Proposal to Cease Testing Blood Donations for CMV

Proposal to Cease Testing Blood Donations for CMV Status Public Executive summary (200 words) In response to SaBTO recommendations for replacing CMV seronegative cellular blood components with leucodepleted blood components, an implementation project has been established pending approval from the Board. The proposed implementation date of January 2018 is considered a realist timeframe for this approach. Communication with clinicians indicates the acceptance of leucodepleted components as CMV safe, replacing the selection of CMV seronegative components. Information has been obtained regarding international practices and use of leucodepletion with respect to CMV. This paper sets out key information on the proposed replacement of CMV seronegative blood products with leucodepleted blood products, provides recommendations of the optimal strategy to achieve this, and takes into consideration patient groups that may be affected. Action requested (bulleted list) The Board is asked to: Note the implementation plans for the introduction of CMV safe blood products Approve the proposal to cease production of all CMV seronegative blood products that undergo leucodepletion and consider these products as CMV safe Approve the proposal to continue the production of CMV seronegative red cell and platelet components for intra-uterine transfusions and neonates Approve the proposal to continue the production of CMV seronegative granulocyte components for CMV seronegative patients Approve the proposal to continue the production of CMV seronegative blood components for seronegative and seropositive pregnant women that require transfusions throughout pregnancy Agree the recommendation to continue to implement CMV PCR as a screening method for early detection for all haemopoietic stem cell and solid organ transplant recipients Purpose of paper (1 paragraph) For over 30 years, there has been an ongoing debate regarding the use of CMV seronegative blood components versus the use of leucodepleted blood components. To date, the use of CMV seronegative blood products has been implemented to reduce the risk of transfusion-transmitted cytomegalovirus in patients considered at risk. Leucodepletion has been performed on all blood products in the UK since 1999. This paper provides an overview on the use of CMV seronegative blood products in comparison to the use of leucodepleted blood components. This paper provides an assessment of patient groups that are considered at risk of CMV and considers advantages to ceasing of CMV testing in the UK. Background Cytomegalovirus (CMV) is a pervasive, cell-associated prototypic virus that is a member of the betaherpesvirus subfamily (Ziemann and Hennig, 2014; Ljungman, 2004). CMV mostly causes asymptomatic infection or mononucleosis-like-infection in an immunocompetent host; however, in an immunocompromised host it can result in chronic and persistent infection with devastating outcomes (Seed et al., 2015). Patient groups that are considered at risk of life-threatening transfusion-transmitted CMV infection includes CMV seronegative patients undergoing haematopoietic stem cell transplantation and solid organ transplantation, low birth weight and premature neonates, foetuses that require intrauterine transfusion, CMV seronegative pregnant women, and highly immunocompromised patients, such as those with malignant disease (Ziemann and Hennig, 2014; SaBTO, 2012). CMV infection is frequently encountered throughout childhood and an estimated 50 60% of the adult population in the United Kingdom (UK) are CMV positive (SaBTO, 2012). CMV infection can be transmitted both horizontally and vertically (Crough and Kannah, 2009). Horizontal transmission occurs through contact with body fluids, such as urine and saliva, sexually through genital secretions, blood transfusion, and hematopoietic stem cell and organ transplant (SaBTO, 2012; Sia and Patel, 2000). Vertical transmission occurs from mother to child, via delivery and breast milk (Crough and Kannah, 2009). Additionally, congenital CMV infection is highly prevalent and may arise through a primary maternal infection during pregnancy (Crough and Kannah, 2009). Following exposure to CMV and the initial infection, the virus remains in a dormant state (Ljungman, 2004). Seroconversion of the host occurs between 6 8 weeks and mounts an immune response, producing CMV specific immunoglobulin (IgG) (Seed et al., 2014). In the UK, there is an estimated seroconversion rate of 1% per annum (SaBTO, 2012). CMV therefore has a window period, in which there may be underlying viremia and high viral load (Liberman et al., 2011). Subsequently, a CMV seropositive individual is considered to have been infected, whilst at the same time considered potentially infectious due to the life-long persistence of the virus (SaBTO, 2012). Transfusion-transmitted CMV infection is regarded as a potential threat to the safety and sufficiency of the blood supply for a multitude of reasons (Roback, 2002). Firstly, transfusion-transmission of CMV that is present in blood and blood components can result in the infection of naà ¯ve recipients (Ziemann and Hennig, 2014; Ljungman, 2004). Secondly, transfusion-transmitted CMV is acknowledged as a primary source of infection, in which donor infectivity is an underlying reason, that may result in CMV disease (Ljungman, 2004). Thirdly, CMV seropositive recipients that are exposed to blood products containing CMV may cause reactivation of the latent virus or reinfection from a new strain (Ziemann and Hennig, 2014; Ljungman, 2004). However, the risk of transfusion-transmitted CMV infection has been significantly reduced through the implementation of leucodepletion and production of specific CMV negative blood and blood products (Ziemann and Hennig, 2014). Since November 1999, all blood products (unless state otherwise) produced by the UK blood service are leucodepleted (Guidelines for the Blood Transfusion Services in the United Kingdom, 2013). Initially, this was a response taken to reduce the risk of variant Creutzfeldt-Jakob (vCJD) disease in blood transfusions; however, this risk reduction strategy has proven beneficial in additional areas of transfusion science and blood safety (Guidelines for the Blood Transfusion Services in the United Kingdom, 2013). The UK specification for leucodepletion is: more than 90% of leucocyte-depleted components should contain less than 1 x 106 leucocytes and more than 99% of components should contain less than 5 x 106 leucocytes (SaBTO, 2012). The specification for 99% of components is regarded as the level in which blood components are deemed CMV safe (SaBTO, 2012). Leucodepletion has considerably reduced the risk of transfusion-transmitted CMV, to a level that mirrors the selection of CMV negative blood products (Ljungman, 2004; Bowden et al., 1995). However, it has yet to be shown to what extent the techniques are comparable and how this may affect patient groups considered at risk of CMV infection (Ljungman, 2004). It is important to note that whilst leucodepletion removes most white cells from blood products, it is not 100% effective (Kumar, 2006). Therefore, there is a residual risk of CMV transmission in blood products of recently infected donors (Kumar, 2006). This occurs in the window period of the virus from 6 8 weeks to 1 year following seroconversion, in which the virus may be present in the remaining plasma or white cells (SaBTO, 2012; Ziemann et al., 2010; Drew and Roback, 2007). CMV transmission can occur in both donors that have an active infection, including primary or reactivated, or latent infection (Azevedo, 2015). The leading mechanism of transfusion-transmitted CMV infection is through mononuclear cells that are believed to harbour a latent infection (Ljungman, 2004). CMV is thought to persist in circulating monocytes, in which an estimated 1 in 10,000 and 1 in 100,000 peripheral blood monocular cells carry CMV (SaBTO, 2012). Pennington et al (2001) conducted a study that provided evidence to suggest that leucodepletion filters are highly effective in removing mononuclear cells and may reduce CMV levels to 0.1 viral copies per mL in leucodepleted blood. Furthermore, blood products that have been leucodepleted are monitored continuously, using flow cytometry, to assess efficiency (SaBTO, 2012). Moreover, the prospect of having a component issued that contains a leucocyte count above the UK specification can be calculated (SaBTO, 2012). In regards to testing for transfusion-transmitted CMV, there are two main methods that are used. This includes serological testing and Nucleic Acid Technology (NAT) testing (SaBTO, 2012). Serological testing involves the use of antibody screening which is accomplished through the use of enzyme immunoassay (EIA) tests that detect total CMV antibody (Ross, 2011). Screening for CMV infection using serology is the most prevalent method used and is based on the agglutination principle (Ross, 2011; Ljungman, 2004). The method offers several advantages as it is fast, highly sensitive, and highly specific, constituting an ideal screening test (Ross, 2011). This method, however, is associated with two key limitations. Firstly, the window period presents a challenge in regards to activation of the primary infection and seroconversion (Ljungman, 2004). Secondly, there is a risk of obtaining false negative screening results (Ljungman, 2004). Therefore, there is a risk that CMV may be transmitted via a CMV seronegative component (SaBTO, 2012). In addition to serology, NAT testing is used to detect CMV DNA and subsequent infection (Ross, 2011). Several qualitative and quantitative assays are available for this method (SaBTO, 2012). This screening method is associated with variation in the sensitivity and specificity of available assays (Roback et al., 2003;2001). Studies have highlighted inter-laboratory variation for samples containing low viral load (Pang et al, 2009; Wolff et al., 2009). As a result, a CMV DNA reference has been developed for comparison of results when sensitivity is a challenge (Ross, 2011). To produce a supply of CMV negative blood and blood components, several donations are screened each year. Overall, an estimated 25 40% of donors are CMV antibody positive, dependent on age. The production and use of CMV negative blood components forms a significant undertaking for the blood service. According to the report released by the Advisory Committee on the Safety of Blood, Tissues, and Organs (SaBTO) in March 2012, in the last 5 years, the number of CMV negative platelets and red cells has increased. The report notes that NHSBT charge  £7.76 for CMV negative red cells and platelets, covering the inventory and screening costs. This amounts to a total of  £2.5 million per annum, in which  £230,000 is dedicated to apheresis platelets and  £2,270,000 to red cells. The number of donations that are screened is greater than the number of donations that are issued as CMV negative. In addition, not all donations screened will deliver a negative result. Subsequently, it has been proposed that the use and production of CMV negative components is reviewed. SaBTO recommends the use of a single inventory and accepting leucodepleted blood products as CMV safe. This is outlined in section 6. Proposal 6.1 This proposal has been written to ask the blood centre to consider ceasing CMV testing for an agreed list of blood products and in its replacement, support the use of leucodepleted blood components that are considered CMV safe. 6.2 The proposal of ceasing CMV testing for the replacement of leucodepleted components that are considered CMV safe is associated with several advantages. Inventory management Management of a single inventory would offer an advantage to blood banks and hospitals. This would be a preferred method to the current used for ease of access. NHSBT must ensure CMV negative components are available across the country on multiple NHS sites. To achieve this, NHSBT spend approximately  £95,000 n the delivery of CMV negative components. Wastage The Belgian Blood Service have produced a report that states implementation of pathogen reduction in platelets to inactivate CMV may result in an overall decrease in the wastage of platelets. A 1.5% reduction is estimated, which would result in a saving of  £0.22 million. Improved compliance with safety initiatives Reduction in the wastage of blood products and implementation of a single inventory would enable the target of 80% platelets by apheresis to be met sooner. Furthermore, this would support transfusion related acute lung injury (TRALI) prevention, as the number of male platelet donors would increase due to enhanced recruitment strategies. This would further enable costs of HLA antibody screening of potential female platelet donors to be avoided. Reduction in hospital blood bank workload Because of the removal of CMV seronegative components, the workload in hospitals and blood banks would decrease. Staff would no longer have to spend time ordering or checking platelets as CMV negative components. This would have a direct positive impact on the stock management. Staff that may potentially be free from the responsibility associated with CMV negative products will be able to invest their time elsewhere, to improve the efficiency of the blood service. Reduction in clinical errors The Serious Hazards of Transfusion (SHOT) have reported from 2000 to 2010, 1040 reports were filed stating special requirements were not met. Of these, 83 were attributed to the inappropriate selection of blood components that were not CMV negative. 65 were attributed to selection of blood components that were both CMV negative and irradiated components. However, none of these cases reported CMV transmission. 6.3 The proposed implementation date of this project is January 2018. Further clinical guidance is to be requested from SaBTO who will instruct in the implementation plan of this proposal. 6.4 Consideration must be given to specific patient groups that are considered at risk of CMV infection. This includes: Haematopoietic stem cell transplant patients Leucodepleted blood products can be used for all patient groups post haemopoietic stem cell transplantation Patients receiving transfusions and may need a transplant also may receive leucodepleted products CMV PCR should be used to assess CMV infection for patient groups to enable early detection and treatment Intra-uterine transfusions and neonates CMV negative components should be provided for intra-uterine transfusions and neonates (up to 28 days post expected due date) All blood products produced at a reduce size for neonates should be CMV seronegative Pregnant patients CMV seronegative blood products should be provided to pregnancy women, regardless of CMV status. Components should also be provided for transfusions throughout pregnancy, for example in the case of haemoglobinopathies. HIV and immunodeficient patients These patients should receive leucodepleted blood as there is no evidence to suggest a benefit with the use of CMV seronegative components Organ transplant patients Organ transplant patients should receive leucodepleted blood only CMV PCR should be used to assess CMV infection for patient groups to enable early detection and treatment Granulocytes Granulocyte components provided should be CMV seronegative for all patients as these components cannot be leucodepleted 6.5 Potential impact on blood centre employees includes the reduction in workload. Considerations needs to be given towards how this workload can be replaced. Consideration also needs to be given towards the possibility of redundancy, as a successive effect of this proposal. 6.6 The board must be aware of the clinical and financial benefits of this proposal; however, the board should also be aware of potential limitations regarding the operation of the proposal. The board should also be aware of potential legal repercussions should someone become infected with CMV through a blood component. 6.7 Stakeholders that will need to be involved include both internal and external. Internal stakeholders will include the manager of the NHSBT site and the head of testing. External stake holders will need to raise public awareness regarding the change in production of seronegative CMV components. Doctors will also need to be aware of the changes implemented to CMV negative components and be aware of who this applies for. E.g. certain patient groups will still receive CMV seronegative components. References A. Ross, S., Novak, Z., Pati, S. and B. Boppana, S. (2011). Overview of the Diagnosis of Cytomegalovirus Infection. Infectious Disorders Drug Targets, 11(5), pp.466-474. Azevedo, L., Pierrotti, L., Abdala, E., Costa, S., Strabelli, T., Campos, S., Ramos, J., Latif, A., Litvinov, N., Maluf, N., Caiaffa Filho, H., Pannuti, C., Lopes, M., Santos, V., Linardi, C., Yasuda, M. and Marques, H. (2015). Cytomegalovirus infection in transplant recipients. Clinics, 70(7), pp.515-523. Crough, T. and Khanna, R. (2009). Immunobiology of Human Cytomegalovirus: from Bench to Bedside. Clinical Microbiology Reviews, 22(1), pp.76-98. DOH UK, (2012). SaBTO Report of Cytomegalovirus Tested Blood Components, Position Statement. [online] pp.1 15. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215125/dh_133086.pdf [Accessed 13 Mar. 2017]. Drew, W. and Roback, J. (2007). Prevention of transfusion-transmitted cytomegalovirus: reactivation of the debate? Transfusion, 47(11), pp.1955-1958. Guidelines for the Blood Transfusion Services in the United Kingdom. 8th Edition, TSO Norwich, http://www.transfusionguidelines.org/transfusion-handbook/3-providing-safe-blood. [Accessed 25/10/2016] Kumar, H., Gupta, P., Mishra, D., Sarkar, R. and Jaiprakash, M. (2006). Leucodepletion and Blood Products. Medical Journal Armed Forces India, 62(2), pp.174-177. Ljungman, P. (2004). Risk of cytomegalovirus transmission by blood products to immunocompromised patients and means for reduction. British Journal of Haematology, 125(2), pp.107-116. Pang, X., Fox, J., Fenton, J., Miller, G., Caliendo, A. and Preiksaitis, J. (2009). Interlaboratory Comparison of Cytomegalovirus Viral Load Assays. American Journal of Transplantation, 9(2), pp.258-268. Pennington, J., Garner, S., Sutherland, J. and Williamson, L. (2001). Residual subset population analysis in WBC-reduced blood components using real-time PCR quantitation of specific mRNA. Transfusion, 41(12), pp.1591-1600. Roback, J. (2002). CMV and blood transfusions. Reviews in Medical Virology, 12(4), pp.211-219. Roback, J., Drew, W., Laycock, M., Todd, D., Hillyer, C. and Busch, M. (2003). CMV DNA is rarely detected in healthy blood donors using validated PCR assays. Transfusion, 43(3), pp.314-321. Roback, J., Hillyer, C., Drew, W., Laycock, M., Luka, J., Mocarski, E., Slobedman, B., Smith, J., Soderberg-Naucler, C., Todd, D., Woxenius, S. and Busch, M. (2001). Multicenter evaluation of PCR methods fordetecting CMV DNA in blood donors. Transfusion, 41(10), pp.1249-1257. Seed, C., Wong, J., Polizzotto, M., Faddy, H., Keller, A. and Pink, J. (2015). The residual risk of transfusion-transmitted cytomegalovirus infection associated with leucodepleted blood components. Vox Sanguinis, 109(1), pp.11-17. Sia, I. and Patel, R. (2000). New Strategies for Prevention and Therapy of Cytomegalovirus Infection and Disease in Solid-Organ Transplant Recipients. Clinical Microbiology Reviews, 13(1), pp.83-121. Wolff, D., Heaney, D., Neuwald, P., Stellrecht, K. and Press, R. (2009). Multi-Site PCR-Based CMV Viral Load Assessment-Assays Demonstrate Linearity and Precision, but Lack Numeric Standardization. The Journal of Molecular Diagnostics, 11(2), pp.87-92. Ziemann, M. and Hennig, H. (2014). Prevention of Transfusion-Transmitted Cytomegalovirus Infections: Which is the Optimal Strategy?. Transfusion Medicine and Hemotherapy, 41(1), pp.7-7. Ziemann, M., Unmack, A., Steppat, D., Juhl, D., Gà ¶rg, S. and Hennig, H. (2010). The natural course of primary cytomegalovirus infection in blood donors. Vox Sanguinis, 99(1), pp.24-33.

An Analysis of Blake’s The Wild Swans at Coole Essay -- Wild Swans at

An Analysis of Blake’s "The Wild Swans at Coole"  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   "The Wild Swans at Coole" is a poem that deals with the aging process of William Butler Yeats. It is a deeply personal poem that explores the cycle of life through nature. The poem is set in Coole Park in autumn, which is located on Lady Gregory’s estate. The poet is on or near the shore of a large pond, and is observing the swans. It has been nineteen years since the first time he came to this place, and it is on this visit that he begins to realize that he is getting older. The poet parallels nature in the poem, as it represents his present state while, in the poem, there is a contrast between the poet and the swan because the swan is used as a metaphor for the poet’s youth. The poem is written in iambic pentameter and consists of five pairs of stressed and unstressed syllables. The use of nature in the poem serves to illustrate the poet’s age. The first line of the poem, "The trees are in their autumn beauty", presents the reader with a sense of maturity. The trees are ready to complete their yearly cycle by losing their leaves. A vision of bare branches comes to mind after reading this line, representing vulnerability in a bare tree. The leaves that the tree has shed protected the "skeleton" of the tree. Like the tree, the poet will lose something as well when his own cycle nears completion. The leaves can also be associated with the poet’s youth; like a tree, without its leaves, man without his youth is vulnerable. The poet will lose his youth, and in his old age, he too will be exposed to the harshness of the world. The use of the line "The woodland paths are dry" in line 2 reinforces the first line of the poem by presenting the reader with an image of dried... ...eping, but he is in fact waking from his death. "The Wild Swans at Coole" is a poem dominated by the ideas of the poet’s youth, and the presence of death in his future. Yeat’s uses symbols such as nature to represent his present self, and the swans to represent his youth. On this, the poet’s nineteenth visit to Coole, he becomes aware of his age. He parallels himself with much of what he sees in nature, and envies the swans because they represent a permanence that the poet could not achieve. It is as if time has stood still at this pond because it is the same as Yeat’s remembers it to be nineteen years ago. The ending of the poem foreshadows the poets demise, and it can be assumed that this visit will be his last to Coole Park on Lady Gregory’s estate. Works Cited: Parrish, Stephen The Wild Swans at Coole (Ithaca & London: Cornell University Press, 1995)

Vdot Paper

Running head: VIRGINIA DEPARTMENT OF TRANSPORTATION CASE STUDY Virginia Department of Transportation Case Study A high-performance business or body, time after time, attains excellence whilst fashioning a first-rate work atmosphere (Schermerhorn, 2010). The Virginia Department of Transportation (VDOT) was once considered a premier transportation department, but over the years their reputation had become damaged due to budget overruns and a public perception that VDOT could not do its job. When Mark Warner was elected governor of Virginia in 2001, he wanted a new commissioner for VDOT that had private sector experience to turn VDOT around. His search led him to appoint Philip Shucet, a transportation engineer with both public and private sector experience. This paper will discuss some of the management theories that could have been applied to problems at VDOT, as well as how management has reacted to challenges. Next, an environmental analysis will be conducted and short, mid, and long-term goals will be discussed. Finally, Shucet’s motivation to take the job and the motivational problems at VDOT will be addressed. Management Theories McGregor’s Theory X â€Å"assumes that people dislike work, lack ambition, are irresponsible and resistant to change, and prefer to be led† (Oke, 2011, pg. 26). Theory Y â€Å"assumes that people are willing to work, accept responsibility, and are capable of self-direction and creativity† (Oke, 2011, pg. 26). When Shucet arrived at VDOT, Theory X was much more in place, as is often the case in large bureaucracies. There was little teamwork or communication between departments and no one really knew the status of any of the projects (Clawson & Yemen, 2011). If Shucet implemented Theory Y much of this would change as employees took responsibility for their projects and became motivated to succeed. Frederick Taylor’s scientific management theory would also help to improve performance at VDOT. Taylor’s theory stresses finding the right workers for the job and training them correctly (Oke, 2011). Downsizing led to massive retirements of highly skilled workers during the 1990’s. This pushed under or unqualified people into positions they were not ready for (Clawson & Yemen, 2005). An evaluation of the staff and their qualifications for their current positions could result in a restructuring that would better match skills with job requirements. Implementation of Henri Fayol’s administrative principles would have had a significant impact on VDOT. Fayol spells out five duties of management; foresight, organization, command, coordination, and control (Oke, 2011). While there were deficiencies in all of these categories, two in particular were weak, coordination and control. Coordination is defined as actions that â€Å"fit diverse efforts together and ensure that information is shared and problems solved† (Oke, 2011, p. 22). As discussed earlier, information sharing was a significant weakness at VDOT. Control is actions that â€Å"make sure things happen according to plan and to take necessary corrective action† (Oke, 2011, p. 22). Since no one knew the status of the projects, management could not take corrective actions in a timely manner. Six Challengers The six challenges in today’s workforce are ethics, globalization, technology, knowledge, diversity, and change (Oke, 2011). Ethical issues were a significant problem at VDOT. The commissioner of VDOT was a political appointee and this sometimes led to under-qualified individuals or people with their own agendas being placed in charge of a multi-billion dollar organization (Trying to Keep Virginia Moving, 2005). The appointment of Shucet corrected this, as he did not have political aspirations and was concerned only about getting VDOT functioning correctly for the long-term. Globalization was not much of a factor at VDOT since they are a governmental entity that does not compete on the open market and their business is entirely located in Virginia. Shucet noticed quickly that there were technologies available to the employees that were not being utilized efficiently or effectively. This increased workloads and reduced the communication. VDOT had lost a significant portion of their most knowledgeable workers to early retirements and resources needed to be devoted to improving the knowledge and skills of the current workforce. Diversity is a challenge in all organizations, but was not specifically addressed in this case study. The final challenge is change, which is often difficult for large, bureaucratic organizations like VDOT. There was much that needed to change, from the organizational structure, to communications, to major procedures such as budgeting and tracking of projects. Private businesses are forced to change to keep pace with competition. However, until Shucet arrived, VDOT did not have the necessary motivators to implement the necessary changes. Environmental Analysis The specific and general environment conditions played a pivotal role in the effectiveness and trustworthiness of the VDOT organization before Shucet was hired. The organization was barraged with scrutiny from both ends of the hierarchical spectrum. The politicians in Virginia created an impression that VDOT was both poorly managing and severely under-funding their proposed projects. Virginia citizens were also criticizing VDOT wondering and if their tax dollars were being spent properly (Darden, 2005). VDOT is a government organization that must face the pressures of scrutiny from many groups and should have had answers to provide the stakeholders. The taxpayers had a right to know why projects were being under-funded, why approximately 15% of VDOT’s projects were going unfinished and what they were going to do about fixing it. Unfortunately, VDOT did not have the answers (Darden, 2005). Economic conditions were negatively impacting VDOT. They did not have the current or projected revenue to complete the projects within the six-year plan. Their estimates were based on expected population growth in Virginia as well as expected growth in tax revenue that the population increase would generate. When the projections fell short it resulted in VDOT’s projects not being fully funded. The political conditions created a sense of tension among VDOT and the many political bodies that had influence over it. In addition, local politicians were publicly criticizing their own transportation department, demeaning the organization in the eyes of its most critical stakeholder, the taxpayers of Virginia. Goals Based on the environmental analysis, one short-term goal for VDOT would be to decrease the political impact on the organization. Governor Warner accomplished this goal by appointing Shucet and then leaving him alone. In an interview, Shucet said that in the three years since becoming commissioner, the governor had called him â€Å"about six times† (Bacon, 2004, n. p. ). This allowed VDOT to plan for the long-term and not just to meet a political agenda. Another short-term goal would be to make VDOT more transparent to the public. Shucet did this by creating a website showing the status and cost of all of the VDOT’s projects (Bacon, 2004). A mid to long-term goal would be increasing the completion rate of VDOT’s projects. In Shucet’s second year, VDOT’s completion rate increased to 39% and was expected to meet its projection of 60% in year three. The long-term goal was to reach a completion rate of 80% (Bacon, 2004). Both of these goals should decrease the taxpayers’ displeasure with VDOT. VDOT was experiencing significant revenue shortfalls. Rather than just raising taxes to increase revenue, a final long-term goal would be to change the focus of transportation planning in Virginia away from just building new roads to finding new, more economical solutions to the state’s transportation problems (Bacon, 2004). This goal will help to ensure the taxpayers are getting the most value for their tax dollar. Shucet’s Motivation There are a number of theories that could apply to the motivating factor that led to Shucet taking on the VDOT commissioner position. However, Maslow’s Hierarchy of Needs provides an excellent one. Shucet had met all of his lower order needs and was looking to fulfill his need for self-actualization through creative and challenging work, by having decision making authority, and by being autonomous (Oke, 2011). VDOT was a complex problem. This was an opportunity for Shucet to fix the third largest transportation department and regain their status as one of the best departments of transportation in the country. The commissioner of VDOT is a high-ranking state position and Governor Warner allowed him the autonomy he needed to freely make decisions to improve the department. Motivational Theories Motivational theory is composed of four sections; content, process, reinforcement, and job enrichment. Herzberg’s two-factor theory is a content theory that states that by increasing satisfier factors, a manager can increase job satisfaction. Prior to Shucet’s arrival, individuals were not accountable for their projects. By making individuals more accountable and acknowledging accomplishments, Shucet could motivate his employees to perform better. Expectancy theory, a process theory, links achievement and reward to performance. Because of the lack of accountability under prior commissioners, there was not a link between performance and achievement, and most likely no rewards system. People are motivated to work harder if they know it will make a difference and that there is a reward for them. By implementing a rewards system, VDOT could motivate their employees to accomplish the mission of the organization. Positive reinforcement â€Å"strengthens or increases the frequency of desirable behavior by making a pleasant consequence contingent on its occurrence† (Oke, 2011, p. 93). With all of the public scrutiny of VDOT, morale was very low. By identifying the things the groups were doing well and by providing praise and other rewards as new goals were accomplished, Shucet could turn the attitudes of the employees around. Job enrichment increases job scope and job depth (Oke, 2011). Since one of the goals of VDOT was to hold individuals more accountable for their projects, enriching their jobs would allow them the flexibility and authority to truly take ownership of their jobs. When employees feel they have a stake in the outcome of a project they are more motivated to do well. Discussion Even when an organization is as dysfunctional as VDOT was, there are numerous tools available to managers to improve their organizations. Everything from the structure of the organization as a whole to the definition of each individual’s job contributes to the success or failure of an organization. The ability to implement the correct tool for the situation at the correct time is what sets great managers apart from the rest. References Bacon, J. A. (2004). The Shucet Shakeup. Retrieved October 5, 2011 from http://www. baconsrebellion. com/Issues04/09-07/Bacon. htm Clawson, J. G. & Yemen, G. (2005). Virginia Department of Transportation: Trying to Keep Virginia Moving. Charlottesville, VA: Darden Business Publishing. Retrieved October 12, 2011, from http://it. darden. virginia. edu/VDOT/studentWeb/ content/index. htm? speed=128 Oke, R. (2011). Management and organizational behavior. Hoboken, NJ: Wiley Custom Learning Solutions. Custom text ISBN 13: 9780470942710 Schermerhorn, J. R. (2010). Management. (10th ed). Hoboken, NJ: John Wiley & Sons, Inc. Trying To Keep Virgina Moving. (2005). Retrieved October 14, 2011, from http://it. darden. virginia. edu/VDOT/studentWeb/content/index. htm? speed=128

How to Make Glass Using Your Grill

I know, I know... your grill is the cherished hearth-o-barbeque, but if you happen to have an old grill or a friend who has a grill but doesnt cook... or if you are a diehard pyro, you can make your own glass!How does this work? Well, you cant make just any glass in your grill. It needs to be glass that has a relatively low melting point, such as soda lime glass. This is glass made from grinding silicon dioxide (sand) with borax, washing soda or lime. Youre still going to need about 2000Â °F to make the glass, but if the ancients could do it, so can you. They would have used a fire with a bellows, but you can use a charcoal fire that is fed air using a vacuum cleaner.If you want to try this project, you can get details and watch the video of home glassmaking in action at Popular Sciences website, Popsci.com. Definitely watch the video. Its a spectacular demonstration, plus youll see why most people will choose to use their grill for steaks rather than making glass. FIRE!Colored Glas s Chemistry | How to Make Water Glass