes, and evaluation questionnaires to develop and compare case studies. Nine cases are described. All use many of the same improvement strategies. Differences in the way improvements are organized define 3 distinct archetypes: the Technophiles, the Motivated Team, and the Care Enterprise. There is no single approach that explains the superior performance of high-performing practices, though each has adopted variations of PPRNet's improvement model. Practices will vary in their path to high-quality care. The archetypes could prove to be a useful guide to other practices selecting an overall quality improvement approach.

Unifying Planning and Management in Public Organizations

Better planning procedures applied to both program and human resource management is key to improving productivity in public organizations. As the cornerstone of the management process, planning establishes the direction, limits, and outcomes to be achieved; it provides the road map for the orderly management of transition. But sometimes planning processes have been confusing and unproductive exercises for line management because the process has been cumbersome, the key issues have not been addressed, or there has been insufficient commitment to ensure implementation. These problems are result of expansionism in the public sector during the past three decades. A growing economy has supported swelling of all levels of government. But as governmental operations have become larger and more complex, approaches to planning have often become unwieldy. This period of expansionism has ended. For only the fourth time since 1919 and the first time since the late 1940s, there is decline in public employment. Reestablishing economic strength, reducing inflation, and restoring confidence in fiscal policies are squeezing government agencies from every direction. Decreased tax revenues, reduced outside assistance, inflationary erosion of the buying power of public funds, and increased demands for public services form the environment within which public agency planning must prove its value. Budget cuts at all levels of government have forced the issue of more with less, and in some cases of doing a little less with lot less. Meeting these demands for increased productivity will be impossible without the adoption of improvements in program planning and human resource management. Improving program management through better planning is necessity for better productivity; applying good planning practices to managing human resources is another. Decreases in productivity in manufacturing during the past several years have become national issue. Whether productivity has had corresponding decrease in public agencies is unknown because information systems on the subject are inadequate. But whether productivity has declined or not, it is clear an increase in return on tax dollars spent is necessity. Although substantial tax funds are spent to construct office buildings, buy equipment, build jails and penitentiaries, and provide welfare payments to the needy, the bulk of the appropriations are for the salaries of the employees. These employees-the human resources providing the public services so much in demand-often represent 70 percent to 80 percent of an organization's budget. Attempts to improve productivity are usually linked to technological advancements, but it seems evi-

Research Items

Food Supply of India.—In the presidential address delivered to the agricultural section at the seventeenth meeting of the Indian Science Congress at Allahabad (Calcutta: Asiatic Society of Bengal), G. Clarke discussed the necessity of increasing the food supply to meet the needs of the growing population in India. From a consideration of the agricultural returns for 1922–23 and 1925–26, it is evident that the area available for food production in India is 1.2 acres per unit population, whereas in America and France, countries comparable with India as regards the importance of agriculture, the corresponding figures are 2.6 and 2.3 respectively. The amount of new land in India suitable for cultivation is no longer sufficient to provide the increased area required, so that the solution of the problem lies in increasing the yield of the land already in use. Weather conditions and the shortness of the growing season are the chief difficulties confronting the agriculturist, but the use of modern methods of research, and in particular a closer study of the critical periods of crops, that is, those intervals during which the plant shows maximum sensibility to external factors such as moisture or nitrogen supplies, should do much towards the attainment of better results. Further, green manuring is particularly advocated as an economical means for soil improvement and the maintenance of an adequate nitrogen supply. From a comparison of conditions in other countries and analogy with the progress of the sugarcane industry in India, it is possible to obtain a rough estimate of the increased production likely to follow the application of scientific methods to agriculture. After making due allowance for the inevitable lag in the adoption of improvements, and taking into consideration the abundant labour resources and responsive nature of the soil in India, it is thought that within the next two or three decades an increased output of 30 per cent in normal seasons may reasonably be expected. Increased expenditure on scientific research is, however, assumed.