928 resultados para service level management
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Includes bibliography
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Incluye Bibliografía
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Dental caries still affect a considerable proportion of children, however the epidemiological profile of oral diseases is changing, social inequalities cause different disease patterns. The same problems occur for the use of services, which damage those who are more susceptible to oral diseases in numerous ways. To verify the association between the variables: socioeconomic condition, oral health and access to dental services providing oral health care for preschool children. The study population consisted of 2,759 children up to 6 years-old. The clinical exams followed the World Health Organization (WHO) criteria. The data were collected using a self-applied questionnaire, answered by the carers of children, with questions about socioeconomic variables and access to dental services. In terms of social class, a majority of the subjects came from the middle socioeconomic level (babies, 84.7%; children, 82.8%). Babies who had caries, 48.4% and 67.2% of the children that had decayed teeth had access to dental service. There was a association between the variables: the reason for the last dental appointment and the parent's perception of the treatment need of their children (babies p=0.0004 and children p < 0.0001); the parent's perception of the treatment need of their children and the oral health condition (babies p=0.0008 and children p < 0.0001); access to dental services and oral health condition (babies p=0.0021 and children p < 0.0001). The majority of the population studied sought care from public dental service and was from the middle class.
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Outsourcing logistics has established itself in the area of the LSP (Logistics Service Provider), which offers a range of services to its customers. In this line, transportation is characterized as one of the most important services, and therefore efficient fleet management is essential for establishing a high level of customer service. With advances in technology and vehicle tracking systems, this approach of management has gained new possibilities for the improvement of logistics services. By studying the specific case of an LSP, this paper investigates the use of these technologies in the management of their business and services. The results indicate that the LSP seeks to increase its services and to streamline information in order to respond to customer needs in real time. It is also evident in this case under study that the combination of the technology available together with the fleet management system has become a distinguishing feature for this LSP, one which increases their skills and important information for both customers and business.
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Grassland ecosystems have been severely reduced and grassland bird populations have experienced consistent declines. National Park Service (NPS) properties on the Great Plains provide breeding habitat for grassland songbirds, though little is known about the quality of this habitat. A short-term study on songbirds at three NPS properties complemented current monitoring, providing an among park comparison addressing grassland bird productivity and fidelity relative to NPS property size. During 2008-2009, I assessed avian species richness, and estimated bird density and grassland songbird nest success. Bird species richness was greatest at small and medium sites, while number of nesting obligate species was greatest at the large site. Species-specific densities varied among sites, with few grassland obligates occurring at all three sites. Nest success estimates for grassland obligates were highest at the small site and lower at the large site. Another method to quantify habitat quality is assessment of breeding site fidelity. Current extrinsic markers used in monitoring site fidelity are inadequate for small birds; stable isotope analyses provide an alternative. I compared two techniques for assigning stable isotope tissue origin and measured grassland songbird site fidelity. My method of assigning origin provided site-specific variances of expected stable isotope values, an improvement over the most commonly used method. Fidelity tended to be higher at the large site, which may indicate a more robust breeding community of grassland birds. The small size of two of my sites precluded large sample sizes and made strong inferences difficult. To quantify how scientists cope with weak inference, I conducted a literature review. Strong inference was rarely observed, and most authors of weak-inference papers provided specific management recommendations. I suggest that adaptive management is an ideal method to resolve uncertainty from weak inference. Managers should consider my results within the context of regional and global management and the extent to which their unit might aide songbird conservation.
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When looking at developing countries, the prolonged intensive medical and nursing care required by many patients places extra demands on an already stretched healthcare budget. The purpose of this study was to verify the effectiveness of a systematic rehabilitative program for swallowing and oral-motor movements in intensive care unit patients with the diagnosis of tetanus. Forty-five patients who were clinically diagnosed with tetanus were included in the study. Participants were divided in two groups: Cl - consisted of 18 tetanus patients who were consecutively admitted to the infectious disease ICU from January 2002 to December 2005, prior to the existence of a systematic swallowing and oral-motor intervention: GII - consisted of 27 tetanus patients who were consecutively admitted to the infectious disease ICU from January 2006 to December 2009 and were submitted to a specific rehabilitative management of swallowing and of the oral-motor movements. Results indicate that the proposed rehabilitative program reduced by approximately 50% the time patients remained in the ICU. The significant improvement observed in patients with tetanus who were submitted to the rehabilitative program for swallowing and oral-motor movements occurred in conjunction with a reduction in the amount of time necessary to reintroduce oral feeding, to decannulate and to remove the feeding tubes. In conclusion, swallowing/muscle exercise, in patients with severe/very severe tetanus, seem to promote the remission of muscle tension and seem to maximize functional swallowing. (C) 2012 Elsevier B.V. All rights reserved.
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The purpose of this study was to assess the effect of low level laser therapy on subjects with intra-articular temporomandibular disorders (IA-TMD), and to quantify and compare severity of signs and symptoms before, during, and after the laser applications. The sample consisted of 45 subjects randomly divided into three groups (G) of 15 subjects each: G-I: 15 individuals with IA-TMD submitted to an energy dose of 52.5 J/cm(2); G-II: dose of 105.0 J/cm(2); and G-III: placebo group (0 J/cm(2)). In all groups, the applications were performed on condylar points on the masseter and anterior temporalis muscles. Two weekly sessions were held for five weeks, totaling 10 applications. The assessed variables were: mandibular movements and painful symptoms evoked by muscle palpation. These variables were measured before starting the study, then immediately after the first, fifth, and tenth laser application, and finally, 32 days after completing the applications. The results showed that there were statistically significant differences for G-I and G-II at the level of 1% between the doses, as well as between assessments. Therefore, it was concluded that the use of low level laser increased the mean mandibular range of motion and reduced painful symptoms in the groups that received effective treatment, which did not occur in the placebo group.
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Supply chain starts with a demand arisen and ends with material transport and delivery at its final destination. With this in mind, most of manufacturing, processors or distribution companies of consumer goods, spare parts and components for production, processing and finished goods, within national or international markets, may not have information and control over its supply chain performance. This article presents concept and logistics models evolution, purchase order and international supplier management, control tower and its logistics information systems. This also presents a real process implementation for a global high tech manufacturer company.
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Asset Management (AM) is a set of procedures operable at the strategic-tacticaloperational level, for the management of the physical asset’s performance, associated risks and costs within its whole life-cycle. AM combines the engineering, managerial and informatics points of view. In addition to internal drivers, AM is driven by the demands of customers (social pull) and regulators (environmental mandates and economic considerations). AM can follow either a top-down or a bottom-up approach. Considering rehabilitation planning at the bottom-up level, the main issue would be to rehabilitate the right pipe at the right time with the right technique. Finding the right pipe may be possible and practicable, but determining the timeliness of the rehabilitation and the choice of the techniques adopted to rehabilitate is a bit abstruse. It is a truism that rehabilitating an asset too early is unwise, just as doing it late may have entailed extra expenses en route, in addition to the cost of the exercise of rehabilitation per se. One is confronted with a typical ‘Hamlet-isque dilemma’ – ‘to repair or not to repair’; or put in another way, ‘to replace or not to replace’. The decision in this case is governed by three factors, not necessarily interrelated – quality of customer service, costs and budget in the life cycle of the asset in question. The goal of replacement planning is to find the juncture in the asset’s life cycle where the cost of replacement is balanced by the rising maintenance costs and the declining level of service. System maintenance aims at improving performance and maintaining the asset in good working condition for as long as possible. Effective planning is used to target maintenance activities to meet these goals and minimize costly exigencies. The main objective of this dissertation is to develop a process-model for asset replacement planning. The aim of the model is to determine the optimal pipe replacement year by comparing, temporally, the annual operating and maintenance costs of the existing asset and the annuity of the investment in a new equivalent pipe, at the best market price. It is proposed that risk cost provide an appropriate framework to decide the balance between investment for replacing or operational expenditures for maintaining an asset. The model describes a practical approach to estimate when an asset should be replaced. A comprehensive list of criteria to be considered is outlined, the main criteria being a visà- vis between maintenance and replacement expenditures. The costs to maintain the assets should be described by a cost function related to the asset type, the risks to the safety of people and property owing to declining condition of asset, and the predicted frequency of failures. The cost functions reflect the condition of the existing asset at the time the decision to maintain or replace is taken: age, level of deterioration, risk of failure. The process model is applied in the wastewater network of Oslo, the capital city of Norway, and uses available real-world information to forecast life-cycle costs of maintenance and rehabilitation strategies and support infrastructure management decisions. The case study provides an insight into the various definitions of ‘asset lifetime’ – service life, economic life and physical life. The results recommend that one common value for lifetime should not be applied to the all the pipelines in the stock for investment planning in the long-term period; rather it would be wiser to define different values for different cohorts of pipelines to reduce the uncertainties associated with generalisations for simplification. It is envisaged that more criteria the municipality is able to include, to estimate maintenance costs for the existing assets, the more precise will the estimation of the expected service life be. The ability to include social costs enables to compute the asset life, not only based on its physical characterisation, but also on the sensitivity of network areas to social impact of failures. The type of economic analysis is very sensitive to model parameters that are difficult to determine accurately. The main value of this approach is the effort to demonstrate that it is possible to include, in decision-making, factors as the cost of the risk associated with a decline in level of performance, the level of this deterioration and the asset’s depreciation rate, without looking at age as the sole criterion for making decisions regarding replacements.
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The wide diffusion of cheap, small, and portable sensors integrated in an unprecedented large variety of devices and the availability of almost ubiquitous Internet connectivity make it possible to collect an unprecedented amount of real time information about the environment we live in. These data streams, if properly and timely analyzed, can be exploited to build new intelligent and pervasive services that have the potential of improving people's quality of life in a variety of cross concerning domains such as entertainment, health-care, or energy management. The large heterogeneity of application domains, however, calls for a middleware-level infrastructure that can effectively support their different quality requirements. In this thesis we study the challenges related to the provisioning of differentiated quality-of-service (QoS) during the processing of data streams produced in pervasive environments. We analyze the trade-offs between guaranteed quality, cost, and scalability in streams distribution and processing by surveying existing state-of-the-art solutions and identifying and exploring their weaknesses. We propose an original model for QoS-centric distributed stream processing in data centers and we present Quasit, its prototype implementation offering a scalable and extensible platform that can be used by researchers to implement and validate novel QoS-enforcement mechanisms. To support our study, we also explore an original class of weaker quality guarantees that can reduce costs when application semantics do not require strict quality enforcement. We validate the effectiveness of this idea in a practical use-case scenario that investigates partial fault-tolerance policies in stream processing by performing a large experimental study on the prototype of our novel LAAR dynamic replication technique. Our modeling, prototyping, and experimental work demonstrates that, by providing data distribution and processing middleware with application-level knowledge of the different quality requirements associated to different pervasive data flows, it is possible to improve system scalability while reducing costs.
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L’obiettivo dell’elaborato è mostrare come, partendo da una robusta base teorica nelle discipline del Project Management e del Business Process Reengineering, sia possibile ridefinire un sistema di gestione dei progetti (a livello singolo e di aggregato) e sviluppare, presso il personale coinvolto, le competenze necessarie a sostenere autonomamente ed a migliorare il sistema così creato. La reingegnerizzazione della progettazione nell’azienda in esame si è sviluppata nell’arco di un quadriennio: nel 2010 è stata concretizzata la prima release dei processi di gestione del progetto singolo e dell’aggregato, nel 2011 è maturata la seconda release, mentre nel biennio 2012-2013 si sono “congelati” i risultati ottenuti e si è sviluppata l’autonomia dei Project Manager interni e del Project Management Office. Dall’analisi è emersa l’importanza di un solido approccio metodologico negli interventi di innovazione organizzativa.
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Resource management is of paramount importance in network scenarios and it is a long-standing and still open issue. Unfortunately, while technology and innovation continue to evolve, our network infrastructure system has been maintained almost in the same shape for decades and this phenomenon is known as “Internet ossification”. Software-Defined Networking (SDN) is an emerging paradigm in computer networking that allows a logically centralized software program to control the behavior of an entire network. This is done by decoupling the network control logic from the underlying physical routers and switches that forward traffic to the selected destination. One mechanism that allows the control plane to communicate with the data plane is OpenFlow. The network operators could write high-level control programs that specify the behavior of an entire network. Moreover, the centralized control makes it possible to define more specific and complex tasks that could involve many network functionalities, e.g., security, resource management and control, into a single framework. Nowadays, the explosive growth of real time applications that require stringent Quality of Service (QoS) guarantees, brings the network programmers to design network protocols that deliver certain performance guarantees. This thesis exploits the use of SDN in conjunction with OpenFlow to manage differentiating network services with an high QoS. Initially, we define a QoS Management and Orchestration architecture that allows us to manage the network in a modular way. Then, we provide a seamless integration between the architecture and the standard SDN paradigm following the separation between the control and data planes. This work is a first step towards the deployment of our proposal in the University of California, Los Angeles (UCLA) campus network with differentiating services and stringent QoS requirements. We also plan to exploit our solution to manage the handoff between different network technologies, e.g., Wi-Fi and WiMAX. Indeed, the model can be run with different parameters, depending on the communication protocol and can provide optimal results to be implemented on the campus network.