Has DRG payment influenced the technical efficiency and productivity of diagnostic technologies in Portuguese public hospitals? An empirical analysis using parametric and non‐parametric methods

The use of Diagnosis Related Groups (DRG) as a mechanism for hospital financing is a currently debated topic in Portugal. The DRG system was scheduled to be initiated by the Health Ministry of Portugal on January 1, 1990 as an instrument for the allocation of public hospital budgets funded by the National Health Service (NHS), and as a method of payment for other third party payers (e.g., Public Employees (ADSE), private insurers, etc.). Based on experience from other countries such as the United States, it was expected that implementation of this system would result in more efficient hospital resource utilisation and a more equitable distribution of hospital budgets. However, in order to minimise the potentially adverse financial impact on hospitals, the Portuguese Health Ministry decided to gradually phase in the use of the DRG system for budget allocation by using blended hospitalspecific and national DRG casemix rates. Since implementation in 1990, the percentage of each hospitals budget based on hospital specific costs was to decrease, while the percentage based on DRG casemix was to increase. This was scheduled to continue until 1995 when the plan called for allocating yearly budgets on a 50% national and 50% hospitalspecific cost basis. While all other nonNHS third party payers are currently paying based on DRGs, the adoption of DRG casemix as a National Health Service budget setting tool has been slower than anticipated. There is now some argument in both the political and academic communities as to the appropriateness of DRGs as a budget setting criterion as well as to their impact on hospital efficiency in Portugal. This paper uses a twostage procedure to assess the impact of actual DRG payment on the productivity (through its components, i.e., technological change and technical efficiency change) of diagnostic technology in Portuguese hospitals during the years 1992–1994, using both parametric and nonparametric frontier models. We find evidence that the DRG payment system does appear to have had a positive impact on productivity and technical efficiency of some commonly employed diagnostic technologies in Portugal during this time span.

An empirical analysis of the global audit market: International Financial Reporting Standards-related changes and differences within the Big 4 global networks

Ongoing debates within the professional and academic communities have raised a number of questions specific to the international audit market. This dissertation consists of three related essays that address such issues. First, I examine whether the propensity to switch between auditors of different sizes (i.e., Big 4 versus non-Big 4) changes as adoption of International Financial Reporting Standards (IFRS) becomes a more common phenomenon, arguing that smaller auditors have an opportunity to invest in necessary skills and training needed to enter this market. Findings suggest that clients are relatively less (more) likely to switch to (away from) a Big 4 auditor if the client's adoption of IFRS occurs in more recent years. ^ In the second essay, I draw on these inferences and test whether the change in audit fees in the year of IFRS adoption changes over time. As the market becomes less concentrated, larger auditors becomes less able to demand a premium for their services. Consistent with my arguments, results suggest that the change in audit service fees declines over time, although this effect seems concentrated among the Big 4. I also find that this effect is partially attributable to a differential effect of the auditors' experience in pricing audit services related to IFRS based on the period in which adoption occurs. The results of these two essays offer important implications to policy debates on the costs and benefits of IFRS adoption. ^ In the third essay, I differentiate Big 4 auditors into three classifications—Parent firms, Brand Name affiliates, and Local affiliates—and test for differences in audit fee premiums (relative to non-Big 4 auditors) and audit quality. Results suggest that there is significant heterogeneity between the three classifications based on both of these characteristics, which is an important consideration for future research. Overall, this dissertation provides additional insights into a variety of aspects of the global audit market.^

Modelagem e análise dinâmica de um sistema de conversão de energia eólica dotado de gerador síncrono de imã permanente utilizando a plataforma ATP

Human development requires a broad balance between ecological, social and economic factors in order to ensure its own sustainability. In this sense, the search for new sources of energy generation, with low deployment and operation costs, which cause the least possible impact to the environment, has been the focus of attention of all society segments. To do so, the reduction in exploration of fossil fuels and the encouragement of using renewable energy resources for distributed generation have proved interesting alternatives to the expansion of the energy matrix of various countries in the world. In this sense, the wind energy has acquired an increasingly significant role, presenting increasing rates of power grid penetration and highlighting technological innovations such as the use of permanent magnet synchronous generators (PMSG). In Brazil, this fact has also been noted and, as a result, the impact of the inclusion of this source in the distribution and sub-transmission power grid has been a major concern of utilities and agents connected to Brazilian electrical sector. Thus, it is relevant the development of appropriate computational tools that allow detailed predictive studies about the dynamic behavior of wind farms, either operating with isolated load, either connected to the main grid, taking also into account the implementation of control strategies for active/reactive power generation and the keeping of adequate levels of voltage and frequency. This work fits in this context since it comprises mathematical and computational developments of a complete wind energy conversion system (WECS) endowed with PMSG using time domain techniques of Alternative Transients Program (ATP), which prides itself a recognized reputation by scientific and academic communities as well as by electricity professionals in Brazil and elsewhere. The modeling procedures performed allowed the elaboration of blocks representing each of the elements of a real WECS, comprising the primary source (the wind), the wind turbine, the PMSG, the frequency converter, the step up transformer, the load composition and the power grid equivalent. Special attention is also given to the implementation of wind turbine control techniques, mainly the pitch control responsible for keeping the generator under the maximum power operation point, and the vector theory that aims at adjusting the active/reactive power flow between the wind turbine and the power grid. Several simulations are performed to investigate the dynamic behavior of the wind farm when subjected to different operating conditions and/or on the occurrence of wind intensity variations. The results have shown the effectiveness of both mathematical and computational modeling developed for the wind turbine and the associated controls.

Playing popular science

This was a peer-reviewed event that took place at the DiGRA-FDG conference in August 2016. While it has a paper component (the attached proposal), the output was a demonstration of games rather than a conference paper. As such, this entry should be considered an Event or Exhibition.

Monitoring Compliance with Open Access policies

In the last few years, academic communities have seen an increase in the number of Open Access (OA) policies being adopted at the institutional and funder levels. In parallel to policy implementation, institutions and funders have also been engaged in developing mechanisms to monitor academics and researchers compliance with the existing OA policies. This study highlights a few of the cases where compliance is being effectively monitored by institutions and funders. In the first section, Open Access is briefly overviewed and the rationale for monitoring OA policy compliance is explained. The second section looks at best practices in monitoring policy compliance with OA policies by funders and institutions. The case studies reflect on compliance with the UK Funding Councils and the USA National Institutes of Health OA policies. The third section makes recommendations on what processes and procedures universities and funders should adopt to monitor compliance with their OA policies. The final section recapitulates some of the key ideas related to monitoring policy compliance.

Libraries Transforming Communities: The Value in an Academic Library Community at Lincoln University

Inman E. Page Library is coined as an, “Information Mall.” It houses special collections, archives, general reference services, computers, artistic programming, technological resources and space for different types of events. It is a modern academic library in the 21st century that was built on a legacy of scholarly opportunities for Lincoln University students, faculty, and our community in Jefferson City, MO and surrounding cities. The value that needs to be placed on this library is that it is an institution within an institution and should be given top priority as it pertains to continued funding, faculty support, and a place of higher learning that has a library etiquette. As well as, students need to understand the importance of how a library will affect their academic careers.

Meiobenthic communities of seagrass beds (Zostera capricorni) and unvegetated sediments along the coast of New South Wales, Australia

Seagrass beds have higher biomass, abundance, diversity and productivity of benthic organisms than unvegetated sediments. However, to date most studies have analysed only the macrofaunal component and ignored the abundant meiofauna present in seagrass meadows. This study was designed to test if meiobenthic communities, especially the free-living nematodes, differed between seagrass beds and unvegetated sediments. Sediment samples from beds of the eelgrass Zostera capricorni and nearby unvegetated sediments were collected in three estuaries along the coast of New South Wales, Australia. Results showed that sediments below the seagrass were finer, with a higher content of organic material and were less oxygenated than sediments without seagrass. Univariate measures of the fauna (i.e. abundance, diversity and taxa richness of total meiofauna and nematode assemblages) did not differ between vegetated and unvegetated sediments. However multivariate analysis of meiofaunal higher taxa showed significant differences between the two habitats, largely due to the presence and absence of certain taxa. Amphipods, tanaidacea, ostracods, hydrozoans and isopods occurred mainly in unvegetated sediments, while kinorhyncs, polychaetes, gastrotrichs and turbellarians were more abundant in vegetated sediments. Regarding the nematode assemblages, 32.4% of the species were restricted to Z. capricorni and 25% only occurred in unvegetated sediments, this suggests that each habitat is characterized by a particular suite of species. Epistrate feeding nematodes were more abundant in seagrass beds, and it is suggested that they graze on the microphytobenthos which accumulates underneath the seagrass. Most of the genera that characterized these estuarine unvegetated sediments are also commonly found on exposed sandy beaches. This may be explained by the fact that Australian estuaries have very little input of freshwater and experience marine conditions for most of the year. This study demonstrates that the seagrass and unvegetated sediments have discrete meiofaunal communities, with little overlap in species composition. (C) 2010 Elsevier Ltd. All rights reserved.

Children’s respiratory health and daily particulate levels in ten non-urban communities

We conducted a study to assess the association between the acute respiratory health of children and the levels of particulates in communities near and away from active opencast coal mines. The study enrolled children aged 1–11 years from the general population of five socioeconomically matched pairs of nonurban communities in northern England. Diaries of respiratory events were collected for 1405 children, and information was collected on the consultations of 2442 children with family/general practitioners over the 6-week study periods during 1996–1997, with concurrent monitoring of particulate levels. The associations found between daily PM10 levels and respiratory symptoms were frequently small and positive and sometimes varied between communities. The magnitude of these associations were in line with those from previous studies, even though daily particulate levels were low, and the children were drawn from the general population, rather than from the population with respiratory problems. The associations among asthma reliever use, consultations with general practitioners, and daily particulate levels were of a similar strength but estimated less precisely. The strength of association between all respiratory health measures and particulate levels was similar in communities near and away from opencast coal mining sites.

Virtual communities of practice: investigating motivations and constraints in the processes of knowledge creation and transfer

With accelerated market volatility, faster response times and increased globalization, business environments are going through a major transformation and firms have intensified their search for strategies which can give them competitive advantage. This requires that companies continuously innovate, to think of new ideas that can be transformed or implemented as products, processes or services, generating value for the firm. Innovative solutions and processes are usually developed by a group of people, working together. A grouping of people that share and create new knowledge can be considered as a Community of Practice (CoP). CoP’s are places which provide a sound basis for organizational learning and encourage knowledge creation and acquisition. Virtual Communities of Practice (VCoP's) can perform a central role in promoting communication and collaboration between members who are dispersed in both time and space. Nevertheless, it is known that not all CoP's and VCoP's share the same levels of performance or produce the same results. This means that there are factors that enable or constrain the process of knowledge creation. With this in mind, we developed a case study in order to identify both the motivations and the constraints that members of an organization experience when taking part in the knowledge creating processes of VCoP's. Results show that organizational culture and professional and personal development play an important role in these processes. No interviewee referred to direct financial rewards as a motivation factor for participation in VCoPs. Most identified the difficulty in aligning objectives established by the management with justification for the time spent in the VCoP. The interviewees also said that technology is not a constraint.

Hearing evaluation of portuguese school communities: school‑based audiology and hearing screening

Introduction: Hearing loss h sone raised impact in the development and academic progress of a child. In several developed countries, early detection is part of the national health plan through universal neonatal hearing screening (UNHS) and also with school hearing screening programs (SHSP), but only a few have published national data and revised protocols. Currently in Portugal, the UNHS is implemented in the main district hospitals but not the SHPS, as well we still do not make use of concrete data nor publication of studies on the national reality. Objectives: The incidence of the hearing loss and of otological problems was studied in school communities in the north of the country with 2550 participants between 3 and 17 years old. Methods: Statistical data collected within the schools with a standard auditory hearing screening protocol. All participants were evaluated with the same protocol, an audiological anamnesis, otoscopy and audiometric exam screening (500, 1000, 2000 and 4000 Hz) were fulfilled. Results: Different otological problems were identified and the audiometric screening exam counted auditory thresholds that outpointed uni and bilateral hearing loss in about 5.7% of the cases. Conclusions: The study has demonstrated that auditory school screening should take place as early as possible and be part of the primary health care to identify and direct children to appropriate rehabilitation, education and attendance. Thus, reducing high costs with late treatment.

Knowledge sharing in virtual communities

The Internet has transformed the scope, boundaries and dynamics of social and economic interactions. It is argued to have broadened the notion of the community from physical, colocated groups towards collectives that are able to transcend time and space, i.e. virtual communities. Even if virtual communities have been on the academic agenda for a couple of decades, there is still surprisingly little research on knowledge sharing within them. In addition, prior research has largely neglected the complex dynamics between Internet-based communication channels and the surrounding communities in which they are embedded. This thesis aims at building a better understanding of knowledge sharing supported by conversational technologies in intra-organisational virtual communities and external virtual communities supporting relationships with customers. The focus is thus on knowledge sharing in types of virtual communities that seem to be of relevance to business organisations. The study consists of two parts. The first part introduces the research topic and discusses the overall results. The second part comprises seven research publications. Qualitative research methods are used throughout the study. The results of the study indicate that investigation of the processes of knowledge sharing in virtual communities requires a socio-technical perspective, combining the individual, social and technological levels, and understanding the interplay between them. It is claimed that collective knowledge in virtual communities creates the enabling structure for knowledge sharing, and forms the invisible structure of the community on the basis of which it operates. It consists of a shared context, social capital and a unique community culture. The Internet does not inevitably erode social interaction: it seems that supporting social relationships by means of communication technology is a matter of quantity rather than quality. In order to provide access to external knowledge and expertise, firms need to open themselves up to an array of Internet-based conversations, and to consider the relevance of virtual communities to their businesses.

Interaction and knowledge exchange among academic business librarians in Ontario

A research project submitted to the Faculty of Extension, University of Alberta in partial fulfillment of the requirements for the degree of Master of Arts in Communications and Technology in 2005.

Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador

The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. By 2009, train-the-trainer project initiation involved 27 participatory action research Master’s theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master’s and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Alliances of academic and non-academic partners from the South and North provide a promising orientation for learning together about ways of addressing negative trends of development. Assessing the impacts and sustainability of such processes, however, requires longer term monitoring of results and related challenges.

Building communities via a learning landscape

The Learning Landscape project described here is known as RedGloo and has several objectives; among others it aims to help students to make friends, contacts and join communities based on interests and competencies. RedGloo provides a space where students can support each other with personal, academic and career development, sharing insights gained from extracurricular activities as well as their degree programmes. It has shown tendencies of becoming a learning community with several communities of practice.

A tale of two Montreal communities: parental perspectives on their children's multi-lingual and multi-literate development

This comparative inquiry examines the multi-/bilingual nature and cultural diversity of two distinctly different linguistic and ethnic communities in Montreal – English speakers and Chinese speakers – with a focus on the multi/bilingual and multi/biliterate development of children from these two communities who attend French-language schools, by choice in one case and by law in the other. In both of these communities, children traditionally achieve academic success. The authors approach this investigation from the perspective of the parents’ aspirations and expectations for, and their support of and involvement in, their children’s education. These two communities share key similarities and differences that, when considered together, help to clarify a number of issues involving multi/biliteracy development, socio-economic and linguistic capital, minority/majority language status, mother-tongue support, home–school continuities, and linguistic identity.