Preset Targets Research Articles

Structural Equation Model of Trust and Partnering Success

The establishment of trust has been identified as the most critical factor that facilitates partnering success. As such, management should direct their efforts and energy to enhance trust effectively and systematically. It is hypothesized that partners’ trust level is positively related to their performance, permeability, and relational bonding and can be system based. This paper reports the use of the structural equation modeling technique to test this hypothesis. Project-based data on partnering success and the relative importance of the four trust factors were collected through a questionnaire survey, and the level of partnering success was assessed by the achievement of the preset project targets. The findings of the study support the hypothesized positive relationship between the partners’ trust level and partnering success. In addition, performance, permeability, and relational bonding were found to make significant contributions toward parties’ trust level.

Real-time control of pig growth through an integrated management system (IMS)

Integrated management systems (IMS) for pigs offer the prospects of optimising meat production and minimising nitrogenous pollution through closed-loop control of pig growth by nutritional control (Whittemore, et al., 2001). Such an IMS requires a real-time sensor system, a nutritional model which is optimised in response to data collected in by the sensor system, and a control system which uses forward predictions of the model to predict the nutritional regime required to satisfy growth and pollution targets. An experiment was carried out to determine the accuracy to which a novel IMS system can direct pig weight gain and fatness towards preset targets through nutritional control.

Bispectral index, serum drug concentrations and emergence associated with individually adjusted target-controlled infusions of remifentanil and propofol for laparoscopic surgery

Target-controlled infusions (TCI) are used to simplify administration and increase precision of i.v. drugs during general anaesthesia. However, there is a limited relationship between preset targets and measured concentrations of drugs and between measured concentrations and measures of brain function, such as the bispectral index (BIS). We set out to evaluate the performance of TCI devices for propofol (Diprifusor) and remifentanil (Remifusor, prototype), during laparoscopic cholecystectomy in 21 patients. We also checked if there was any correlation between serum concentrations of propofol and BIS during individually adjusted anaesthesia. The Diprifusor and Remifusor had a median absolute performance error of 60% and 25% respectively. Propofol concentrations were underpredicted by a median of 60%, and remifentanil concentrations were slightly overpredicted by a median of 7%. When anaesthesia was adjusted to keep BIS values between 45 and 60, no correlation existed between measured concentrations of propofol and the corresponding BIS values, although both BIS and serum propofol concentration discriminated well between the awake and asleep states. Emergence was rapid and uneventful in all patients. Female patients had a more rapid emergence than male patients (6.6 and 11.6 min respectively). TCI devices for remifentanil and propofol result in large variation in measured serum concentrations. The lack of correlation between BIS and serum concentrations of propofol adds to the debate about whether BIS measures hypnosis as a graded state during surgery. This study confirms that women wake up faster than men, but provides no explanation for this repeatedly shown difference.

The impact of financial incentives and a patient registry on preventive care quality: increasing provider adherence to evidence-based smoking cessation practice guidelines

Background This study tested the effects of two organizational support processes, the provision of financial incentives for superior clinical performance and the availability of a patient (smoker) registry and proactive telephone support system for smoking cessation, on provider adherence to accepted practice guidelines and associated patient outcomes. Methods Forty clinics of a large multispecialty medical group practice providing primary care services were randomly allocated to study conditions. Fifteen clinics each were assigned to the experimental conditions “control” (distribution of printed versions of smoking cessation guidelines) and “incentive” (financial incentive pay-out for reaching preset clinical performance targets). Ten clinics were randomized to receive financial incentives combined with access to a centralized patient registry and intervention system (″registry″). Main outcome measures were adherence to smoking cessation clinical practice guidelines and patients’ smoking cessation behaviors. Results Patients’ tobacco use status was statistically significant ( P < 0.01) more frequently identified in clinics with the opportunity for incentives and access to a registry than in clinics in the control condition. Patients visiting registry clinics accessed counseling programs statistically significantly more often ( P < 0.001) than patients receiving care in the control condition. Other endpoints did not statistically significantly differ between the experimental conditions. Conclusions The impact of financial incentives and a patient registry/intervention system in improving smoking cessation clinical practices and patient behaviors was mixed. Additional research is needed to identify conditions under which such organizational support processes result in significant health care quality improvement and warrant the investment.

Monitoring performance of road safety programmes in New Zealand

While the number of crashes during a certain time period such as a week, month or a year indicates the level of risk on the road, it may fluctuate without any change in the actual underlying risk. If the number of crashes increases or decreases during a period of time, it indicates one of two possibilities: (1) the probability of a crash during the period has changed, or (2) the difference is due to the stochastic nature of the event, i.e. it is due to a random fluctuation. A control chart system is developed in the paper to identify the occurrence of actual risk changes or deviation from the expected level and likelihood of meeting the target. The paper discusses the development of control charts to monitor fatalities at the national level, which can also be used at regional levels, with respect to the pre-set targets. In a traditional control chart, the production process is composed of identifiable and controllable inputs. The levels of the inputs can be designed before production. In the case of road safety, it is not feasible to do so. Here the nature and quality of the input ‘controls’ are such that they may influence the safety outcomes indirectly. Estimates of variability used in the analysis must take account of this peculiarity. The attainability of a target, to be achieved within a given period, depends not only on future safety outcomes but also on outcomes in the past. A cumulative control chart has been developed in this paper to particularly facilitate the monitoring of targets.

Efficient Water Pricing Policies as an Appropriate Municipal Revenue Source

Marginal-cost pricing of municipal water in water-scarce regions is both an efficient way to achieve conservation goals and an efficient revenue source for municipalities. Nevertheless, marginal-cost water pricing is quite unusual and often prohibited, probably because water revenues are perceived to have an unfairly regressive incidence. To examine the validity of this perception, Census data from San Antonio, Texas, is used to estimate the income elasticity of demand for water there. This result and similar estimates elsewhere suggest that the regressivity of water revenues compares favorably with published regressivity estimates for traditional municipal revenue sources. Moreover, a form of two-part water pricing is shown capable of increasing progressivity without inefficiency. Revenue under this pricing regime is flexible, which allows authorities to meet a range of preset revenue targets, trading off neither efficiency nor fairness.

Reengineering of Small and Medium-Sized Ship Production Facilities: An Example for Turkish Shipbuilding Industry

This paper represents a summary of the studies conducted for the development, design and evaluation of several Turkish shipyards' expansion programs. In each case, depending on the availability of usable area, existing equipment, machinery and investment limits, different considerations and scenarios needed to be generated. During the study, definition of the scope of work and the terms of preference, perceived ship construction logic and capacity requirements are presented and discussed, leading to the selection of the overall layout amongst various alternatives. During the plant design and evaluation of selected equipment within the pre-set production targets, various industrial engineering techniques have been extensively used. Among the most important of these are the specific studies for line balancing of block production, and simulation of new steel fabrication plant. The semi-automated flow type module construction plant was developed for maximizing the throughput and work efficiency in a controlled environment. This study indicates that, under proper operation conditions, it is possible to convert an existing shipyard into a third-generation shipyard by a careful application of modern computational tools and through the adoption of an innovative approach.

Self-organising neural networks for adaptive control

Self-organizing neural networks have been implemented in a wide range of application areas such as speech processing, image processing, optimization and robotics. Recent variations to the basic model proposed by the authors enable it to order state space using a subset of the input vector and to apply a local adaptation procedure that does not rely on a predefined test duration limit. Both these variations have been incorporated into a new feature map architecture that forms an integral part of an Hybrid Learning System (HLS) based on a genetic-based classifier system. Problems are represented within HLS as objects characterized by environmental features. Objects controlled by the system have preset targets set against a subset of their features. The system's objective is to achieve these targets by evolving a behavioural repertoire that efficiently explores and exploits the problem environment. Feature maps encode two types of knowledge within HLS — long-term memory traces of useful regularities within the environment and the classifier performance data calibrated against an object's feature states and targets. Self-organization of these networks constitutes non-genetic-based (experience-driven) learning within HLS.

Quality assurance in preschool surveillance.

A quality assurance programme was used to evaluate community and primary care based preschool surveillance using the National Child Health Computer System in 40 examination centres. Quarterly reports were generated from returns from clinical medical officers and general practitioners to list non-attenders, uptake, and timeliness for the four preschool checks. These provided rapid and comparative feedback on personal performance for participating health professionals and led to marked rises in recorded timeliness and uptake against preset targets. Pre-existing uptake was highest at the 6 week check with least overall improvement. Greatest improvements occurred at the 18 month health visitor check but, in general, results plateaued when the programme had been in use for 12 to 18 months. Particular problems such as data legibility and mobile populations were identified and solutions formulated. It is postulated that improvements in performance were due to enhanced professional motivation as no other factors changed. This system provides a valuable contribution in the light of changing patterns of service provision.