Late-medieval construction site management at the Monastery of Jerónimos in Lisbon

Through the analysis of the exceptional accounting documents of 1517 related to the construction of the Monastery of Jerónimos (Lisbon), this paper discusses the main characteristics of a new model of construction site organization. In the later Middle Ages we can find, among others, two main models of constructing site organization. One, older and more widespread, consisted in a centralized and pyramidal management model. The other, apparently more recent, was based in the existence of several autonomous teams working simultaneously, each one responsible for building a specific part or section of the building. This paper describes and discusses this new organizational model as it was adopted and implemented by João de Castilho (1470–1552) for the construction of the Monastery of Jerónimos in 1517, probably for the first time in Portugal, but with some parallels in other places in Europe.

Project management under uncertainty: a study on solution methods

Project Management involves onetime endeavors that demand for getting it right the first time. On the other hand, project scheduling, being one of the most modeled project management process stages, still faces a wide gap from theory to practice. Demanding computational models and their consequent call for simplification, divert the implementation of such models in project management tools from the actual day to day project management process. Special focus is being made to the robustness of the generated project schedules facing the omnipresence of uncertainty. An "easy" way out is to add, more or less cleverly calculated, time buffers that always result in project duration increase and correspondingly, in cost. A better approach to deal with uncertainty seems to be to explore slack that might be present in a given project schedule, a fortiori when a non-optimal schedule is used. The combination of such approach to recent advances in modeling resource allocation and scheduling techniques to cope with the increasing flexibility in resources, as can be expressed in "Flexible Resource Constraint Project Scheduling Problem" (FRCPSP) formulations, should be a promising line of research to generate more adequate project management tools. In reality, this approach has been frequently used, by project managers in an ad-hoc way.

Concise server-wide causality management for eventually consistent data stores

Large scale distributed data stores rely on optimistic replication to scale and remain highly available in the face of net work partitions. Managing data without coordination results in eventually consistent data stores that allow for concurrent data updates. These systems often use anti-entropy mechanisms (like Merkle Trees) to detect and repair divergent data versions across nodes. However, in practice hash-based data structures are too expensive for large amounts of data and create too many false conflicts. Another aspect of eventual consistency is detecting write conflicts. Logical clocks are often used to track data causality, necessary to detect causally concurrent writes on the same key. However, there is a nonnegligible metadata overhead per key, which also keeps growing with time, proportional with the node churn rate. Another challenge is deleting keys while respecting causality: while the values can be deleted, perkey metadata cannot be permanently removed without coordination. Weintroduceanewcausalitymanagementframeworkforeventuallyconsistentdatastores,thatleveragesnodelogicalclocks(BitmappedVersion Vectors) and a new key logical clock (Dotted Causal Container) to provides advantages on multiple fronts: 1) a new efficient and lightweight anti-entropy mechanism; 2) greatly reduced per-key causality metadata size; 3) accurate key deletes without permanent metadata.

Safety management of cranes on construction sites in Portugal: Critical factors of safety

The evolution of the construction caused a need to use more effective equipments, capable of meeting the increasingly demanding deadlines for the completion of works. In this context, the safety and efficiency of equipment have become key aspects in order to optimize the execution time of the works, as well as reducing labor costs and loss of materials. With the evolution of construction and construction processes, cranes have come to represent a signal of the construction of buildings, revealing to be, in most of the cases, the main equipment of construction sites. Currently, some engineers revels some apprehension regarding the use and handling of cranes which is natural and acceptable, since an equipment failure can lead to serious or fatal accidents. The factors affecting safety management of the cranes in construction sites were investigated, identified, classified and evaluated according to their degree of importance, through interviews with representatives of the general contractors of a set of selected construction sites.

Environmental management systems implementation

All organisations make some contribution to the degradation of the environment through their use of resources and production of waste. Environmental management systems (EMS) standards can provide a tool for companies to systematically reduce their environmental impacts. ISO 14001 was published in 1996. This fitted in with plans of the case study company to take proactive action in this area, even though there was no legislative requirement for them to do so. As EMS implementation was a new area at the time, appropriate methodologies were developed to address different aspects of the implementation, and ISO 14001 was successfully implemented in the company. The results of the primary research included: ♦ Drawing up a methodology for identifying and interpreting the environmental legislation that may have an impact on the organisation and compiling a register of such regulations. ♦ Developing a robust methodology for assessing significant environmental aspects and impacts and applying this to the software company. ♦ Establishing objectives and targets for those aspects identified as significant and implementing environmental management programmes to meet these. ♦ Developing an internal environmental audit procedure based on auditing against the significant aspects. ♦ Integrating areas of the EMS with the existing quality management system in order to avoid duplication of effort. ♦ Undergoing an external assessment process in order to achieve certification of the system. The thesis concludes that the systematic approach defined in ISO 14001 provided a mechanism that the organisation was able to adopt to bring about improvement in its environmental performance. The system was based on a thorough evaluation of the organisation's significant environmental aspects in order to bring about a reduction in its negative impacts. The ISO 14001 requirement for continual improvement is the key driver of the system, and this is what differentiates it from ISO 9000.

Analysis of energy management in GMIT

Energy management is the process of monitoring, controlling and conserving energy in a building or organisation. The main reasons for this are for cost purposes and benefit to the environment. Through various techniques and solutions for lighting, heating, office equipment, the building fabric etc along with a change in people’s attitudes there can be a substantial saving in the amount spent on energy. A good example o f energy waste in GMIT is the lighting situation in the library. All the lights are switched on all day on even in places where that is adequate daylighting, which is a big waste o f energy. Also the lights for book shelves are left on. Surely all these books won’t be searched for all at the one time. It would make much more sense to have local switches that the users can control when they are searching for a particular book. Heating controls for the older parts o f the college are badly needed. A room like 834 needs a TRV to prevent it from overheating as temperatures often reach the high twenties due to the heat from the radiators, computers, solar gains and heat from users o f the room. Also in the old part o f the college it is missing vital insulation, along with not being air tight due to the era when it was built. Pumped bonded bead insulation and sealant around services and gaps can greatly improve the thermal performance o f the building and help achieve a higher BER cert. GMIT should also look at the possibility o f installing a CHP plant to meet the base heating loads. It would meet the requirement o f running 4500 hours a year and would receive some financial support from the Accelerated Capital Allowance. I f people’s attitudes are changed through energy awareness campaigns and a few changes made for more energy efficient equipment, substantial savings can be made in the energy expenditure.

Quality management for education (second level schools)

Quality Management is a well-developed and widely used approach within industry to gain competitive edge and increased market share. It is a new management approach for schools who are now applying it without having the culture or experience of its evolution. Industrially based Quality management systems and excellence models have been developed. These excellence models and frameworks are based on the principles and concepts of TQM which are recognised as essential elements of high performing organisations. Schools are complex social institutions that provide a service. Like any other service industry, the customers of education are expecting and demanding a better service or else they will go elsewhere. Schools are beginning to reform and change to adapt to such demands. This has been reflected in Ireland in the Education Act, 1998. It is now the right time to develop a quality management system specifically for schools. The existing industrial excellence models have been modified for use in the private and public sector and some have been specifically tailored for education. The problem with such models is that they are still too sophisticated and the language still too industrial for schools. This Thesis develops and Excellence Model for Second Level Schools and provides guidance and school specific tools for its implementation.

Data for the sustainable management of an emerging fishery: Age, growth and stock structure of Atlantic saury Scomberesox saurus saurus (Walbaum), in the Northeastern Atlantic Ocean

Almost half of Ireland’s commercial stocks face overexploitation. As traditional species decrease in abundance and become less profitable, the industry is increasingly turning to alternate species. Atlantic saury (Scomberesox saurus saurus (Walbaum)) has been identified as a potential species for exploitation. Very little information is available on its biology or population dynamics, especially for Irish waters. This thesis aims to obtain sound scientific data, which will help to ensure that a future Atlantic saury fishery can be sustainably managed. The research has produced valuable data, some of which contradicts previous studies. Growth of Atlantic saury measured using otolith microstructure is found to be more than twice that previously calculated from annual structures on scales and otoliths. This results in a significant reduction of the expected life span from five to about two years. Investigation of maturity stage at age indicates that Atlantic saury will reproduce for the first time at age one and will survive for one or at most two reproduction seasons. It is concluded that a future Irish fishery will target mostly fish prior to their first reproduction. Finally the thesis gives some insights into the population structure of Atlantic saury, by analysis of otolith morphometric. Significant differences are detected between Northeastern Atlantic and western Mediterranean Sea specimens of the 0+ age class (less than one year old). The implications of these results for the management of an emerging fishery are discussed.

When is the Best Time for the Second Antiplatelet Agent in Non-St Elevation Acute Coronary Syndrome?

Abstract Dual antiplatelet therapy is a well-established treatment in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), with class I of recommendation (level of evidence A) in current national and international guidelines. Nonetheless, these guidelines are not precise or consensual regarding the best time to start the second antiplatelet agent. The evidences are conflicting, and after more than a decade using clopidogrel in this scenario, benefits from the routine pretreatment, i.e. without knowing the coronary anatomy, with dual antiplatelet therapy remain uncertain. The recommendation for the upfront treatment with clopidogrel in NSTE-ACS is based on the reduction of non-fatal events in studies that used the conservative strategy with eventual invasive stratification, after many days of the acute event. This approach is different from the current management of these patients, considering the established benefits from the early invasive strategy, especially in moderate to high-risk patients. The only randomized study to date that specifically tested the pretreatment in NSTE-ACS in the context of early invasive strategy, used prasugrel, and it did not show any benefit in reducing ischemic events with pretreatment. On the contrary, its administration increased the risk of bleeding events. This study has brought the pretreatment again into discussion, and led to changes in recent guidelines of the American and European cardiology societies. In this paper, the authors review the main evidence of the pretreatment with dual antiplatelet therapy in NSTE-ACS.

Entrepreneurship, management services and economic growth

We model the joint production of entrepreneurs and workers where the former provide both entrepreneurial (strategic) and managerial (coordination, motivation) services, and management services are shared with individual workers in an output maximizing way. The static equilibrium of the model determines the endogenous share of entrepreneurs in the economy in a given moment of time. The time dynamics of the solution implies that a given growth rate in quality of entrepreneurial services contributes to productivity growth proportionally to the share of entrepreneurs at the start of the period and improvement in quality of entrepreneurial services is convergence enhancing. Model predictions are tested with data from OECD countries in the period 1970-2002. We find that improvements in quality of entrepreneurial services over time explain up to 100% of observed average productivity growth in these countries.

Relay-assisted transmission and radio resource management for wireless networks

The following paper presents an overview of the Ph.D Thesis1 presented in [1], which compiles all the research done during the period of time between 2004-2007. In that dissertation the relay-assisted transmission with half-duplex relays is analyzed from different points of view. This study is motivated by the necessity of finding innovative solutions to cope with the requirements of next generation wireless services, and with current radio technology. The use of relayed communications represents a change of paradigm of conventional communications, and requires the definition and evaluation of protocols to be applied to single or multiple-user relay communication. With the two fold goal of enhancing spectral efficiency and homogenize service in cellular communications, system design is investigated at physical (type of transmissions of the relay, decoding mode, ..) and upper layers (resource allocation, dynamic link control).

Choline-PET in prostate cancer management: The point of view of the radiation oncologist.

Among PET radiotracers, FDG seems to be quite accepted as an accurate oncology diagnostic tool, frequently helpful also in the evaluation of treatment response and in radiation therapy treatment planning for several cancer sites. To the contrary, the reliability of Choline as a tracer for prostate cancer (PC) still remains an object of debate for clinicians, including radiation oncologists. This review focuses on the available data about the potential impact of Choline-PET in the daily clinical practice of radiation oncologists managing PC patients. In summary, routine Choline-PET is not indicated for initial local T staging, but it seems better than conventional imaging for nodal staging and for all patients with suspected metastases. In these settings, Choline-PET showed the potential to change patient management. A critical limit remains spatial resolution, limiting the accuracy and reliability for small lesions. After a PSA rise, the problem of the trigger PSA value remains crucial. Indeed, the overall detection rate of Choline-PET is significantly increased when the trigger PSA, or the doubling time, increases, but higher PSA levels are often a sign of metastatic spread, a contraindication for potentially curable local treatments such as radiation therapy. Even if several published data seem to be promising, the current role of PET in treatment planning in PC patients to be irradiated still remains under investigation. Based on available literature data, all these issues are addressed and discussed in this review.

BORN AT 27 WEEKS OF GESTATION WITH CLASSICAL PKU: CHALLENGES OF DIETETIC MANAGEMENT IN A VERY PRETERM INFANT

Only few cases of classical phenylketonuria (PKU) in premature infants have been reported. Treatment of these patients is challenging due to the lack of a phenylalanine-free amino acid solution for parenteral infusion. The boy was born at 27 weeks of gestation with a weight of 1000 g (P10). He received parenteral nutrition with a protein intake of 3 g/kg/day. On day 7 he was diagnosed with classical PKU (genotype IVS10-11G>A/IVS12+ 1G>A) due to highly elevated phenylalanine (Phe) level in newborn screening (2800 micromol/L). His maximum plasma Phe level reached 3696 micromol/L. Phe intake was stopped for 4 days. During this time the boy received intravenous glucose and lipids as well as little amounts of Phe-free formula by a nasogastric tube. Due to a deficit of essential amino acids and insufficient growth, a parenteral nutrition rich in branched-chain amino-acids and relatively poor in Phe was added, in order to promote protein synthesis without overloading in Phe. Under this regimen, Phe plasma levels normalized on day 19 when intake of natural protein was started. The boy has now a corrected age of 2 years. He shows normal growth parameters and psychomotor development. Despite a long period of highly elevated Phe levels in the postnatal period our patient shows good psychomotor development. The management of premature infants with PKU depends on the child's tolerance to enteral nutrition. It demands an intensive follow-up by an experienced team and dedicated dietician. Appropriate Phe-free parenteral nutrition would be necessary especially in case of gastro-intestinal complications of prematurity.

Adhésion thérapeutique aux traitements oncologiques oraux et prise en charge interdisciplinaire [Therapeutic adherence to oral cancer therapy and interdisciplinary management].

Medication adherence is a well-known risk factor in internal medicine. However in oncology this dimension is emerging due to the increasing number of oral formulations. First results in the oral oncology literature suggest that patients' ability to cope with medical prescription decreases with time. This might preclude patients from reaching clinical outcomes. Factors impacting on medication adherence to oral oncology treatments have not been yet extensively described neither strategies to address them and support patient's needs. Oncologists and pharmacists in our University outpatient settings performed a pilot study which aimed at measuring and facilitating adherence to oral oncology treatments and at understanding determinants of patient's adherence. The ultimate purpose of such a patient-centered and interdisciplinary collaboration would be to promote patient self-management and complement the standard medical follow-up.

Clinical review: practical recommendations on the management of perioperative heart failure in cardiac surgery.

Acute cardiovascular dysfunction occurs perioperatively in more than 20% of cardiosurgical patients, yet current acute heart failure (HF) classification is not applicable to this period. Indicators of major perioperative risk include unstable coronary syndromes, decompensated HF, significant arrhythmias and valvular disease. Clinical risk factors include history of heart disease, compensated HF, cerebrovascular disease, presence of diabetes mellitus, renal insufficiency and high-risk surgery. EuroSCORE reliably predicts perioperative cardiovascular alteration in patients aged less than 80 years. Preoperative B-type natriuretic peptide level is an additional risk stratification factor. Aggressively preserving heart function during cardiosurgery is a major goal. Volatile anaesthetics and levosimendan seem to be promising cardioprotective agents, but large trials are still needed to assess the best cardioprotective agent(s) and optimal protocol(s). The aim of monitoring is early detection and assessment of mechanisms of perioperative cardiovascular dysfunction. Ideally, volume status should be assessed by 'dynamic' measurement of haemodynamic parameters. Assess heart function first by echocardiography, then using a pulmonary artery catheter (especially in right heart dysfunction). If volaemia and heart function are in the normal range, cardiovascular dysfunction is very likely related to vascular dysfunction. In treating myocardial dysfunction, consider the following options, either alone or in combination: low-to-moderate doses of dobutamine and epinephrine, milrinone or levosimendan. In vasoplegia-induced hypotension, use norepinephrine to maintain adequate perfusion pressure. Exclude hypovolaemia in patients under vasopressors, through repeated volume assessments. Optimal perioperative use of inotropes/vasopressors in cardiosurgery remains controversial, and further large multinational studies are needed. Cardiosurgical perioperative classification of cardiac impairment should be based on time of occurrence (precardiotomy, failure to wean, postcardiotomy) and haemodynamic severity of the patient's condition (crash and burn, deteriorating fast, stable but inotrope dependent). In heart dysfunction with suspected coronary hypoperfusion, an intra-aortic balloon pump is highly recommended. A ventricular assist device should be considered before end organ dysfunction becomes evident. Extra-corporeal membrane oxygenation is an elegant solution as a bridge to recovery and/or decision making. This paper offers practical recommendations for management of perioperative HF in cardiosurgery based on European experts' opinion. It also emphasizes the need for large surveys and studies to assess the optimal way to manage perioperative HF in cardiac surgery.