Purpose: The Purpose of this research was to design, implement and evaluate a patient centered asthma intervention pilot program directed by physicians and administered by community pharmacists to a group of Managed Care contracted Oregon Health Plan asthmatics. The evaluation was to determine if the proposed intervention could improve the enrolled asthma patient's related education and quality of life while simultaneously creating economic benefit for the sponsoring health plan. Methods: The study was designed to be a prospective, six month pre and posttest quasi-experimental evaluation combined with a Solomon-like two-control group comparison. All patients in the sponsoring health plan twelve years of age and older who had six months of continuous enrollment were eligible. Enrollment of the target patients was voluntary and the time period of the evaluation (November, 1997 to May, 1998) was purposely conducted to capture the notoriously difficult asthma trigger cold and allergy seasons. Information regarding the cost and frequency of pre and post emergency room visits, hospitalizations, physician's office and medications use and Health Related Quality of Life (HRQL) was collected for the intervention group and control group. Satisfaction information for the major actors was collected and analyzed at posttest. Within group comparisons were conducted using the paired T-test and the unpaired T-test was used for between group comparison. Results: Patients in the intervention group who had their physician and pharmacist fully participate in respectively directing and administering the study protocol showed associated improvements in their quality of life measures. Economic benefit to the health plan is suggested by a cost benefit ratio of 1:5.71 resulting from favorable decreases in health care related resources and improved asthma related medication utilization. Analysis of the satisfaction measures suggests that all the major participants were very satisfied with the intervention. Conclusion: Even though the sample size in this pilot study was relatively small, the resulting information should not be immediately discounted. The evidence suggests that in those cases where the study protocol was followed, favorable economic, HRQL and satisfaction is comparable to larger, previously conducted studies. / Graduation date: 2000

Thesis (Ph. D.)--University of Adelaide, Dept. of Clinical Nursing, 2003. / "March 2003." Includes bibliographical references (leaves 340-350). Available in print format and electronically. http://web4.library.adelaide.edu.au/theses/09PH/09phw746.pdf Title page, contents and abstract only.

The use of computers in the classroom could allow both educators and learners to achieve new capabilities. There are underlying factors, however, that are obstructing the adoption rate of computer use for instructional purposes in schools. The study focused on these problems with a view to determining which critical success factors promote a higher adoption rate of computer usage in education. This study derived its theoretical framework from various technology adoption and educational models Methodology: The nature of the study required a . Furthermore, it investigated ways in which computer technology could enhance learning. mixed methods approach to be employed, making use of both quantitative and qualitative data. Two questionnaires, one for the educators and one for the principals of the schools were hand-delivered to 60 secondary schools. Exploratory factor analysis and various internal consistency measures were used to assess and analyse the data.Conclusion: Educationists and policy-makers must include all principals and educators when technological innovations are introduced into schools. All these role-players need to be cognisant of the implications if innovations are not appropriately implemented. Including the use of computers in educator training programs is important so that pre-service educators can see the benefits of using the computer in their own teaching.

Till följd av marknadens utveckling har beroendet av informationsutbyte och samverkan i olika nätverk ökat. De senaste årtiondenas fokus på informationsutbyte och samarbete ledde till att Supply Chain Management uppstod. Flera forskare har karakteriserat lyckad styrning av samverkan som en kärnkompetens som krävs för att vara konkurrenskraftig. Ägande och kontrollfunktioner som tidigare låg inom samma verksamhet har förändrats och tillämpningen av VMI har uppkommit. VMI innebär att leverantören övertar ansvaret för lagerstyrningen hos kunden. Samarbetet kräver effektivt informationsflöde inom försörjningskedjan och ett bättre informationssystem, vilket ökar möjligheten att förbättra kedjans effektivitet. Vi hade, med den här utgångspunkten i åtanke, för avsikt att besvara problemformuleringen: Hur hanteras information i VMI-styrda relationer inom koncerner? Syften med undersökningen var att undersöka hur lagerstyrning i form av VMI fungerar i en koncern, förklara hur VMI påverkar informationsflöde och relationer i en koncern samt att analysera betydelsen av VMI för informationsutbytet. Efter teoretiska studier genomfördes en undersökning på en koncern där VMI har införts och givit resultat. Resultaten från intervjuerna har sedan analyserats och vi har kommit fram till följande. För att hantera information i VMI-styrda relationer krävs att det finns bra system, en tydlig ansvarsfördelning och förtroende mellan parterna.

Abstract Kongsberg Automotive (KA), a first- and second-tier supplier to some of the largest automotive manufactures, has acknowledged the need to enhance their competitiveness and to collaborate within the supply chain. In order to do this, KA must improve the current business processes by establishing long term relationships with their suppliers. Today, KA face a high level of inventory, which has resulted substantial amount of tied up capital and inefficient processes. Therefore, this study will evaluate KA’s and three chosen suppliers’ possibilities and the effects that a vendor managed inventory (VMI) partnership will imply. VMI is a concept within supply chain management, where the supplier is fully responsible for managing the customer’s inventory level. To achieve this, the supplier is given access to sensitive information of the customer’s inventory level and demand and can, thereby, replenish the customer’s stock when needed. Although, some firms have embraced the concept with success, others have retreated forcefully. To fulfil the purpose of this study, we have done a broad literature review regarding VMI and performance measurements, as well as, organisational structures and information sharing in collaborative partnerships. Further, to better understand the implementation and effects of VMI, a benchmarking study was made at Volvo Powertrain in Skövde, an early VMI pioneer. In addition to the thorough study of KA’s processes, field visits were made at the suppliers’ to visualize their material and information flow in order to examine in what areas VMI would have an impact. The conclusion of this study is that a VMI strategy, in supplement with a consignment stock policy, is possible for KA. However, issues concerning responsibilities and ownership have become apparent throughout the study that needs to be agreed upon. Further, the study indicates that the benefits from a VMI implementation will be greater for KA, than for the suppliers. Specifically, a reduction in inventory value can be attained by KA, while the suppliers only can obtain minor improvements within the areas of inventory, production, and order processing. On the other hand, the suppliers will face drawbacks, mainly in their order processing, which will result in increased costs. However, we advice KA to further discuss and test the VMI and consignment stock strategy in a pilot project in order to find the right solution for the company and the suppliers.

Volunteer-managed nonprofit organizations (VNPOs) are defined as nonprofit organizations managed exclusively by volunteers without paid-staff. There is no well-recognized theory describing how to govern or structure VNPOs, despite their significance in the social economy. This study argues non-bureaucratic governance and non-hierarchical structures are appropriate for some VNPOs. Rothschild-Whitt (1979) proposes six significant challenges for organizations with non-bureaucratic governance. Using multiple case-study methodology, the magnitude of these challenges was assessed in three VNPOs adopting non-bureaucratic governance and non-hierarchical structure. Four challenges, namely, time, homogeneity, emotional intensity, and individual differences, did not adversely affect the selected VNPOs. Two challenges, namely, nondemocratic individuals and environmental constraints, remained obstacles for the selected VNPOs. Five other challenges to non-bureaucratic governance specific to VNPOs were also identified and discussed, specifically, succession planning and recruitment, task completion, minimal socialization, pressure to achieve consensus, and administrative issues. Insights from such studies may help to better manage non-bureaucratic/non-hierarchical VNPOs.

Volunteer-managed nonprofit organizations (VNPOs) are defined as nonprofit organizations managed exclusively by volunteers without paid-staff. There is no well-recognized theory describing how to govern or structure VNPOs, despite their significance in the social economy. This study argues non-bureaucratic governance and non-hierarchical structures are appropriate for some VNPOs. Rothschild-Whitt (1979) proposes six significant challenges for organizations with non-bureaucratic governance. Using multiple case-study methodology, the magnitude of these challenges was assessed in three VNPOs adopting non-bureaucratic governance and non-hierarchical structure. Four challenges, namely, time, homogeneity, emotional intensity, and individual differences, did not adversely affect the selected VNPOs. Two challenges, namely, nondemocratic individuals and environmental constraints, remained obstacles for the selected VNPOs. Five other challenges to non-bureaucratic governance specific to VNPOs were also identified and discussed, specifically, succession planning and recruitment, task completion, minimal socialization, pressure to achieve consensus, and administrative issues. Insights from such studies may help to better manage non-bureaucratic/non-hierarchical VNPOs.

The purpose of this study is to use Dimension Authoring Language (DAL) to write a Computer-Based Education (CBE) program which can control the DECtalk device and to use GIGI. utility programs and graphics editors, to improve DAL graphic capability. CBE embodies the idea of using computers as a tool in teaching by computer. Also the CBE control programs can keep track of students' record in the instructor's area. This way, instructors can improve lecture materials according to those records. The first chapter explains. what CBE is and its applications in education. The second chapter explains how DAL works and how to solve some of the language's technical problems. The third chapter explains how DECtalk works and how we can control this device in DAL programs. Since pictures can improve CBE programs, the fourth chapter explains picture files and graphic editors. Some problems related to DAL, DECtalk, and picture files are solved in this paper. However, there are several problems which still remain unsolved.Ball State UniversityMuncie, IN 47306

Inflows affect water quality, food web dynamics, and even the incidence of harmful algal blooms. It may be that inflows can be manipulated to create refuge habitat for biota trying to escape poor environmental conditions, such as fish populations in lakes during times of toxic Prymnesium parvum blooms. Water availability sometimes can be an issue, especially in arid climates, which limits this approach to management. Utilizing source water from deeper depths to displace surface waters, however, might effectively mimic inflow events. I test this notion by conducting in-lake mesocosm experiments with natural plankton communities where I manipulate hydraulic flushing. Results show that P. parvum cell density is reduced by 69%, and ambient toxicity completely ameliorates during pre-bloom conditions in the lake. During conditions of bloom development, population density is reduced by 53%, toxicity by 57%, and bloom proportions are never reached. There is minimal effect of these inflows on total phytoplankton and zooplankton biomass, and little effect on water quality. Shifts toward more rapidly growing phytoplankton taxa are observed, as are enhanced copepod nauplii. In other words, while inflows using deep waters suppress P. parvum bloom initiation and development, they are benign to other aspects of the lower food web and environment. The results from using deep lake water to suppress harmful algal blooms indicate this may be a promising management approach and further studies are recommended to test whether this mitigating effect can translate to a large-scale in-lake treatment.

Vendor Managed Inventory (VMI), Consignment Inventory (CI) and a combination of both (C&VMI) are supply-chain sourcing agreements between a vendor and customer. VMI allows the vendor to initiate orders on behalf of the customer. In CI, the customer pays for the goods supplied by the vendor only upon use. The vendor under C&VMI decides customer-replenishments, and owns the goods replenished until they are deployed by the customer. Our thesis studies these agreements in three essays. <br /><br /> The first essay considers a vendor <em>V</em> that manufactures a particular product at a unique location. That item is sold to a single retailer, the customer <em>C</em>. Three cases are treated in detail: Independent decision making (no agreement between the parties); VMI, whereby the supplier <em>V</em> initiates orders on behalf of <em>C</em>; and Central decision making (both Vendor and Customer are controlled by the same corporate entity). <br /><br /> Values of some cost parameters may vary between the three cases, and each case may cause a different actor to be responsible for particular expenses. Under a constant demand rate, optimal solutions are obtained analytically for the customer's order quantity, the vendor's production quantity, hence the parties' individual and total costs in the three cases. Inequalities are obtained to delineate those situations in which VMI is beneficial. <br /><br /> The problem setting in the second essay is the same with that of Essay 1, but the sourcing agreements investigated are now CI and C&VMI. In CI, as in the usual independent-sourcing approach, the customer has authority over the timing and quantity of replenishments. CI seems to favour the customer because, in addition, he pays for the goods only upon use. Under a C&VMI agreement, the vendor still owns the goods at the customer's premises, but at least can determine how much to store there. <br /><br /> The second essay thus contrasts the cases CI and C&VMI, and compares each of them to a no-agreement case. General conditions under which those cases create benefits for the vendor, the customer and the whole chain are determined. <br /><br /> Essay 3 investigates VMI and C&VMI separately for a vendor and multiple customers who face time-varying, but deterministic demand for a single product. In any of those agreements, the vendor seeks the best set of customers to achieve economies of scale. MIP models are developed to find that set of customers, and to determine the vendor's optimal production, transportation, and customer-replenishment quantities. The model for VMI is solved using a heuristic that produces two sub-models, and uses hierarchical solution approach for production, customer-replenishment and transportation decisions. C&VMI model is solved using Lagrangian relaxation. Various numerical examples are used to test the solution approaches used. <br /><br /> In the mean time, the customers can guarantee to be no worse off under VMI or C&VMI than the no-agreement case by setting the right levels of maximum inventory. A model to determine those levels and a solution algorithm are also proposed in Essay 3. <br /><br /> The first two essays can help a vendor or customer in a supply chain to determine the least costly sourcing option, which depends on the relative values of various cost parameters. A vendor with multiple customers can make use of the results in the third essay, which reveal the best possible economies of scale under VMI or C&VMI. Those customers can guarantee to be no worse of than traditional sourcing when they set the proposed levels of maximum inventory.