Phase V of a comparative study of VA and private sector procurement, contracting and distribution of medical supplies and non-perishable subsistence /

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Studies on Inventory with Positive Service Time Under Local Purchase Driven by N/T- Policy

In this thesis, certain continuous time inventory problems with positive service time under local purchase guided by N/T-policy are analysed. In most of the cases analysed, we arrive at stochastic decomposition of system states, that is, the joint distribution of the system states is obtained as the product of marginal distributions of the components. The thesis is divided into ve chapters

Effects of the preventive and corrective adjustments in economical designs for online process control for attributes with misclassification errors

The procedure for online process control by attributes consists of inspecting a single item at every m produced items. It is decided on the basis of the inspection result whether the process is in-control (the conforming fraction is stable) or out-of-control (the conforming fraction is decreased, for example). Most articles about online process control have cited the stoppage of the production process for an adjustment when the inspected item is non-conforming (then the production is restarted in-control, here denominated as corrective adjustment). Moreover, the articles related to this subject do not present semi-economical designs (which may yield high quantities of non-conforming items), as they do not include a policy of preventive adjustments (in such case no item is inspected), which can be more economical, mainly if the inspected item can be misclassified. In this article, the possibility of preventive or corrective adjustments in the process is decided at every m produced item. If a preventive adjustment is decided upon, then no item is inspected. On the contrary, the m-th item is inspected; if it conforms, the production goes on, otherwise, an adjustment takes place and the process restarts in-control. This approach is economically feasible for some practical situations and the parameters of the proposed procedure are determined minimizing an average cost function subject to some statistical restrictions (for example, to assure a minimal levelfixed in advanceof conforming items in the production process). Numerical examples illustrate the proposal.

Impact of a computerized physician order entry system on compliance with prescription accuracy requirements.

OBJECTIVE: To assess the change in non-compliant items in prescription orders following the implementation of a computerized physician order entry (CPOE) system named PreDiMed. SETTING: The department of internal medicine (39 and 38 beds) in two regional hospitals in Canton Vaud, Switzerland. METHOD: The prescription lines in 100 pre- and 100 post-implementation patients' files were classified according to three modes of administration (medicines for oral or other non-parenteral uses; medicines administered parenterally or via nasogastric tube; pro re nata (PRN), as needed) and analyzed for a number of relevant variables constitutive of medical prescriptions. MAIN OUTCOME MEASURE: The monitored variables depended on the pharmaceutical category and included mainly name of medicine, pharmaceutical form, posology and route of administration, diluting solution, flow rate and identification of prescriber. RESULTS: In 2,099 prescription lines, the total number of non-compliant items was 2,265 before CPOE implementation, or 1.079 non-compliant items per line. Two-thirds of these were due to missing information, and the remaining third to incomplete information. In 2,074 prescription lines post-CPOE implementation, the number of non-compliant items had decreased to 221, or 0.107 non-compliant item per line, a dramatic 10-fold decrease (chi(2) = 4615; P < 10(-6)). Limitations of the computerized system were the risk for erroneous items in some non-prefilled fields and ambiguity due to a field with doses shown on commercial products. CONCLUSION: The deployment of PreDiMed in two departments of internal medicine has led to a major improvement in formal aspects of physicians' prescriptions. Some limitations of the first version of PreDiMed were unveiled and are being corrected.

Portfolioajattelu ostostrategian kehittämisessä Case: VR Konserni

Tutkimuksen tavoitteena oli selvittää portfolioajattelun hyödyntämistä yrityksen ostostrategian kehittämisessä. Teoreettisen portfolioajattelun soveltamista käytännössä selvitettiin tavallisten tuotteiden ostostrategian kehittämisprosessissa kohdeyrityksessä. Tutkimus toteutettiin kuvailevana case tutkimuksena, jossa aineiston kokoaminen pohjautui aineistotriangulaatioon. Analysointi toteutettiin ostostrategian päätösprosessin kuvaamisella sekä asetettujen esioletusten toteutumisen tutkimisella. Portfolioajattelua hyödynnettiin tutkitussa konserniyhtiössä liiketoimintayksiköiden ostotoimintojen integroimisella: toteuttamalla oston yhtenäisiä toimintatapoja konsernitasolla, yhteen sovittamalla oston tietojärjestelmäratkaisuja sisäisesti sekä kytkemällä konsernin ostojärjestelmä joustavasti ostomarkkinoille. Keskeisenä tutkimustuloksena on perinteisestä aihealueen teoriasta poikkeava havainto, jonka mukaan tavallisten tuotteiden ostostrategiassa painopiste on siirtymässä spot - ostoista ja jatkuvasta kilpailuttamisesta pitkäaikaisempiin sopimuksiin ja tiiviimpään yhteistyöhön toimittajien kanssa. Tähän on vaikuttamassa erityisesti sähköisen ostamisen järjestelmien käyttöönotto.

Huoltovarmuuskeskeinen varaosavaraston suunnittelututkimus

Tämän diplomityön päätavoitteena on ollut kunnossapidon kohteiden varaosien hallintaan soveltuvan laskentamallin kehittäminen ja sen tutkiminen valitussa case-kohteessa. Laskentamallissa on kartoitettu huoltovarmuuskeskeisen varastonhallinnan kannalta ne minimitiedot, joiden avulla voidaan olemassa olevat niukat lähtötiedot huomioiden tarkastella varastointikustannuksiin ja varaosien puuteriskiin liittyvää varastointiproblematiikkaa päätöksenteon tueksi. Laskentamalli voidaan jakaa kustannuskomponentteihin, jotka ovat varaosiin sitoutuneet pääomakustannukset, varaosien varastoimisesta aiheutuvat varastointikustannukset ja varaosan puutteesta laitteen vikaantuessa aiheutuvat tuotannon menetyksen kustannukset. Tämän mallin avulla on tarkoitus löytää varaosanimikkeille sopivat tilauspisteet sekä ostoeräkoot osan puutteesta aiheutuva riskikustannus huomioiden. Tämän työn tutkimusosiossa selvitettiin laskentamallin soveltuvuus ABB Oy Servicen huoltopalveluliiketoiminnan tukemiseen eri kunnossapitokohteissa. Teorioiksi mallin luomiseen määriteltiin todennäköisyyslaskentaan perustuva Poisson-jakauma varaosavaraston palveluasteen määrittämiseksi kulutustiedon / vikataajuuden perusteella sekä EOQ taloudellisen ostoeräkoon laskemiseksi.

ERP and cardiovascular correlates of source memory discrimination in older and younger adults /

There is much evidence to support an age-related decline in source memory ability. However, the underlying mechanisms responsible for this decline are not well understood. The current study was carried out to determine the electrophysiological correlates of source memory discrimination in younger and older adults. Event-related potentials (ERPs) and continuous electrocardiographic (ECG) data were collected from younger (M= 21 years) and older (M= 71 years) adults during a source memory task. Older adults were more likely to make source memory errors for recently repeated, non-target words than were younger adults. Moreover, their ERP records for correct trials showed an increased amplitude in the late positive (LP) component (400-800 msec) for the most recently presented, non-target stimuli relative to the LP noted for target items. Younger adults showed an opposite pattern, with a large LP component for target items, and a much smaller LP component for the recently repeated non-target items. Computation of parasympathetic activity in the vagus nerve was performed on the ECG data (Porges, 1985). The resulting measure, vagal tone, was used as an index of physiological responsivity. The vagal tone index of physiological responsivity was negatively related to the LP amplitude for the most recently repeated, non-target words in both groups, after accounting for age effects. The ERP data support the hypothesis that the tendency to make source memory errors on the part of older adults is related to the ability to selectively control attentional processes during task performance. Furthermore, the relationship between vagal tone and ERP reactivity suggests that there is a physiological basis to the heightened reactivity measured in the LP response to recently repeated non-target items such that, under decreased physiological resources, there is an impairment in the ability to selectively inhibit bottom-up, stimulus based properties in favour of task-related goals in older adults. The inconsistency of these results with other explanatory models of source memory deficits is discussed. It is concluded that the data are consistent with a physiological reactivity model requiring inhibition of reactivity to irrelevant, but perceptually-fluent, stimuli.

Sistemas de gestión para el control de la cadena de abastecimiento que apropie características de los cubos OLAP como marco de aplicación en una empresa colombiana del sector de alimentos.

Se basa en un análisis teórico de los sistemas de información como lo es el almacenaje de datos, cubos OLAP e inteligencia de negocios. Seguidamente, se hace un análisis de los sectores económicos de Colombia con un especial interés sobre el sector de alimentos, de esta manera conceptualizar la empresa sobre la cual este trabajo se enfocara. Se encontrará un análisis del caso de éxito Summerwood Corporation, el cual brindará una justificación para la propuesta final presentada a la empresa Dipsa Food, Pyme dedicada a la producción de alimentos no perecederos ubicada en la ciudad de Bogotá D.C –Colombia, la cual tiene gran interés en cuanto al desarrollo de nuevas tecnologías que brinden información fidedigna para la toma de decisiones

Forgetting as a consequence of retrieval: a meta-analytic review of retrieval-induced forgetting

Retrieving a subset of items can cause the forgetting of other items, a phenomenon referred to as retrieval-induced forgetting. According to some theorists, retrieval-induced forgetting is the consequence of an inhibitory mechanism that acts to reduce the accessibility of non-target items that interfere with the retrieval of target items. Other theorists argue that inhibition is unnecessary to account for retrieval-induced forgetting, contending instead that the phenomenon can be best explained by non-inhibitory mechanisms, such as strength-based competition or blocking. The current paper provides the first major meta-analysis of retrieval-induced forgetting, conducted with the primary purpose of quantitatively evaluating the multitude of findings that have been used to contrast these two theoretical viewpoints. The results largely supported inhibition accounts, but also provided some challenging evidence, with the nature of the results often varying as a function of how retrieval-induced forgetting was assessed. Implications for further research and theory development are discussed.

Symptomatic expression of depression among Jewish adolescents: effects of gender and age

Background Depression symptomatology was assessed with the Beck Depression Inventory (BDI) in a sample of Jewish adolescents, in order to compare the frequency and severity of depression with non-Jewish adolescents as well as examine gender difference of the expression of depressive symptomatology. Method Subjects comprised 475 students from Jewish private schools, aged 13-17 years, who were compared with an age-matched non-Jewish sample (n = 899). Kendall`s definition was adopted to classify these adolescents according to level of depressive symptoms. The frequency of depression was calculated for ethnicity, gender and age strata. Discriminant analysis and principal component analysis were performed to assess the importance of depression-specific and non-specific items, along with the factor structure of the BDI, respectively. Results The overall mean score on the BDI in the Jewish and the non-Jewish sample was 9.0 (SD = 6.4) and 8.6 (SD = 7.2), respectively. Jewish girls and boys had comparable mean BDI scores, contrasting with non-Jewish sample, where girls complained more of depressive symptoms than boys (p < 0.001). The frequency of depression, adopting a BDI cutoff of 20, was 5.1% for the Jewish sample and 6.3% for the non-Jewish sample. The frequency of depression for Jewish girls and boys was 5.5% (SE = 1.4) and 4.6% (SE = 1.5), respectively. On the other hand, the frequency of depression for non-Jewish girls and boys was 8.4% (SE = 1.2) and 4.0% (SE = 1.0), respectively. The female/male ratio of frequency of BDI-depression was 1.2 in the Jewish sample, but non-Jewish girls were twice (2.1) as likely to report depression as boys. Discriminant analysis showed that the BDI highly discriminates depressive symptomatology among Jewish adolescents, and measured specific aspects of depression. Factor analysis revealed two meaningful factors for the total sample and each gender (cognitive-affective dimension and somatic dimension), evidencing a difference between Jewish boys and Jewish girls in the symptomatic expression of depression akin to non-Jewish counterparts. Conclusions Ethnic-cultural factor might play a role in the frequency, severity and symptomatic expression of depressive symptoms in Jewish adolescents. The lack of gender effect on depression, which might persist from adolescence to adulthood among Jewish people, should be investigated in prospective studies.

Effect of measurement error and autocorrelation on the (X)over-bar chart

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Notes on the feeding habits of the skate Rioraja agassizi (Chondrichthyes, Rajidae) off southeastern Brazil

Feeding habits of the skate Rioraja agassizi were analyzed in southeastern Brazil from samples obtained along Silo Paulo coast. A total of 258 specimens were examined, ranging between 96 and 532 mm total length. About 57.85% were females and 42.15% were males, resulting in a 1:1.37 sex-ratio to females. From 223 stomachs collected (94 males and 129 females) empty stomachs represented only 1.4%. Nine prey categories were identified: Polychaeta, Copepoda, Cumacea, Isopoda, Gammaridea, Dendrobranchiata, Brachyura, Teleostei, and one non-animal category (non-identifiable items). Crustaceans were the most important item, indicating that the species has a carcinophagic preference. The presence of fish was just verified in juveniles and some adult individuals, with predominance in summer. Sex, maturity stage and seasonality did not influence the feeding habits of the species.

Frugivory by toucans (Ramphastidae) at two altitudes in the Atlantic Forest of Brazil

Toucans are prominent components of the tropical American avifauna. Although these birds are very conspicuous, there are few ecological studies focusing on them. In this study, the diets of four sympatric toucans (Ramphastos vitellinus, R. dicolorus, Selenidera maculirostris, and Baillonius bailloni) were assessed by recording feeding bouts at two altitudes in the Atlantic Forest of southeast Brazil. Our results show that toucans are predominantly frugivorous birds (96.5% of the 289 feeding bouts were on fruits). In the lowlands (70 m elev.), only fruits (48 species, 27 families) were recorded, while in the highlands (700 m elev.), toucans were observed feeding on fruits (25 species, 22 families), flowers, leaves, and insects. Non-fruit items were recorded only in the highlands, most of them eaten by B. bailloni. Cecropia glaziovii and Euterpe edulis, two abundant plants in the highland and lowland sites, respectively, and Virola oleifera, a plant that produces lipid-rich arillate fruits, were eaten heavily by the toucans. The number of feeding bouts recorded for R. vitellinus in the lowlands was positively correlated with lipid content of the fruits eaten. The diameters of fruits eaten by toucans varied greatly (range = 0.4-25.0 mm). While the large Ramphastos species not only ate tiny fruits (e.g., Hyeronima alchorneoides) but also large ones (e.g., Virola gardneri), the toucanets ate piecemeal the large fruits that exceeded their gape width, suggesting that gape size did not limit the use of any fruit by the toucans at our study sites.

Notes on the measurement of poverty by the income method

Includes bibliography

Acessibilidade no ensino superior: instrumento para avaliação, satisfação dos alunos com deficiência e percepção de coordenadores de cursos

Pós-graduação em Educação - FFC