Toimintolaskennan hyödyntäminen prosessijohtamisen tukena julkisen sektorin terveydenhuolto-organisaatiossa

Tämän tutkielman tavoitteena on tutkia toimintolaskennan ja toimintojohtamisen käyttöä sekä hyödyntämistä prosessijohtamisen tukena. Työssä keskitytään tarkastelemaan ilmiötä julkisen sektorin terveydenhuoltoalalla. Tutkielmassa sovelletaan kvalitatiivista eli laadullista tutkimusmenetelmää. Tutkielma koostuu kahdesta osasta. Teoriaosassa käsitellään alan kirjallisuutta tieteellisten artikkelien valossa. Empiriaosassa selvitettiin tutkittavan organisaation kustannus- ja toimintolaskennan hyödyntämisestä prosessijohtamisen tukena. Aineistonkeruu empiirisen osion osalta toteutettiin avoimina ja strukturoimattomina haastatteluina. Tutkielman tuloksina muodostui ymmärrys organisaation kustannuslaskennan nykytilanteesta ja hyödyntämismahdollisuuksista prosessienkehittämisessä. Kustannus- ja toimintolaskentaa hyödynnetään nykyisin pääasiassa hinnoittelupäätöksiin. Kustannustietoja ei systemaattisesti hyödynnetä prosessienkehittämisessä eikä arvioitaessa potentiaalisia kehitys- ja parannuskohteita. Toimintolaskennan erityispiirteet tukevat kuitenkin sitä, että toimintolaskenta sopii terveydenhuolto-organisaatioon kustannuslaskentamalliksi. Voidaan todeta kustannuslaskennan tukevan Lean- kehitystyön kohdentamista ja tuloksien arviointia.

Impact of node mobility in user-centric routing

Recent paradigms in wireless communication architectures describe environments where nodes present a highly dynamic behavior (e.g., User Centric Networks). In such environments, routing is still performed based on the regular packet-switched behavior of store-and-forward. Albeit sufficient to compute at least an adequate path between a source and a destination, such routing behavior cannot adequately sustain the highly nomadic lifestyle that Internet users are today experiencing. This thesis aims to analyse the impact of the nodes’ mobility on routing scenarios. It also aims at the development of forwarding concepts that help in message forwarding across graphs where nodes exhibit human mobility patterns, as is the case of most of the user-centric wireless networks today. The first part of the work involved the analysis of the mobility impact on routing, and we found that node mobility significance can affect routing performance, and it depends on the link length, distance, and mobility patterns of nodes. The study of current mobility parameters showed that they capture mobility partially. The routing protocol robustness to node mobility depends on the routing metric sensitivity to node mobility. As such, mobility-aware routing metrics were devised to increase routing robustness to node mobility. Two categories of routing metrics proposed are the time-based and spatial correlation-based. For the validation of the metrics, several mobility models were used, which include the ones that mimic human mobility patterns. The metrics were implemented using the Network Simulator tool using two widely used multi-hop routing protocols of Optimized Link State Routing (OLSR) and Ad hoc On Demand Distance Vector (AODV). Using the proposed metrics, we reduced the path re-computation frequency compared to the benchmark metric. This means that more stable nodes were used to route data. The time-based routing metrics generally performed well across the different node mobility scenarios used. We also noted a variation on the performance of the metrics, including the benchmark metric, under different mobility models, due to the differences in the node mobility governing rules of the models.

Farm practices to manage the impact of severe tropical cyclone damage on banana production – a case study from tropical Australia

Most Australian banana production occurs on the north-eastern tropical coast between latitudes 15-18°S, and can experience summer cyclone activity. Damage from severe tropical cyclones has serious impact on banana-based livelihoods. The most significant impacts include immediate loss of production and income for several months, the region-wide synchronization of cropping and the expense of rehabilitating affected plantations. Severe tropical cyclones have directly affected the main production region twice in recent years Tropical Cyclone (TC) Larry (Category 4) in March 2006 and TC Yasi (Category 5) in February 2011. Based on TC Larry experiences, pre- and post-cyclone farm practices were developed to reduce these impacts in future cyclonic events. The main pre-cyclone farm practice focused on maintaining production units and an earlier return to fruit production by partially or completely removing the plant canopy to reduce wind resistance. Post-cyclone farm practices focused on managing the industry-wide crop synchronization using crop timing techniques to achieve a staggered return to cropping by scheduling production to provide continuous fruit supply. With TC Yasi in 2011, some banana producers implemented these practices, allowing them to examine their effectiveness in reducing cyclonic impacts. Additional research and development activities were conducted to refine our understanding of their effectiveness and improve their application for future cyclonic events. Based on these activities and farm-based observations, suggested practice-based management strategies can be developed to help reduce the impact of severe tropical cyclones in the future. Canopy removal maintained banana plants as productive units, and provided earlier but smaller bunches, generating earlier-than-expected income. Queensland producers expressed willingness to adopt canopy removal for future cyclone threats where appropriate, despite its labor-intensiveness. Mechanization would allow larger scale adoption. Implementing a staggered cropping program successfully achieved a consistent, continuous fruit supply after a cyclone impact. Both techniques should be applicable to other cyclone-prone regions.

Considering climate change in the development of marine protected areas

Marine ecosystems are facing a diverse range of threats, including climate change, prompting international efforts to safeguard marine biodiversity through the use of spatial management measures. Marine Protected Areas (MPAs) have been implemented as a conservation tool throughout the world, but their usefulness and effectiveness is strongly related to climate change. However, few MPA programmes have directly considered climate change in the design, management or monitoring of an MPA network. Under international obligations, EU, UK and national targets, Scotland has developed an MPA network that aims to protect marine biodiversity and contribute to the vision of a clean, healthy and productive marine environment. This is the first study to critically analyse the Scottish MPA process and highlight areas which may be improved upon in further iterations of the network in the context of climate change. Initially, a critical review of the Scottish MPA process considered how ecological principles for MPA network design were incorporated into the process, how stakeholder perceptions were considered and crucially what consideration was given to the influence of climate change on the eventual effectiveness of the network. The results indicated that to make a meaningful contribution to marine biodiversity protection for Europe the Scottish MPA network should: i) fully adopt best practice ecological principles ii) ensure effective protection and iii) explicitly consider climate change in the management, monitoring and future iterations of the network. However, this review also highlighted the difficulties of incorporating considerations of climate change into an already complex process. A series of international case studies from British Columbia, Canada; central California, USA; the Great Barrier Reef, Australia and the Hauraki Gulf, New Zealand, were then conducted to investigate perceptions of how climate change has been considered in the design, implementation, management and monitoring of MPAs. The key lessons from this study included: i) strictly protected marine reserves are considered essential for climate change resilience and will be necessary as scientific reference sites to understand climate change effects ii) adaptive management of MPA networks is important but hard to implement iii) strictly protected reserves managed as ecosystems are the best option for an uncertain future. This work provides new insights into the policy and practical challenges MPA managers face under climate change scenarios. Based on the Scottish and international studies, the need to facilitate clear communication between academics, policy makers and stakeholders was recognised in order to progress MPA policy delivery and to ensure decisions were jointly formed and acceptable. A Delphi technique was used to develop a series of recommendations for considering climate change in Scotland’s MPA process. The Delphi participant panel was selected for their knowledge of the Scottish MPA process and included stakeholders, policy makers and academics with expertise in MPA research. The results from the first round of the Delphi technique suggested that differing views of success would likely influence opinions regarding required management of MPAs, and in turn, the data requirements to support management action decisions. The second round of the Delphi technique explored this further and indicated that there was a fundamental dichotomy in panellists’ views of a successful MPA network depending upon whether they believed the MPAs should be strictly protected or allow for sustainable use. A third, focus group round of the Delphi Technique developed a feature-based management scenario matrix to aid in deciding upon management actions in light of changes occurring in the MPA network. This thesis highlights that if the Scottish MPA network is to fulfil objectives of conservation and restoration, the implications of climate change for the design, management and monitoring of the network must be considered. In particular, there needs to be a greater focus on: i) incorporating ecological principles that directly address climate change ii) effective protection that builds resilience of the marine and linked social environment iii) developing a focused, strong and adaptable monitoring framework iv) ensuring mechanisms for adaptive management.

Modelo de Scoring para o Crédito à Habitação: Um estudo de caso em Portugal

Mestrado em Contabilidade e Gestão das Instituições Financeiras

Informing Marine Spatial Planning (MSP) with numerical modelling: A case-study on shellfish aquaculture in Malpeque Bay (Eastern Canada)

A moratorium on further bivalve leasing was established in 1999–2000 in Prince Edward Island (Canada). Recently, a marine spatial planning process was initiated explore potential mussel culture expansion in Malpeque Bay. This study focuses on the effects of a projected expansion scenario on productivity of existing leases and available suspended food resources. The aim is to provide a robust scientific assessment using available datasets and three modelling approaches ranging in complexity: (1) a connectivity analysis among culture areas; (2) a scenario analysis of organic seston dynamics based on a simplified biogeochemical model; and (3) a scenario analysis of phytoplankton dynamics based on an ecosystem model. These complementary approaches suggest (1) new leases can affect existing culture both through direct connectivity and through bay-scale effects driven by the overall increase in mussel biomass, and (2) a net reduction of phytoplankton within the bounds of its natural variation in the area.

Modelling the development of an online learning resource by health care professionals

The aim of this study was to model the process of development for an Online Learning Resource (OLR) by Health Care Professionals (HCPs) to meet lymphoedema-related educational needs, within an asset-based management context. Previous research has shown that HCPs have unmet educational needs in relation to lymphoedema but details on their specific nature or context were lacking. Against this background, the study was conducted in two distinct but complementary phases. In Phase 1, a national survey was conducted of HCPs predominantly in community, oncology and palliative care services, followed by focus group discussions with a sample of respondents. In Phase 2, lymphoedema specialists (LSs) used an action research approach to design and implement an OLR to meet the needs identified in Phase 1. Study findings were analysed using descriptive statistics (Phase 1), and framework, thematic and dialectic analysis to explore their potential to inform future service development and education theory. Unmet educational need was found to be specific to health care setting and professional group. These resulted in HCPs feeling poorly-equipped to diagnose and manage lymphoedema. Of concern, when identified, lymphoedema was sometimes buried for fear of overwhelming stretched services. An OLR was identified as a means of addressing the unmet educational needs. This was successfully developed and implemented with minimal additional resources. The process model created has the potential to inform contemporary leadership theory in asset-based management contexts. This doctoral research makes a timely contribution to leadership theory since the resource constraints underpinning much of the contribution has salience to current public services. The process model created has the potential to inform contemporary leadership theory in asset-based management contexts. Further study of a leadership style which incorporates cognisance of Cognitive Load Theory and Self-Determination Theory is suggested. In addition, the detailed reporting of process and how this facilitated learning for participants contributes to workplace education theory

Assessment of a data-limited, multi-species shark fishery in the Great Barrier Reef Marine Park and south-east Queensland

The status of five species of commercially exploited sharks within the Great Barrier Reef Marine Park (GBRMP) and south-east Queensland was assessed using a data-limited approach. Annual harvest rate, U, estimated empirically from tagging between 2011 and 2013, was compared with an analytically-derived proxy for optimal equilibrium harvest rate, UMSY Lim. Median estimates of U for three principal retained species, Australian blacktip shark, Carcharhinus tilstoni, spot-tail shark, Carcharhinus sorrah, and spinner shark, Carcharhinus brevipinna, were 0.10, 0.06 and 0.07 year-1, respectively. Median U for two retained, non-target species, pigeye shark, Carcharhinus amboinensis and Australian sharpnose shark, Rhizoprionodon taylori, were 0.27 and 0.01 year-1, respectively. For all species except the Australian blacktip the median ratio of U/UMSY Lim was <1. The high vulnerability of this species to fishing combined with life history characteristics meant UMSY Lim was low (0.04-0.07 year-1) and that U/UMSY Lim was likely to be > 1. Harvest of the Australian blacktip shark above UMSY could place this species at a greater risk of localised depletion in parts of the GBRMP. Results of the study indicated that much higher catches, and presumably higher U, during the early 2000s were likely unsustainable. The unexpectedly high level of U on the pigeye shark indicated that output-based management controls may not have been effective in reducing harvest levels on all species, particularly those caught incidentally by other fishing sectors including the recreational sector. © 2016 Elsevier B.V.

Demonstration of the interactions between aromatic compound-loaded lipid nanocapsules and Acinetobacter baumannii bacterial membrane

International audience

Pathways to adulthood and their precursors: Roles of gender and race

Research on the transition to adulthood dates back nearly four decades, but a growing body of research has taken a new approach by investigating multiple demographic markers in the transition to adulthood simultaneously. Using the life course perspective, this dissertation is built on the literature by first examining contemporary young adults’ pathways to adulthood from ages 18 to 30 and their differences by gender. Data for this study were drawn from the National Longitudinal Survey of Youth 1997; the final sample included 2,185 men and 2,086 women. The college-educated single workers pathway, the college-educated married working parents pathway, and the high-school-educated single parents pathway were identified in both genders. For men, the study also identified the high-school-educated single workers pathway and the high-school-educated married working parents pathway. For women, the study also identified the high-school-educated workers pathway and the high-school-educated married parents pathway. Not only did the definitions of some pathways differ by gender, but even in the pathways with the same definition, gender differences were found in the probabilities of being married, of being a parent, or of being employed full-time. Based on the pathways to adulthood identified, this research examined the family and adolescent precursors and whether race moderates the associations between family structure experiences and young adults’ pathways to adulthood. Parental education, family structure, GPA, delinquency, early sexual activity, and race/ethnicity were the family and adolescent precursors that distinguished among pathways taken by the youth. Two interactions between race and family structure/instability were identified. The positive association between growing up in a single-parent family and the odds of taking the high-school-educated single workers pathway compared to the college-educated married working parents pathway was weaker for Black males than for White males. The positive association between family instability and the odds of taking the college-educated single workers pathway compared to the college-educated married working parents pathway was weaker for Black females than for White females. This dissertation accounted for changes in the multiple statuses related to becoming an adult by following contemporary young adults for 12 years. More research on contemporary young adults’ pathways to adulthood and subgroup differences in the effects of precursors are recommended. Limitations and implications of this study are discussed.

Cerebral misery perfusion diagnosed using hypercapnic blood-oxygenation-level-dependent contrast functional magnetic resonance imaging: a case report

Introduction Cerebral misery perfusion represents a failure of cerebral autoregulation. It is animportant differential diagnosis in post-stroke patients presenting with collapses in the presence of haemodynamically significant cerebrovascular stenosis. This is particularly the case when cortical or internal watershed infarcts are present. When this condition occurs, further investigation should be done immediately. Case presentation A 50-year-old Caucasian man presented with a stroke secondary to complete occlusion of his left internal carotid artery. He went on to suffer recurrent seizures. Neuroimaging demonstrated numerous new watershed-territory cerebral infarcts. No source of arterial thromboembolism was demonstrable. Hypercapnic blood-oxygenation-level-dependent-contrast functional magnetic resonance imaging was used to measure his cerebrovascular reserve capacity. The findings were suggestive of cerebral misery perfusion. Conclusions Blood-oxygenation-level-dependent-contrast functional magnetic resonance imaging allows the inference of cerebral misery perfusion. This procedure is cheaper and more readily available than positron emission tomography imaging, which is the current gold standard diagnostic test. The most evaluated treatment for cerebral misery perfusion is extracranial-intracranial bypass. Although previous trials of this have been unfavourable, the results of new studies involving extracranial-intracranial bypass in high-risk patients identified during cerebral perfusion imaging are awaited. Cerebral misery perfusion is an important and under-recognized condition in which emerging imaging and treatment modalities present the possibility of practical and evidence-based management in the near future. Physicians should thus be aware of this disorder and of recent developments in diagnostic tests that allow its detection.

A Framework for Energy-Efficiency in Smart Home Environments

Part 7: Cyber-Physical Systems

Avaliação do desempenho segundo a metodologia do balanced scorecard: aplicação à gestão hospitalar no Algarve

Dissertação de mest. em Gestão Empresarial, Faculdade de Economia, Univ. do Algarve, 2004

A influência das funções executivas e ansiedade na memória prospetiva de jovens adultos

Dissertação de Mestrado, Neurociências Cognitivas e Neuropsicologia, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2016

Atlantic Area Eunis Habitats. Adding new habitat types from European Atlantic coast to the EUNIS Habitat Classification

Marine protection has been emphasized through global and European conventions which highlighted the need for the establishment of special areas of conservation. Classification and habitat mapping have been developed to enhance the assessment of marine environment and improve spatial and strategic planning of human activities and to help on the implementation of ecosystem based management. European Nature information System (EUNIS) is a comprehensive habitat classification system to facilitate the harmonised description and collection of habitat and biotopes that has been developed by the European Environment Agency (EEA) in collaboration with experts from institutions throughout Europe.