Casemix accounting systems and medical coding:organisational actors balanced on "leaky black boxes"

The adoption of DRG coding may be seen as a central feature of the mechanisms of the health reforms in New Zealand. This paper presents a story of the use of DRG coding by describing the experience of one major health provider. The conventional literature portrays casemix accounting and medical coding systems as rational techniques for the collection and provision of information for management and contracting decisions/negotiations. Presents a different perspective on the implications and effects of the adoption of DRG technology, in particular the part played by DRG coding technology as a part of a casemix system is explicated from an actor network theory perspective. Medical coding and the DRG methodology will be argued to represent ``black boxes''. Such technological ``knowledge objects'' provide strong points in the networks which are so important to the processes of change in contemporary organisations.

Characterization of asymmetric filtered 40 Gb/s RZ-DPSK system-strong filtering considerations

We present the impact of frequency offsetting of strong (e.g. 35 GHz) optical filters on the performance of 42.7 Gb/s 50% RZ-DPSK systems. The performance is evaluated when offsetting the filter by substantial amounts and it is found that with an offset of almost half the bit rate there is a significant improvement in the calculated 'Q' (> 1 dB). We deployed balanced, constructive single ended and destructive single ended detection, so that we could investigate the physical origins of the penalty reduction of asymmetric filtering of 42.7 Gb/s 50% RZ-DPSK system.

Characterization of asymmetric filtered 40 Gb/s RZ-DPSK system-strong filtering considerations

We present the impact of frequency offsetting of strong (e.g. 35 GHz) optical filters on the performance of 42.7 Gb/s 50% RZ-DPSK systems. The performance is evaluated when offsetting the filter by substantial amounts and it is found that with an offset of almost half the bit rate there is a significant improvement in the calculated 'Q' (> 1 dB). We deployed balanced, constructive single ended and destructive single ended detection, so that we could investigate the physical origins of the penalty reduction of asymmetric filtering of 42.7 Gb/s 50% RZ-DPSK system.

Linking comprehensive performance assessment to the balanced scorecard:evidence from Hertfordshire County Council

Over the course of the last twenty years there has been a growing academic interest in performance management, particularly in respect of the evolution of new techniques and their resulting impact. One important theoretical development has been the emergence of multidimensional performance measurement models that are potentially applicable within the public sector. Empirically, academic researchers are increasingly supporting the use of such models as a way of improving public sector management and the effectiveness of service provision (Mayston, 1985; Pollitt, 1986; Bates and Brignall, 1993; and Massey, 1999). This paper seeks to add to the literature by using both theoretical and empirical evidence to argue that CPA, the external inspection tool used by the Audit Commission to evaluate local authority performance management, is a version of the Balanced Scorecard which, when adapted for internal use, may have beneficial effects. After demonstrating the parallels between the CPA framework and Kaplan and Norton's public sector Balanced Scorecard (BSC), we use a case study of the BSC based performance management system in Hertfordshire County Council to demonstrate the empirical linkages between a local scorecard and CPA. We conclude that CPA is based upon the BSC and has the potential to serve as a springboard for the evolution of local authority performance management systems.

Nonlinear multicore waveguiding structures with balanced gain and loss

We study existence, stability, and dynamics of linear and nonlinear stationary modes propagating in radially symmetric multicore waveguides with balanced gain and loss. We demonstrate that, in general, the system can be reduced to an effective PT-symmetric dimer with asymmetric coupling. In the linear case, we find that there exist two modes with real propagation constants before an onset of the PT-symmetry breaking while other modes have always the propagation constants with nonzero imaginary parts. This leads to a stable (unstable) propagation of the modes when gain is localized in the core (ring) of the waveguiding structure. In the case of nonlinear response, we show that an interplay between nonlinearity, gain, and loss induces a high degree of instability, with only small windows in the parameter space where quasistable propagation is observed. We propose a novel stabilization mechanism based on a periodic modulation of both gain and loss along the propagation direction that allows bounded light propagation in the multicore waveguiding structures.