931 resultados para implementation methods


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OBJECTIVE: Show the steps of a Trauma Registry (TR) implementation in a Brazilian public hospital and evaluate the initial data from the database.METHODS: Descriptive study of the a TR implementation in João XXIII Hospital (Hospital Foundation of the state of Minas Gerais) and analysis of the initial results of the first 1,000 patients.RESULTS: The project was initiated in 2011 and from January 2013 we began collecting data for the TR. In January 2014 the registration of the first 1000 patients was completed. The greatest difficulties in the TR implementation were obtaining funds to finance the project and the lack of information within the medical records. The variables with the lowest completion percentage on the physiological conditions were: pulse, blood pressure, respiratory rate and Glasgow coma scale. Consequently, the Revised Trauma Score (RTS) could be calculated in only 31% of cases and the TRISS methodology applied to 30.3% of patients. The main epidemiological characteristics showed a predominance of young male victims (84.7%) and the importance of aggression as a cause of injuries in our environment (47.5%), surpassing traffic accidents. The average length of stay was 6 days, and mortality 13.7%.CONCLUSION: Trauma registries are invaluable tools in improving the care of trauma victims. It is necessary to improve the quality of data recorded in medical records. The involvement of public authorities is critical for the successful implementation and maintenance of trauma registries in Brazilian hospitals.

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OBJECTIVE: to evaluate the impact of the new technology of multidetector computed tomography (MDCT) in improving the accuracy and early diagnosis of BSBI.METHODS: patients with blunt small bowel injuries (BSBI) grade> I were identified retrospectively and their CT scans reviewed by an experienced radiologist. Clinical and tomographic findings were analyzed and patients grouped as "pre-MDCT" and "post-MDCT", according to the time of implementation of a 64-slice MDCT.RESULTS: of the 26 patients with BSBI 16 had CT scans. Motor vehicle collision (62.5%) was the most frequent mechanism of injury. In the pre-MDCT period, five of the 13 patients (38.5%) had abdominal CT, and in the post-MDCT, 11 of 13 patients (84.6%) had the exam. During pre-MDCT, all CT scans were abnormal with findings of pneumoperitoneum (60%), free fluid (40%) and bowel wall enhancement (20%). In the post-MDCT group, all exams but one were abnormal and the most frequent findings were free fluid (90.9%), bowel wall enhancement (72.7%), and pneumoperitoneum (54.5%). However, the rate of delayed laparotomy did not change. The mortality rate in both groups were similar, with 20% during pre-MDCT and 18.2% during post-MDCT.CONCLUSION: the use of MDCT in abdominal trauma in our service has increased the sensibility of the diagnosis, but has had no impact on outcome so far.

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According to several surveys and observations, the percentage of successfully conducted IT projects without over-budgeting and delays in time schedule are extremely low. Many projects also are evaluated as failures in terms of delivered functionality. Nuldén (1996) compares IT projects with bad movies; after watching for 2 hours, one still tries to finish it even though one understands that it is a complete waste of time. The argument for that is 'I've already invested too much time to terminate it now'. The same happens with IT projects: sometimes the company continues wasting money on these projects for a long time, even though there are no expected benefits from these projects. Eventually these projects are terminated anyway, but until this moment, the company spends a lot. The situation described above is a consequence of “escalation of commitment” - project continuation even after a manager receives negative feedback of the project’s success probability. According to Keil and Mähring (2010), even though escalation can occur in any type of project, it is more common among complex technological projects, such as IT projects. Escalation of commitment very often results in runaway projects. In order to avoid it, managers use de-escalation strategies, which allow the resources to be used in more effective. These strategies lead to project termination or turning around, which stops the flow of wasted investments. Numbers of researches explore escalation of commitment phenomena based on experiments and business cases. Moreover, during the last decade several frameworks were proposed for de-escalation strategy. However, there is no evidence of successful implementation of the de-escalation of commitment strategy in the literature. In addition, despite that fact that IT project management methodologies are widely used in the companies, none of them cover the topic of escalation of commitment risks. At the same time, there are no researches proposing the way to implement de-escalation of commitment strategy into the existing project management methodology The research is focused on a single case of large ERP implementation project by the consulting company. Hence, the main deliverables of the study include suggestions of improvement in de-escalation methods and techniques in the project and in the company. Moreover, the way to implement these methods into existing project management methodology and into the company general policies is found.

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ABSTRACTObjective:to analyze the implementation of a trauma registry in a university teaching hospital delivering care under the unified health system (SUS), and its ability to identify points for improvement in the quality of care provided.Methods:the data collection group comprised students from medicine and nursing courses who were holders of FAPESP scholarships (technical training 1) or otherwise, overseen by the coordinators of the project. The itreg (ECO Sistemas-RJ/SBAIT) software was used as the database tool. Several quality "filters" were proposed to select those cases for review in the quality control process.Results:data for 1344 trauma patients were input to the itreg database between March and November 2014. Around 87.0% of cases were blunt trauma patients, 59.6% had RTS>7.0 and 67% ISS<9. Full records were available for 292 cases, which were selected for review in the quality program. The auditing filters most frequently registered were laparotomy four hours after admission and drainage of acute subdural hematomas four hours after admission. Several points for improvement were flagged, such as control of overtriage of patients, the need to reduce the number of negative imaging exams, the development of protocols for achieving central venous access, and management of major TBI.Conclusion: the trauma registry provides a clear picture of the points to be improved in trauma patient care, however, there are specific peculiarities for implementing this tool in the Brazilian milieu.

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Rapid ongoing evolution of multiprocessors will lead to systems with hundreds of processing cores integrated in a single chip. An emerging challenge is the implementation of reliable and efficient interconnection between these cores as well as other components in the systems. Network-on-Chip is an interconnection approach which is intended to solve the performance bottleneck caused by traditional, poorly scalable communication structures such as buses. However, a large on-chip network involves issues related to congestion problems and system control, for instance. Additionally, faults can cause problems in multiprocessor systems. These faults can be transient faults, permanent manufacturing faults, or they can appear due to aging. To solve the emerging traffic management, controllability issues and to maintain system operation regardless of faults a monitoring system is needed. The monitoring system should be dynamically applicable to various purposes and it should fully cover the system under observation. In a large multiprocessor the distances between components can be relatively long. Therefore, the system should be designed so that the amount of energy-inefficient long-distance communication is minimized. This thesis presents a dynamically clustered distributed monitoring structure. The monitoring is distributed so that no centralized control is required for basic tasks such as traffic management and task mapping. To enable extensive analysis of different Network-on-Chip architectures, an in-house SystemC based simulation environment was implemented. It allows transaction level analysis without time consuming circuit level implementations during early design phases of novel architectures and features. The presented analysis shows that the dynamically clustered monitoring structure can be efficiently utilized for traffic management in faulty and congested Network-on-Chip-based multiprocessor systems. The monitoring structure can be also successfully applied for task mapping purposes. Furthermore, the analysis shows that the presented in-house simulation environment is flexible and practical tool for extensive Network-on-Chip architecture analysis.

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Social media is a multidimensional marketing and communications channel which can support and enhance a business’ reputation, sales and even longevity. Social media as a business tool encourages an interaction between customers and companies which gives opportunities for a company to better understand their customers, to target them more effectively and to collaborate and create dialogues with them which is not possible through traditional media channels. The aim of a social media strategy is to increase brand awareness, image, loyalty and recognition. The peer networks that social media creates allows a company to disseminate information through loyal customers to new and prospective customers to ultimately increase reach. The purpose of the study is to understand the marketer’s perspective of social media marketing use and how it is currently utilized in marketing and communications activities in Finland. Three companies were interviewed covering fourteen different implementations of social media marketing campaigns. These were then analysed to ascertain the utilization methods and experience gained on recent campaigns in the Finnish market The utilization of social media marketing was analysed using the methods of thematic analysis and inductive and abductive reasoning. Elements and themes were drawn out of the separate interviews to create a framework with which to explore, evaluate and match theories that define social media usage by companies. It became clear from all of the interviews that social media as a tool is most effective when it captures the viewer’s interest through rich and entertaining content. This directed the theoretical research towards Engagement Theory and Content Marketing which look to emphasize the importance of communities, collaboration, interaction, and peer-sharing as the key drivers of a social media marketing campaign.

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Implementing an enterprise resource planning (ERP) system often means a major change to an organization and involves significant risks. It is typical that many of the ERP system implementations fail resulting in tremendous damage to the business. Moreover, running normal business operations during an ERP system implementation is far more complicated than normally. This thesis focuses on how an organization should manage the ERP system implementation process in order to maintain supply performance during the implementation phase. The theoretical framework in this thesis focuses on ERP system implementations with a critical success factor approach. Critical success factors can be divided into strategic and tactical level success factors. By considering these critical success factors, ERP system implementation project’s timeline and best practices of an ERP implementation, a critical success factor based ERP system implementation management framework is presented. The framework can be used as a theoretical framework when the goal is to avoid ERP system implementation phase issues that are driven by the ERP system implementation project and that may decrease organization’s supply performance. This thesis is a case study that was written on an assignment to a confectionary company Cloetta Suomi Oy. In order to collect data, interviews of the case company personnel were conducted. In addition, several other data collection methods were used throughout the research process. These data collection methods include examination of presentations and archival records as well as direct observations in case company meetings and in various work duties. The results of this thesis indicate that there are several factors that may decrease organization’s supply performance during the ERP system implementation. These issues are categorized under external and internal issues and further into six risk drivers that are suppliers, customers, products, staff, information systems and other projects. After the description and categorization of each issue, the thesis focuses on finding solutions on how to avoid or mitigate the impact of these issues on the organization’s supply performance. This examination leads to several operational activities that are also practical to business practitioners. It is also stated that a successful ERP system implementation that also causes minimal disturbance to organization’s supply performance during the ERP system implementation, is achieved by considering three levels of actions.

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This study is a qualitative action research by its nature with elements of personal design in the form of a tangible model implementation framework construction. Utilized empirical data has been gathered via two questionnaires in relation to the arranged four workshop events with twelve individual participants. Five of them represented maintenance customers, three maintenance service providers and four equipment providers respectively. Further, there are two main research objectives in proportion to the two complementary focusing areas of this thesis. Firstly, the value-based life-cycle model, which first version has already been developed prior to this thesis, requires updating in order to increase its real-life applicability as an inter-firm decision-making tool in industrial maintenance. This first research objective is fulfilled by improving appearance, intelligibility and usability of the above-mentioned model. In addition, certain new features are also added. The workshop participants from the collaborating companies were reasonably pleased with made changes, although further attention will be required in future on the model’s intelligibility in particular as main results, charts and values were all reckoned as slightly hard to understand. Moreover, upgraded model’s appearance and added new features satisfied them the most. Secondly and more importantly, the premises of the model’s possible inter-firm implementation process need to be considered. This second research objective is delivered in two consecutive steps. At first, a bipartite open-books supported implementation framework is created and its different characteristics discussed in theory. Afterwards, the prerequisites and the pitfalls of increasing inter-organizational information transparency are studied in empirical context. One of the main findings was that the organizations are not yet prepared for network-wide information disclosure as dyadic collaboration was favored instead. However, they would be willing to share information bilaterally at least. Another major result was that the present state of companies’ cost accounting systems will definitely need implementation-wise enhancing in future since accurate and sufficiently detailed maintenance data is not available. Further, it will also be crucial to create supporting and mutually agreed network infrastructure. There are hardly any collaborative models, methods or tools currently in usage. Lastly, the essential questions about mutual trust and predominant purchasing strategies are cooperation-wise important. If inter-organizational activities are expanded, a more relational approach should be favored in this regard. Mutual trust was also recognized as a significant cooperation factor, but it is hard to measure in reality.

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Entrepreneurial marketing is newly established term and there is need for more specific studies in order to understand the concept fully. SMEs have entrepreneurial marketing elements more visible in their marketing and therefore provide more fruitful insights for this research. SMEs marketing has gained more recognition during the past years and in some cases innovative characteristics can be identified despite constraints such as lack of certain resources. The purpose of this research is to study entrepreneurial marketing characteristics and SME processes in order to wider understanding and gain more insights of entrepreneurial marketing. In addition, planning and implementation of entrepreneurial marketing processes is examined in order to gain full coverage of SMEs marketing activities. The research was conducted as a qualitative research and data gathering was based on semi-structured interview survey, which involved nine company interviews. Multiple case research was used to analyze data so that focus and clarity could be maintained in organized manner. Case companies were chosen from different business fields so that more variation and insights could be identified. The empirical results suggest that two examined processes networking and word-of-mouth communication are very important processes for case companies which supports the previous researches. However, the entrepreneurial marketing characteristics had variation some were more visible and recognizable than others. Examining more closely the processes companies did not fully understand that networking or word-of-mouth marketing could be used as efficiently as other conventional marketing methods.

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Innovative gas cooled reactors, such as the pebble bed reactor (PBR) and the gas cooled fast reactor (GFR) offer higher efficiency and new application areas for nuclear energy. Numerical methods were applied and developed to analyse the specific features of these reactor types with fully three dimensional calculation models. In the first part of this thesis, discrete element method (DEM) was used for a physically realistic modelling of the packing of fuel pebbles in PBR geometries and methods were developed for utilising the DEM results in subsequent reactor physics and thermal-hydraulics calculations. In the second part, the flow and heat transfer for a single gas cooled fuel rod of a GFR were investigated with computational fluid dynamics (CFD) methods. An in-house DEM implementation was validated and used for packing simulations, in which the effect of several parameters on the resulting average packing density was investigated. The restitution coefficient was found out to have the most significant effect. The results can be utilised in further work to obtain a pebble bed with a specific packing density. The packing structures of selected pebble beds were also analysed in detail and local variations in the packing density were observed, which should be taken into account especially in the reactor core thermal-hydraulic analyses. Two open source DEM codes were used to produce stochastic pebble bed configurations to add realism and improve the accuracy of criticality calculations performed with the Monte Carlo reactor physics code Serpent. Russian ASTRA criticality experiments were calculated. Pebble beds corresponding to the experimental specifications within measurement uncertainties were produced in DEM simulations and successfully exported into the subsequent reactor physics analysis. With the developed approach, two typical issues in Monte Carlo reactor physics calculations of pebble bed geometries were avoided. A novel method was developed and implemented as a MATLAB code to calculate porosities in the cells of a CFD calculation mesh constructed over a pebble bed obtained from DEM simulations. The code was further developed to distribute power and temperature data accurately between discrete based reactor physics and continuum based thermal-hydraulics models to enable coupled reactor core calculations. The developed method was also found useful for analysing sphere packings in general. CFD calculations were performed to investigate the pressure losses and heat transfer in three dimensional air cooled smooth and rib roughened rod geometries, housed inside a hexagonal flow channel representing a sub-channel of a single fuel rod of a GFR. The CFD geometry represented the test section of the L-STAR experimental facility at Karlsruhe Institute of Technology and the calculation results were compared to the corresponding experimental results. Knowledge was gained of the adequacy of various turbulence models and of the modelling requirements and issues related to the specific application. The obtained pressure loss results were in a relatively good agreement with the experimental data. Heat transfer in the smooth rod geometry was somewhat under predicted, which can partly be explained by unaccounted heat losses and uncertainties. In the rib roughened geometry heat transfer was severely under predicted by the used realisable k − epsilon turbulence model. An additional calculation with a v2 − f turbulence model showed significant improvement in the heat transfer results, which is most likely due to the better performance of the model in separated flow problems. Further investigations are suggested before using CFD to make conclusions of the heat transfer performance of rib roughened GFR fuel rod geometries. It is suggested that the viewpoints of numerical modelling are included in the planning of experiments to ease the challenging model construction and simulations and to avoid introducing additional sources of uncertainties. To facilitate the use of advanced calculation approaches, multi-physical aspects in experiments should also be considered and documented in a reasonable detail.

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The experiences of several healthcare organizations were considered to distinguish the most frequently used lean tools, the success and failure factors, and the obstacles that may appear while implementing lean. As a result, two approaches to “go lean” were defined, and analyzed from the prospective of the applicability to healthcare processes. Industrialization of healthcare was studied, and the most promising digital technology tools to improve healthcare process were highlighted. Finally, the analysis of healthcare challenges and feasible ways to address them was conducted and presented as the main result of this work. The possible ways of implementation of the findings and limitations were described in the conclusion.

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Due to various advantages such as flexibility, scalability and updatability, software intensive systems are increasingly embedded in everyday life. The constantly growing number of functions executed by these systems requires a high level of performance from the underlying platform. The main approach to incrementing performance has been the increase of operating frequency of a chip. However, this has led to the problem of power dissipation, which has shifted the focus of research to parallel and distributed computing. Parallel many-core platforms can provide the required level of computational power along with low power consumption. On the one hand, this enables parallel execution of highly intensive applications. With their computational power, these platforms are likely to be used in various application domains: from home use electronics (e.g., video processing) to complex critical control systems. On the other hand, the utilization of the resources has to be efficient in terms of performance and power consumption. However, the high level of on-chip integration results in the increase of the probability of various faults and creation of hotspots leading to thermal problems. Additionally, radiation, which is frequent in space but becomes an issue also at the ground level, can cause transient faults. This can eventually induce a faulty execution of applications. Therefore, it is crucial to develop methods that enable efficient as well as resilient execution of applications. The main objective of the thesis is to propose an approach to design agentbased systems for many-core platforms in a rigorous manner. When designing such a system, we explore and integrate various dynamic reconfiguration mechanisms into agents functionality. The use of these mechanisms enhances resilience of the underlying platform whilst maintaining performance at an acceptable level. The design of the system proceeds according to a formal refinement approach which allows us to ensure correct behaviour of the system with respect to postulated properties. To enable analysis of the proposed system in terms of area overhead as well as performance, we explore an approach, where the developed rigorous models are transformed into a high-level implementation language. Specifically, we investigate methods for deriving fault-free implementations from these models into, e.g., a hardware description language, namely VHDL.

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Laser cutting implementation possibilities into paper making machine was studied as the main objective of the work. Laser cutting technology application was considered as a replacement tool for conventional cutting methods used in paper making machines for longitudinal cutting such as edge trimming at different paper making process and tambour roll slitting. Laser cutting of paper was tested in 70’s for the first time. Since then, laser cutting and processing has been applied for paper materials with different level of success in industry. Laser cutting can be employed for longitudinal cutting of paper web in machine direction. The most common conventional cutting methods include water jet cutting and rotating slitting blades applied in paper making machines. Cutting with CO2 laser fulfils basic requirements for cutting quality, applicability to material and cutting speeds in all locations where longitudinal cutting is needed. Literature review provided description of advantages, disadvantages and challenges of laser technology when it was applied for cutting of paper material with particular attention to cutting of moving paper web. Based on studied laser cutting capabilities and problem definition of conventional cutting technologies, preliminary selection of the most promising application area was carried out. Laser cutting (trimming) of paper web edges in wet end was estimated to be the most promising area where it can be implemented. This assumption was made on the basis of rate of web breaks occurrence. It was found that up to 64 % of total number of web breaks occurred in wet end, particularly in location of so called open draws where paper web was transferred unsupported by wire or felt. Distribution of web breaks in machine cross direction revealed that defects of paper web edge was the main reason of tearing initiation and consequent web break. The assumption was made that laser cutting was capable of improvement of laser cut edge tensile strength due to high cutting quality and sealing effect of the edge after laser cutting. Studies of laser ablation of cellulose supported this claim. Linear energy needed for cutting was calculated with regard to paper web properties in intended laser cutting location. Calculated linear cutting energy was verified with series of laser cutting. Practically obtained laser energy needed for cutting deviated from calculated values. This could be explained by difference in heat transfer via radiation in laser cutting and different absorption characteristics of dry and moist paper material. Laser cut samples (both dry and moist (dry matter content about 25-40%)) were tested for strength properties. It was shown that tensile strength and strain break of laser cut samples are similar to corresponding values of non-laser cut samples. Chosen method, however, did not address tensile strength of laser cut edge in particular. Thus, the assumption of improving strength properties with laser cutting was not fully proved. Laser cutting effect on possible pollution of mill broke (recycling of trimmed edge) was carried out. Laser cut samples (both dry and moist) were tested on the content of dirt particles. The tests revealed that accumulation of dust particles on the surface of moist samples can take place. This has to be taken into account to prevent contamination of pulp suspension when trim waste is recycled. Material loss due to evaporation during laser cutting and amount of solid residues after cutting were evaluated. Edge trimming with laser would result in 0.25 kg/h of solid residues and 2.5 kg/h of lost material due to evaporation. Schemes of laser cutting implementation and needed laser equipment were discussed. Generally, laser cutting system would require two laser sources (one laser source for each cutting zone), set of beam transfer and focusing optics and cutting heads. In order to increase reliability of system, it was suggested that each laser source would have double capacity. That would allow to perform cutting employing one laser source working at full capacity for both cutting zones. Laser technology is in required level at the moment and do not require additional development. Moreover, capacity of speed increase is high due to availability high power laser sources what can support the tendency of speed increase of paper making machines. Laser cutting system would require special roll to maintain cutting. The scheme of such roll was proposed as well as roll integration into paper making machine. Laser cutting can be done in location of central roll in press section, before so-called open draw where many web breaks occur, where it has potential to improve runability of a paper making machine. Economic performance of laser cutting was done as comparison of laser cutting system and water jet cutting working in the same conditions. It was revealed that laser cutting would still be about two times more expensive compared to water jet cutting. This is mainly due to high investment cost of laser equipment and poor energy efficiency of CO2 lasers. Another factor is that laser cutting causes material loss due to evaporation whereas water jet cutting almost does not cause material loss. Despite difficulties of laser cutting implementation in paper making machine, its implementation can be beneficial. The crucial role in that is possibility to improve cut edge strength properties and consequently reduce number of web breaks. Capacity of laser cutting to maintain cutting speeds which exceed current speeds of paper making machines what is another argument to consider laser cutting technology in design of new high speed paper making machines.

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Cubiu (Solanum sessiliflorum Dunal) is an Amazonian Basin native fruit. Its importance comes from its high contents of pectin. Currently, processing technologies are necessary for the substitution of the traditional system (small crops and small-scale processing) for a larger scale system and thus increase the use of biodiversity and promote the implementation of Local Productive Arrangements of agribusiness in the Amazon. This research aims to evaluate the methods of peeling cubiu. Ripe fruits were divided into lots (150 each) and subjected to the following treatments: immersion in 2.5% NaOH boiling solution for 5 minutes, exposure to water vapor, and immersion in water at 96 ºC for 5, 10, 15 and 20 minutes. The peel released during heat treatment and immediately removed under running tap water. In the control treatment, the fruits were manually peeled (unheated) with a stainless steel knife. The treatments were evaluated for completeness and ease of peeling, tissue integrity, texture, and peroxidase activity. The immersion in 2.5% NaOH boiling solution (5 minutes) stood out as the best treatment since it inhibited the enzymatic browning and intensified the natural yellow color of the cubiu fruit and easily and fully peeled the whole fruit more rapidly without damaging its tissues. This treatment was chosen as the most advantageous because it can promote simultaneous peeling and bleaching. Therefore, it is recommended for cubiu industrial processing.

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Over the recent years, smart grids have received great public attention. Many proposed functionalities rely on power electronics, which play a key role in the smart grid, together with the communication network. However, “smartness” is not the driver that alone motivates the research towards distribution networks based on power electronics; the network vulnerability to natural hazards has resulted in tightening requirements for the supply security, set both by electricity end-users and authorities. Because of the favorable price development and advancements in the field, direct current (DC) distribution has become an attractive alternative for distribution networks. In this doctoral dissertation, power electronic converters for a low-voltage DC (LVDC) distribution system are investigated. These include the rectifier located at the beginning of the LVDC network and the customer-end inverter (CEI) on the customer premises. Rectifier topologies are introduced, and according to the LVDC system requirements, topologies are chosen for the analysis. Similarly, suitable CEI topologies are addressed and selected for study. Application of power electronics into electricity distribution poses some new challenges. Because the electricity end-user is supplied with the CEI, it is responsible for the end-user voltage quality, but it also has to be able to supply adequate current in all operating conditions, including a short-circuit, to ensure the electrical safety. Supplying short-circuit current with power electronics requires additional measures, and therefore, the short-circuit behavior is described and methods to overcome the high-current supply to the fault are proposed. Power electronic converters also produce common-mode (CM) and radio-frequency (RF) electromagnetic interferences (EMI), which are not present in AC distribution. Hence, their magnitudes are investigated. To enable comprehensive research on the LVDC distribution field, a research site was built into a public low-voltage distribution network. The implementation was a joint task by the LVDC research team of Lappeenranta University of Technology and a power company Suur-Savon S¨ahk¨o Oy. Now, the measurements could be conducted in an actual environment. This is important especially for the EMI studies. The main results of the work concern the short-circuit operation of the CEI and the EMI issues. The applicability of the power electronic converters to electricity distribution is demonstrated, and suggestions for future research are proposed.