System-wide Perspective Research Articles

Two-Year Outcomes of Treatment for Methamphetamine Use

While evaluation research supports the general effectiveness of substance abuse treatment, there is not a comprehensive literature on treatment effectiveness for methamphetamine (MA) use. The authors consider three outcome measures—MA use, criminal activity, and employment—compared across three periods: 24-months pretreatment, during treatment, and 24-months post-treatment. Data are from an intensive natural history interview conducted two to three years after treatment for 349 randomly selected admissions to treatment for MA abuse in a large publicly-funded county treatment system. Through this naturalistic design, data provide a system-wide perspective on effectiveness of treatment as usual. Results showed reduction in MA use and crime during and following treatment and increased employment following treatment over pretreatment levels. Regression analyses showed higher levels of education and more time in treatment related to more positive post-treatment outcomes for all three measures. Lower percentage of post-treatment months with MA use also was related to more pretreatment MA-related problems, lower pretreatment MA use, and residential (compared to outpatient) treatment modality. Lower post-treatment criminal activity was also related to gender (being female), lower pretreatment criminal activity, and residential modality. Higher percentage of post-treatment months with employment also was related to gender (being male), ethnicity (not African-American), and higher pretreatment employment.

Influence of metabolic network structure and function on enzyme evolution

An analysis of evolutionary constraints, gene duplication and essentiability in the yeast metabolic network demonstrates that the structure and function of a metabolic network shapes the evolution of its enzymes.

Contemplating the Assessment of Great River Ecosystems

The science and practice of assessing the status and trends of ecological conditions in great rivers have not kept pace with perturbation wrought on these systems. Participants at a symposium sponsored by the U.S. Environmental Protection Agency (USEPA) and the Council of State Governments concluded that useful and efficient assessments of great river ecosystems require thoughtful alignment of sampling designs, spatial and temporal scales, indicators, management needs, and ecosystem characteristics. Site-specific physical, chemical, and biological data long accumulated by monitoring programs have value but fail to provide the integrated system-wide perspective required for adaptive management and the Clean Water Act. Use of existing data may be limited by methodological incompatibilities, access difficulties, and the exclusive applicability of data to specific habitats or sites. The transition from site-specific to system-wide assessments benefits from research being done by USEPA's Environmental Monitoring and Assessment Program (EMAP) and other programs that use probability surveys and biological indicators. Indicators of various taxa (in particular fish, algae, and benthic invertebrates) have been successfully developed for great rivers. However, optimizing the information these ecological indicators convey to managers and the public is the subject of ongoing research.

The role of social and intellectual capital in achieving competitive advantage through enterprise resource planning (ERP) systems

Abstract Enterprise resource planning (ERP) software merges a firm's data, information flows and business processes into a single package. Vendors argue that ERP provides an extremely useful strategic resource to enhance competitiveness and make it possible for a firm to leverage its other resources more effectively and efficiently. In addition, they allege that ERP encourages a system-wide perspective that is a basis for collaboration and a systems orientation. However, an examination of ERP systems using criteria established in research on resource-based views of the firm and chaos/complexity theory indicates that these claims are overstated. Observation suggests that even if ERP is necessary to coordinate complicated, multifaceted operations, it is far from sufficient to promote a strong competitive position over the long term. Moreover, ERP systems fit best within mechanistic, clockwork organizations dominated by routine, highly programmed technologies and operations, yet it is the non-routine learning and change processes found in complex, self-organizing systems that enable firms to create distinctive competitive advantages from ERP outputs. ERP makes possible deep changes in relationships, culture, and behaviors that can be crucial sources of advantage in the knowledge economy, but the structures and cultures most able to achieve this level of change are a poor fit with ERP requirements. To reconcile this paradox, we propose a dual-core, loosely coupled organization that views ERP as an enabling technology to build and augment social and intellectual capital, rather than as an information technology (IT) solution for organizational inefficiencies. Propositions for using ERP as a foundation for social and intellectual capital formation are introduced. Implications for research and practice are discussed.

Using Online Analytical Processing to Manage Emergency Department Operations

The emergency department (ED) is a unique setting in which to explore and evaluate the utility of information technology to improve health care operations. A potentially useful software tool in managing this complex environment is online analytical processing (OLAP). An OLAP system has the ability to provide managers, providers, and researchers with the necessary information to make decisions quickly and effectively by allowing them to examine patterns and trends in operations and patient flow. OLAP software quickly summarizes and processes data acquired from a variety of data sources, including computerized ED tracking systems. It allows the user to form a comprehensive picture of the ED from both system-wide and patient-specific perspectives and to interactively view the data using an approach that meets his or her needs. This article describes OLAP software tools and provides examples of potential OLAP applications for care improvement projects, primarily from the perspective of the ED. While OLAP is clearly a helpful tool in the ED, it is far more useful when integrated into the larger continuum of health information systems across a hospital or health care delivery system.

Accountability and health systems: toward conceptual clarity and policy relevance.

Improved accountability is often called for as an element in improving health system performance. At first glance, the notion of better accountability seems straightforward, but it contains a high degree of complexity. If accountability is to be more than an empty buzzword, conceptual and analytical clarity is required. This article elaborates a definition of accountability in terms of answerability and sanctions, and distinguishes three types of accountability: financial, performance and political/democratic. An analytic framework for mapping accountability is proposed that identifies linkages among health sector actors and assesses capacity to demand and supply information and exercise oversight and sanctions. The article describes three accountability purposes: reducing abuse, assuring compliance with procedures and standards, and improving performance/learning. Using an accountability lens can: (1) help to generate a system-wide perspective on health sector reform, (2) identify connections among individual improvement interventions, and (3) reveal gaps requiring policy attention. These results can enhance system performance, improve service delivery and contribute to sound policymaking.

Adaptive job routing and scheduling

Computer systems are rapidly becoming so complex that maintaining them with human support staffs will be prohibitively expensive and inefficient. In response, visionaries have begun proposing that computer systems be imbued with the ability to configure themselves, diagnose failures, and ultimately repair themselves in response to these failures. However, despite convincing arguments that such a shift would be desirable, as of yet there has been little concrete progress made towards this goal. These challenges are naturally suited to machine learning methods. Hence, this article presents a new network simulator designed to study the application of machine learning methods from a system-wide perspective. Also, learning-based methods for addressing the problems of job routing and CPU scheduling in the simulated networks are introduced. Experimental results verify that methods using machine learning outperform reasonable heuristic and hand-coded approaches on example networks designed to capture many of the complexities that exist in real systems.

Framing a demand network for sustainability

The embeddedness of companies in their micro and macro environments, their interconnectedness in supply chains and with their stakeholders, makes it impossible for them to develop sustainable strategies in isolation from other actors, the basic motivation for such systemwide perspectives as those in industrial ecology. At the same time, the boundaries of these systems remain unclear. This paper aims to increase the understanding of the relative importance and the interrelations between different actors regarding corporate sustainability, corporate social responsibility, and industrial ecology. The framework of demand networks is conceptualised and proposed as a tool for identifying relevant actors for developing sustainable corporate strategies.

Southeast Asia’s social security systems: Need for a system–wide perspective and professionalism

This paper provides an assessment of the social security arrangements in Southeast Asian countries, and suggests broad directions for reform. Noting the absence of functioning multitier social security systems in these countries, the analysis highlights wide variations in various characteristics of systems in Southeast Asia. The paper underscores the need to enhance professionalism in the performance of core functions of the provident and pension fund organizations in these countries; and to take a system–wide perspective. It recommends constituting a Provident and Pension Fund Authority (PPFA) in each of the Southeast Asian countries to undertake the above tasks.

Engineering curriculum versus industry needs-a case study

This article addresses the relations between the needs of industry and the curriculum for "communications systems" engineers. In a study described in the article, a survey to identify skills and knowledge to be acquired by communication engineering undergraduates has been carried out. Analysis of the findings shows that the field requires a system-wide perspective ("engineering systems thinking" capability), acquisition of basic project-management tools, familiarity with total quality management (TQM) issues, wider use of simulations and analyzes, learning of basic common standards of international standardization organizations and incorporation of advanced communications issues such as ATM and ISDN in the curriculum of undergraduate studies.

Not-So-New Public Management and the Denial of Geography: Ontario Health-Care Reform in the 1990s

New public management (NPM) has become the mantra for public sector restructuring in OECD nations. We critically examine NPM in the context of recent public sector restructuring initiatives in the province of Ontario, Canada. Two NPM-inspired reform mechanisms employed by the Ontario government—the benchmarking of hospital-utilization indicators and the offloading of a greater share of patient-care responsibilities to the private sector—are examined as they impact on the economically disadvantaged city of Thunder Bay in the province's remote Northwestern region. We argue that the health reforms pursued by the Ontario government are focused on a one-dimensional notion of efficiency which denies important socioeconomic and health-service-environment dimensions that account for local differences in health-services utilization. Although this type of reform approach achieves short-term cost savings, we question whether the longer term effects on health and social services are efficient and equitable from a systemwide perspective. Ultimately, we question whether NPM will solve the problems inherent in publicly supported health and social services or will generate a new set of problems linked to the belief in the primacy of market mechanisms.

Life‐Cycle Assessment: Constraints on Moving from Inventory to Impact Assessment

SummaryLife‐cycle assessment (LCA) is a technique for systematically analyzing a product from cradle‐to‐grave, that is, from resource extraction through manufacture and use to disposal. LCA is a mixed or hybrid analytical system. An inventory phase analyzes system inputs of energy and materials along with outputs of emissions and wastes throughout life cycle, usually as quantitative mass loadings. An impact assessment phase then examines these loadings in light of potential environmental issues using a mixed spectrum of qualitative and quantitative methods. The constraints imposed by inventory's loss of spatial, temporal, dose‐response, and threshold information raise concerns about the accuracy of impact assessment. The degree of constraint varies widely according to the environmental issue in question and models used to extrapolate the inventory data. LCA results may have limited value in two areas: (I) local and/ortransient biophysical processes and (2) issues involving biological parameters, such as biodiversity, habitat alteration, and toxicity. The end result is that impact assessment does not measure actual effects or impacts, nor does it calculate the likelihood of an effect or risk Rather, LCA impact assessment results are largely directional environmental indicaton. The accuracy and usefulness of indicators need to be assessed individually and in a circumstance‐specific manner prior to decision making. This limits LCAs usefulness as the sole basis for comprehensive assessments and the comparisons of alternatives. In conclusion, LCA may identify potential issues from a systemwide perspective, but more‐focused assessments using other analytical techniques are often necessary to resolve the issues.

THE DEVELOPMENT AND IMPLEMENTATION OF NOISE CONTROL MEASURES ON AN URBAN RAILWAY

This paper describes the development and implementation of noise control measures by Docklands Light Railway (DLR), London, to meet obligations set out in its Noise and Vibration Policy, adherence to which is set by an Act of the U. K. Parliament. Noise levels from the operational railway exceeded targets given in the policy at two noise-sensitive urban residential sites. Following diagnosis by noise survey of the problems specific to each site and by noise reduction predictions, acoustic absorbent screens were installed which, it was subsequently demonstrated, succeeded in providing the required level of noise reduction. These schemes needed to accommodate the requirements of the railway for maintenance (leading to the barriers having to be fully demountable), safe trackside walking routes and easy passenger evacuation from trains. During construction, liaison was developed with the local authority for the control of environmental pollution (primarily noise) and hours of working (which had to suit railway possessions) and good relations were fostered with local residents through regular contact. Fulfilment of project objectives was demonstrated by a programme of post-installation noise measurements. The paper concludes with an evaluation of noise mitigation performance achieved together with a suggested alternative strategy for addressing the noise problem from a system-wide perspective.

Integrating program review in planning and budgeting: A systemwide perspective

AbstractThe University of Maryland System designed a data‐driven program review process to reallocate resources systemwide.

Hardware Measurement Techniques for High-Speed Networks

The utilization of the inherent bandwidth in high-speed networks is often obstructed by the implementation of the protocols. NIST and ARPA developed VLSI measurement components that permit researchers and product developers to better understand computing and communication bottlenecks by accurate measurement techniques. To illustrate and promote the use of such public domain components, this paper uses image transfer as an example application via a commercial UNIX (UNIX is a trademark of X/Open) (BSD 4.3.1 variant) implementation of the TCP/IP protocol over an Ethernet (10 Mbits/s), and a HIPPI (800 Mbits/s) medium. The only modification done to this commercially available kernel was to add the simple probe code necessary to interface to the NIST MultiKron (MultiKron is a registered trademark of NIST) measurement chip. The accurate data obtained for the various aspects of this protocol implementation clearly illustrate the major bottlenecks, provide insight with regard to scaling, and determine upper bounds on performance. This paper does not, however, attempt to draw any conclusions with regard to the abstract TCP/IP protocol itself or the generic services of the UNIX operating system, rather it provides a system-wide perspective on how a wide range of design options and implementation parameters impact the effective throughput to the application.

Health Maintenance Organizations: Good or Bad for Canada?

Health Maintenance Organizations (HMOs) as an organizational form have a number of features potentially attractive in Canada as elsewhere. Because HMOs integrate financing and delivery, they offer the potential to strengthen incentives for efficiency, encourage prevention and patient- centred clinical management, and develop a system-wide perspective con- ducive to innovation and the reallocation of resources to address most ef- fectively the health needs of a population. On the other hand, HMOs were developed in the United States, which has a considerably different health care environment and financing system from Canada's. While these differ- ences probably do not detract from the potential benefits to Canada of the HMO organizational form, they create considerable difficulties in determin- ing how HMOs could best be introduced in Canada, where pluralism, entrepreneurship, and competition play substantially less central roles in a health care system which, while under challenge and stress, is perceived to per- form generally well with widespread support.

Modeling U.S. Budgetary and Fiscal Policy Outcomes: A Disaggregated, Systemwide Perspective

This paper develops and estimates a model of U.S. federal budgetary outcomes that allows for considerable disaggregation across spending categories while providing, through cross-equation coefficient restrictions, substantially more statistical power than traditional approaches. We identify significant top-down fiscal policy effects on budgetary allocations primarily within the defense budget. Budgetary responses to macroeconomic conditions are generally countercyclical, although middle-class entitlements appear to react procyclically to inflation. Political control of Congress influences budgetary outcomes, with Democrats giving higher priority to domestic spending programs. The relative rate of public sector inflation affects spending growth, consistent with Baumol's disease. Public opinion affects defense and low-income entitlement spending. Defense spending has also been influenced by perceived Soviet threat as well as the level of armed conflict. There appear to be small election-year effects, although not of the sort predicted by political business cycle models. With a few exceptions, administration-specific impacts are relatively small and not systematically related to the party of the president.