Measuring cost savings in the operating room: a matter of FOCUS (follow-through, obsolescence, control, utilization, standardization)

In summary, changes came slowly at first in the OR. The biggest inventory reduction came about a year after the effort had begun. It would seem that tackling obsolescence, standardizing products, etc. would give an initial "big chunk" savings, with small amounts coming later as inventories are lowered. What we expected did not occur, due to the inherent nature of practices and what was customarily being used. For example, previously, some equipment purchases were paid for by purchasing product, which resulted in long-term commitments and high supply costs. The OR at times seemed more like a process of managing change, not just supplies. FOCUS is a daily process. How many times can you afford to overlook this process? How often are the mistakes of the past repeated? In review, we suggest this simple outline: Follow-through (review each case from start to finish), Obsolescence (schedule inventories every six months), Control (achieve inventory management by adjusting PAR levels to needs), Utilization (utilize product/equipment with your control), and Standardization (standardize products and measure results).     

结构塑性设计优化理论

2—2 园板的举例轴线对称荷载的园板是最简单的例子,无论怎样都保持一般壳体问题的所有基本特性.有一个用特尔斯克(Tresca)材料做的简支夹芯园板.承受均匀分布荷载,在园环中有相等的γ种θ(图2)弯曲的主要比率Kr和Kθ仅仅是通过主要的弯矩M_γ和M_θ而归结为应变.屈服的轨迹已消楚的知道,如图3所示的特尔斯克六方晶体.     

A child health production function estimated from longitudinal data. Cebu Study Team

Collaborating researchers used a multi equation model to analyze 3080 mother-infant pairs living on the island of Cebu in the central Philippines and to estimate a child health production function. The econometric methods used eliminated obstacles such as heterogeneity and endogeneity of significant explanatory factors. They also maximized the longitudinal quality of the data. The results showed that morbidity in 1 period reduced infant weight in following periods. For example, diarrhea and febrile respiratory infection reduced growth in the time period following the illnesses. Further effects of some contributing factors were great near birth not diminished with age. For example, breast feeding promoted growth and protected against infection, especially diarrhea and febrile respiratory infection, more substantially near birth than it did later. Further, in urban areas, preventive health care positively affected growth independently of its indirect influence on reducing respiratory infection. Yet it had little effect on diarrhea. Diarrhea had a strong adverse effect on growth. Exposure of the infant to enteric pathogens had the greatest influence on production of diarrhea. In urban areas, exposure included water supply contamination, exposure to feces, a more pathogenic diet, and community crowding. In rural areas, however, exposure included community crowding and increased rainfall which presumably washed feces into the water supply. Household crowding in both urban and rural areas and irritation from smoke in urban areas only tended to bring about febrile respiratory infection.     

Influence of operating conditions on ceramic ultrafiltration membrane performance when treating textile effluents

This work studies the performance of three commercial ceramic ultrafiltration membranes (ZrO(2)-TiO(2)) treating raw effluent from a textile industry. The effect of crossflow velocity at 3, 4 and 5 m s(-1) as well as membrane characteristics, such as molecular weight cut-off (30, 50 and 150 kDa), on process performance were studied. Experiments were carried out in concentration mode in order to observe the effect of volume reduction factor simultaneously. Results showed a combined influence of both crossflow velocity and molecular weight cut-off on flux performance. TOC and COD removals up to 70% and 84% respectively were reached. On the other hand, almost complete color (>97%) and turbidity (>99%) removals were achieved for all the membranes and operating conditions.     

Discussion of the enabling environments for decentralised water systems

Decentralised water supply systems are becoming increasingly affordable and commonplace in Australia and have the potential to alleviate urban water shortages and reduce pollution into natural receiving marine and freshwater streams. Learning processes are necessary to support the efficient implementation of decentralised systems. These processes reveal the complex socio-technical and institutional factors to be considered when developing an enabling environment supporting decentralised water and wastewater servicing solutions. Critical to the technological transition towards established decentralised systems is the ability to create strategic and adaptive capacity to promote learning and dialogue. Learning processes require institutional mechanisms to ensure the lessons are incorporated into the formulation of policy and regulation, through constructive involvement of key government institutions. Engagement of stakeholders is essential to the enabling environment. Collaborative learning environments using systems analysis with communities (social learning) and adaptive management techniques are useful in refining and applying scientists' and managers' knowledge (knowledge management).     

Sensitivity analysis for the SimpleTreat model to simulate fate of chemicals in sewage treatment plants

SimpleTreat 3.1 predicts the distribution and elimination of chemicals by sewage treatment. The model is used as the default calculation in EUSES 2.0 to estimate exposure concentration in the receiving water, soil and air. A sensitivity analysis was performed to rank input parameters according to their influence on model predictions. Triclosan was selected for the base case. The sewage flow, degradation rates and parameters describing the raw sewage were shown to be the most sensitive inputs. The pH and dissociation constant are very sensitive parameters when working with ionisable compounds. Variation in certain input parameters was propagated through the model to yield greater variation in output parameters with a maximum ratio of 4.0. SimpleTreat 3.1 is a steady state model describing a highly non-steady system. A large variability in the most sensitive parameters is expected within a single sewage plant and parameters should therefore be selected to cover this variability.     

加拿大托巴蒙特罗斯水电工程建设经验

对加拿大托巴蒙特罗斯（TobaMontrose）水电工程的建设进展进行了详细描述。该工程由两座电站组成,以EPC总包形式开发建设。介绍了工程开发背景、融资模式、审批程序,以及设计创新情况,重点强调了当地社区参与及尽量减轻工程环境影响的重要性。对该工程成功建设实施的经验进行了归纳总结。