AIM: To create and apply a framework for quality assessment and improvement in care for inflammatory bowel disease (IBD) patients. METHODS A framework for quality assessment and improvement was created for IBD based o...AIM: To create and apply a framework for quality assessment and improvement in care for inflammatory bowel disease (IBD) patients. METHODS A framework for quality assessment and improvement was created for IBD based on two generally acknowledged quality models. The model of Donabedian (Df) offers a logistical and productive perspective and the Clinical Value Compass (CVC) model adds a management and service perspective. The framework creates a pedagogical tool to understand the balance between the dimensions of clinical care (CVC) and the components of clinical outcome (Df). The merged models create a framework of the care process dimensions as a whole, reflecting important parts of the IBD care delivery system in a local setting. Clinical and organizational quality measures were adopted from clinical experience and the literature and were integrated into the framework. Data were collected at the yearly check-up for 481 IBD patients during 2008. The application of the quality assessment framework was tested and evaluated in a local clinical IBD care setting in Jnkping County, Sweden. RESULTS: The main outcome was the presentation of how locally-selected clinical quality measures, integrated into two complementary models to develop a frame-work, could be instrumental in assessing the quality of care delivered to patients with IBD. The selected quality measures of the framework noted less anemia in the population than previously reported, provided information about hospitalization rates and the few surgical procedures reported, and noted good access to the clinic. CONCLUSION: The applied local quality framework was feasible and useful for assessing the quality of care delivered to IBD patients in a local setting.展开更多
With the enlarge of cross section of roadway, the radius of plastic area and broken area increase, and the tensile stress and shear stress distributing in roof coal-rock layers relevantly increase, which induce suppor...With the enlarge of cross section of roadway, the radius of plastic area and broken area increase, and the tensile stress and shear stress distributing in roof coal-rock layers relevantly increase, which induce support effect not obvious for ordinary bolt（cable）. While bounding point and support structure of the truss cable is in vertex angle of roadway, and supplies coal-rock layers in bounding area with the horizontal and vertical pressure, so it settles the support problems in large cross section coal roadway. From the point of view of mechanics, gave emphasis on the invalid mechanics of ordinary bolt （cable） in large cross section coal roadway and supported mechanics of prestress truss cable. The author successfully used this technique in Wuyang Mine, and had the huge economic efficiency and the social benefit.展开更多
Based on references [1~3]. the mechanical models have been developed to study the presupport mechanism of forepoling bolt structure in this paper. The following problems are discussed:(1) the pre-support mechanism of ...Based on references [1~3]. the mechanical models have been developed to study the presupport mechanism of forepoling bolt structure in this paper. The following problems are discussed:(1) the pre-support mechanism of forepoling bolt structure and stress distribution on its upper broken rock; (2) loading state of forepoling bolt; (3 ) solution of arching in the cross section of excavation.展开更多
This qualitative research study addresses the research question of how the environmental sustainability initiative of 7G （Seventh Generation）, a product design, marketing, and distribution company in the household a...This qualitative research study addresses the research question of how the environmental sustainability initiative of 7G （Seventh Generation）, a product design, marketing, and distribution company in the household and personal care products, could be understood within its supply chain context using Tornatzky and Fleischer＇s TOE （Technology-Organization-Environment） framework. Content analysis, a research technique for making valid inferences from text following a set of procedures, was used and applied to secondary data materials on 7G. The findings reveal that the environmental, organizational, and technological contexts, which are key elements of the TOE framework, are useful in analyzing and comprehending the business practices and business processes adopted by 7G to pursue its sustainability initiative. Of particular interest are those business processes that were included by 7G＇s EMS （Environment Management System） and enabled by green IS （Information Systems）. Both the strengths and weaknesses of 7G＇s efforts are discussed and suggestions are presented for modifying certain phases of the systems development life cycle methodology when implementing green IS.展开更多
基金Supported by The Futurum Research Council, Jnkping County Council, the Foundation for Clinical Cancer Research in Jnkping CountyVINNVRD-research program for more effective and better health care
文摘AIM: To create and apply a framework for quality assessment and improvement in care for inflammatory bowel disease (IBD) patients. METHODS A framework for quality assessment and improvement was created for IBD based on two generally acknowledged quality models. The model of Donabedian (Df) offers a logistical and productive perspective and the Clinical Value Compass (CVC) model adds a management and service perspective. The framework creates a pedagogical tool to understand the balance between the dimensions of clinical care (CVC) and the components of clinical outcome (Df). The merged models create a framework of the care process dimensions as a whole, reflecting important parts of the IBD care delivery system in a local setting. Clinical and organizational quality measures were adopted from clinical experience and the literature and were integrated into the framework. Data were collected at the yearly check-up for 481 IBD patients during 2008. The application of the quality assessment framework was tested and evaluated in a local clinical IBD care setting in Jnkping County, Sweden. RESULTS: The main outcome was the presentation of how locally-selected clinical quality measures, integrated into two complementary models to develop a frame-work, could be instrumental in assessing the quality of care delivered to patients with IBD. The selected quality measures of the framework noted less anemia in the population than previously reported, provided information about hospitalization rates and the few surgical procedures reported, and noted good access to the clinic. CONCLUSION: The applied local quality framework was feasible and useful for assessing the quality of care delivered to IBD patients in a local setting.
基金Supported by the National Natural Science Foundation of China （50074030） and Dr. Special fund of the Ministry of Education （20030290017）
文摘With the enlarge of cross section of roadway, the radius of plastic area and broken area increase, and the tensile stress and shear stress distributing in roof coal-rock layers relevantly increase, which induce support effect not obvious for ordinary bolt（cable）. While bounding point and support structure of the truss cable is in vertex angle of roadway, and supplies coal-rock layers in bounding area with the horizontal and vertical pressure, so it settles the support problems in large cross section coal roadway. From the point of view of mechanics, gave emphasis on the invalid mechanics of ordinary bolt （cable） in large cross section coal roadway and supported mechanics of prestress truss cable. The author successfully used this technique in Wuyang Mine, and had the huge economic efficiency and the social benefit.
文摘Based on references [1~3]. the mechanical models have been developed to study the presupport mechanism of forepoling bolt structure in this paper. The following problems are discussed:(1) the pre-support mechanism of forepoling bolt structure and stress distribution on its upper broken rock; (2) loading state of forepoling bolt; (3 ) solution of arching in the cross section of excavation.
文摘This qualitative research study addresses the research question of how the environmental sustainability initiative of 7G （Seventh Generation）, a product design, marketing, and distribution company in the household and personal care products, could be understood within its supply chain context using Tornatzky and Fleischer＇s TOE （Technology-Organization-Environment） framework. Content analysis, a research technique for making valid inferences from text following a set of procedures, was used and applied to secondary data materials on 7G. The findings reveal that the environmental, organizational, and technological contexts, which are key elements of the TOE framework, are useful in analyzing and comprehending the business practices and business processes adopted by 7G to pursue its sustainability initiative. Of particular interest are those business processes that were included by 7G＇s EMS （Environment Management System） and enabled by green IS （Information Systems）. Both the strengths and weaknesses of 7G＇s efforts are discussed and suggestions are presented for modifying certain phases of the systems development life cycle methodology when implementing green IS.
