The Management of Long-Term Sickness Absence in Large Public Sector Healthcare Organisations: A Realist Evaluation Using Mixed Methods

Purpose The success of measures to reduce long-term sickness absence (LTSA) in public sector organisations is contingent on organisational context. This realist evaluation investigates how interventions interact with context to influence successful management of LTSA. Methods Multi-method case study in three Health and Social Care Trusts in Northern Ireland comprising realist literature review, semi-structured interviews (61 participants), Process-Mapping and feedback meetings (59 participants), observation of training, analysis of documents. Results Important activities included early intervention; workplace-based occupational rehabilitation; robust sickness absence policies with clear trigger points for action. Used appropriately, in a context of good interpersonal and interdepartmental communication and shared goals, these are able to increase the motivation of staff to return to work. Line managers are encouraged to take a proactive approach when senior managers provide support and accountability. Hindering factors: delayed intervention; inconsistent implementation of policy and procedure; lack of resources; organisational complexity; stakeholders misunderstanding each other’s goals and motives. Conclusions Different mechanisms have the potential to encourage common motivations for earlier return from LTSA, such as employees feeling that they have the support of their line manager to return to work and having the confidence to do so. Line managers’ proactively engage when they have confidence in the support of seniors and in their own ability to address LTSA. Fostering these motivations calls for a thoughtful, diagnostic process, taking into account the contextual factors (and whether they can be modified) and considering how a given intervention can be used to trigger the appropriate mechanisms.

Nonlinear behavioral modeling of mixed signal RF-digital I/O devices

Esta tese investiga a caracterização (e modelação) de dispositivos que realizam o interface entre os domínios digital e analógico, tal como os buffers de saída dos circuitos integrados (CI). Os terminais sem fios da atualidade estão a ser desenvolvidos tendo em vista o conceito de rádio-definido-por-software introduzido por Mitola. Idealmente esta arquitetura tira partido de poderosos processadores e estende a operação dos blocos digitais o mais próximo possível da antena. Neste sentido, não é de estranhar que haja uma crescente preocupação, no seio da comunidade científica, relativamente à caracterização dos blocos que fazem o interface entre os domínios analógico e digital, sendo os conversores digital-analógico e analógico-digital dois bons exemplos destes circuitos. Dentro dos circuitos digitais de alta velocidade, tais como as memórias Flash, um papel semelhante é desempenhado pelos buffers de saída. Estes realizam o interface entre o domínio digital (núcleo lógico) e o domínio analógico (encapsulamento dos CI e parasitas associados às linhas de transmissão), determinando a integridade do sinal transmitido. Por forma a acelerar a análise de integridade do sinal, aquando do projeto de um CI, é fundamental ter modelos que são simultaneamente eficientes (em termos computacionais) e precisos. Tipicamente a extração/validação dos modelos para buffers de saída é feita usando dados obtidos da simulação de um modelo detalhado (ao nível do transístor) ou a partir de resultados experimentais. A última abordagem não envolve problemas de propriedade intelectual; contudo é raramente mencionada na literatura referente à caracterização de buffers de saída. Neste sentido, esta tese de Doutoramento foca-se no desenvolvimento de uma nova configuração de medição para a caracterização e modelação de buffers de saída de alta velocidade, com a natural extensão aos dispositivos amplificadores comutados RF-CMOS. Tendo por base um procedimento experimental bem definido, um modelo estado-da-arte é extraído e validado. A configuração de medição desenvolvida aborda não apenas a integridade dos sinais de saída mas também do barramento de alimentação. Por forma a determinar a sensibilidade das quantias estimadas (tensão e corrente) aos erros presentes nas diversas variáveis associadas ao procedimento experimental, uma análise de incerteza é também apresentada.

Alexithymia, emotional processing and psychotherapy : a mixed methods research

Tese de doutoramento, Psicologia (Psicologia Clínica), Universidade de Lisboa, Faculdade de Psicologia, 2014

Governing through community? A comparative study of changing management practices in mixed tenure housing development

An important feature of UK housing policy has been the promotion of consortia between local authorities, private developers and housing associations in order to develop mixed tenure estates to meet a wide range of housing needs. Central to this approach has been a focus on the management of neighbourhoods, based on the assumption that high densities and the inter-mixing of tenure exacerbates the potential for incivility and anti-social behaviour and exerts a disproportionate impact on residents' quality of life. Landlord strategies are therefore based on a need to address such issues at an early stage in the development. In some cases community-based, third sector organisations are established in order to manage community assets and to provide a community development service to residents. In others, a common response is to appoint caretakers and wardens to tackle social and environmental problems before they escalate and undermine residents’ quality of life. A number of innovative developments have promoted such neighbourhood governance approaches to housing practice by applying community development methods to address potential management problems. In the process, there is an increasing trend towards strategies that shape behaviour, govern ethical conduct, promote aesthetic standards and determine resident and landlord expectations. These processes can be related to the wider concept of governmentality whereby residents are encouraged to become actively engaged in managing their own environments, based on the assumption that this produces more cohesive, integrated communities and projects positive images. Evidence is emerging from a number of countries that increasingly integrated and mutually supportive roles and relationships between public, private and third sector agencies are transforming neighbourhood governance in similar ways. This paper will review the evidence for this trend towards community governance in mixed housing developments by drawing on a series of UK case studies prepared for two national agencies in 2007. It will review in particular the contractual arrangements with different tenures, identify codes and guidelines promoting 'good neighbour' behaviour and discuss the role of community development trusts and other neighbourhood organisations in providing facilities and services, designed to generate a well integrated community. The second part of the paper will review evidence from the USA and Australia to see how far there is a convergence in this respect in advanced economies. The paper will conclude by discussing the extent to which housing management practice is changing, particularly in areas of mixed development, whether there is a convergence in practice between different countries and how far these trends are supported by theories of governmentality.

Optimal scheduling of a renewable micro-grid in an isolated load area using mixed-integer linear programming

In the energy management of the isolated operation of small power system, the economic scheduling of the generation units is a crucial problem. Applying right timing can maximize the performance of the supply. The optimal operation of a wind turbine, a solar unit, a fuel cell and a storage battery is searched by a mixed-integer linear programming implemented in General Algebraic Modeling Systems (GAMS). A Virtual Power Producer (VPP) can optimal operate the generation units, assured the good functioning of equipment, including the maintenance, operation cost and the generation measurement and control. A central control at system allows a VPP to manage the optimal generation and their load control. The application of methodology to a real case study in Budapest Tech, demonstrates the effectiveness of this method to solve the optimal isolated dispatch of the DC micro-grid renewable energy park. The problem has been converged in 0.09 s and 30 iterations.

Mixed integer non linear programming and artificial neural network based approach to ancillary services dispatch in competitive electricity markets

Ancillary services represent a good business opportunity that must be considered by market players. This paper presents a new methodology for ancillary services market dispatch. The method considers the bids submitted to the market and includes a market clearing mechanism based on deterministic optimization. An Artificial Neural Network is used for day-ahead prediction of Regulation Down, regulation-up, Spin Reserve and Non-Spin Reserve requirements. Two test cases based on California Independent System Operator data concerning dispatch of Regulation Down, Regulation Up, Spin Reserve and Non-Spin Reserve services are included in this paper to illustrate the application of the proposed method: (1) dispatch considering simple bids; (2) dispatch considering complex bids.

Bullying, cyberbullying & sexuality: “Everyone needs a good friend”

Bullying is a pervasive social issue that occurs in numerous contexts and is particularly recognized in populations that are easily targeted. Individuals who identify as Lesbian, Gay, Bisexual, and Questioning (LGBQ) are at an increased risk of victimization. Using mixed methodology involving 40 participants (N= 20) LGBQ and (N = 20) non-LGBQ and 10 subsequent in-depth interviews, this study examined prevalence rates of (cyber)bullying on the basis of sexual orientation. Results indicate a high frequency of direct and indirect bullying of LGBQ as compared to non-LGBQ youth. Ten interviews revealed themes that precipitate victimization such as the lack of understanding of LGBQ issues, educational shortfalls, societal and stereotypical beliefs. Results highlight the importance and need of formal and informal support (i.e. peer and online support).

Surface acidity and catalytic activity of mixed Fe-Al and Cr-Al pillared montmorillonites

The incorporation of transition metal oxide pillars such as those of iron and chromium along with Al2O3, pillars within the interlayers of a montmorillonite clay is investigated. The surface acidity of these catalysts has been evaluated for the first time employing the equilibrium adsorption of an electron donor, perylene, and the results are compared with those obtained by temperature programmed desorption of ammonia. The principle is based on the ability of a catalyst surface site to accept a single electron from an electron donor like perylene to form charge transfer complexes and the amount of adsorbed species is measured quantitatively by UV-vis spectroscopy. Fina1ly, an attempt has been made to correlate the acidity determined by the two independcnt methods and the catalytic activity of present systems in the benzoylation of toluene with benzoyl chloride. Incorporation of Fe and Cr has changed the properties of AI pitlared montmorillonite. Fe pillared systems have been found to be vcry good catalysts for benzoylation reaction

Acid-Base. Surface Electron Donatin6 &.Catai.Ytlc Properties Of Some Binary Mixed Oxides Containing Rare Earth Elements

Catalysis research underpins the science of modern chemical processing and fuel technologies. Catalysis is commercially one of the most important technologies in national economies. Solid state heterogeneous catalyst materials such as metal oxides and metal particles on ceramic oxide substrates are most common. They are typically used with commodity gases and liquid reactants. Selective oxidation catalysts of hydrocarbon feedstocks is the dominant process of converting them to key industrial chemicals, polymers and energy sources.[1] In the absence of a unique successfiil theory of heterogeneous catalysis, attempts are being made to correlate catalytic activity with some specific properties of the solid surface. Such correlations help to narrow down the search for a good catalyst for a given reaction. The heterogeneous catalytic performance of material depends on many factors such as [2] Crystal and surface structure of the catalyst. Thermodynamic stability of the catalyst and the reactant. Acid- base properties of the solid surface. Surface defect properties of the catalyst.Electronic and semiconducting properties and the band structure. Co-existence of dilferent types of ions or structures. Adsorption sites and adsorbed species such as oxygen.Preparation method of catalyst , surface area and nature of heat treatment. Molecular structure of the reactants. Many systematic investigations have been performed to correlate catalytic performances with the above mentioned properties. Many of these investigations remain isolated and further research is needed to bridge the gap in the present knowledge of the field.

Tailoring magnetic and dielectric properties of rubber ferrite composites containing mixed ferrites

Rubber ferrite composites containing various mixed ferrites were prepared for different compositions and various loadings. The magnetic and dielectric properties of the fillers as well as the ferrite filled matrixes were evaluated separately. The results are correlated. Simple equations are proposed to predetermine the magnetic and dielectric properties. The validity of these equations is verified and they are found to be in good agreement. These equations are useful in tailoring the magnetic and dielectric properties of these composites with predetermined properties

Economic evaluation of proposed pure and mixed stands in Central Vietnam highlands

In comparison with mixed forest stands, the cultivation of pure plantations in Vietnam entails serious ecological consequences such as loss of biodiversity and higher rate of soil erosion. The economic evaluation is elaborated between pure plantations and mixed forests where the fast-growing tree species are mixed with slow growing tree species which are planted in stripes separating the segments with fast-growing tree species (Acacia sp.). For the evaluation, the input values were used from local costs of goods, services and labour. The results show that the internal rate of return is the highest in the case of pure plantation in comparison with mixed forests – 86% to 77%(first planting pattern: Acacia sp. + noble hardwood species) and 54% (second planting pattern: Acacia + Dipterocarpus sp. + Sindora sp.). The average profit per hectare and year is almost five times higher in the case of mixed stands. The first planting pattern reaches 2,650 $, the second planting pattern 2,280 $ and the pure acacia plantation only 460 $. From an economic point of view, the cultivation of mixed forests that corresponds to the principles of sustainable forestry generates a good economical profit while maintaining habitat complexity and biodiversity.

Human Security in India. A Mixed Bag

With security being viewed as ensuring protection from physical and mental harm, freedom from want and fear, human security has moved to the centre stage of the global development agenda. This paper argues that even with low income, one can achieve higher human development like higher life expectancy, lower fertility and high literacy. Amartya Sen, Nobel Laureate of India, has characterised it as “development as freedom”. Lack of substantive freedom is inexorably linked to economic poverty and backwardness. Nearly all States in India have succeeded in reducing poverty, but those States with better human development have fared better. The trickle-down alone will not spread the benefits of reform. Measured State intervention and adequate provision of safety nets for the vulnerable sections of people are needed to make development more sustainable. Democracy and development go hand in hand. The democratic, accountable and transparent governance is the best insurance against poverty and marginalisation. The test of good governance must be premised on how the State and civil society negotiate differences via constitutional guarantees and political institutions. Good governance is the key to equitable growth.-----Con la visión de la seguridad como la garantía de protección contra daños físicos y mentales, de estar liberados de necesidades y temores, la seguridad humana ha pasado a ser la estrella central del programa del desarrollo global. En este trabajo se argumenta que, incluso con ingresos bajos, uno puede lograr un mayor desarrollo humano, como una esperanza de vida más larga, una menor fertilidad y una mejor educación. Amartya Sen, Premio Nobel de India, lo ha caracterizado como “el desarrollo como libertad”. La falta de libertad fundamental está vinculada inexorablemente a la pobreza económica y el retraso. Casi todos los Estados de la India han reducido la pobreza con éxito, pero aquellos que tienen un mejor desarrollo humano han salido mejor. Tan solo esta reducción paulatina no va a difundir los beneficios de la reforma. La intervención medida del Estado y su adecuado suministro de redes de seguridad para los sectores vulnerables de la población son necesarios para hacer más sostenible el desarrollo. La democracia y el desarrollo van de la mano. El gobierno democrático, responsable y transparente es el mejor seguro contra la pobreza y la marginalización. La prueba del buen gobierno debe tener como premisa la forma en que el Estado y la sociedad civil negocien las diferencias a través de garantías constitucionales e instituciones políticas. El buen gobierno es la clave para el crecimiento justo.

Real estate in the mixed-asset portfolio: the question of consistency

The recent poor performance of the equity market in the UK has meant that real estate is increasingly been seen as an attractive addition to the mixed-asset portfolio. However, determining whether the good return enjoyed by real estate is a temporary or long-term phenomenon is a question that remains largely unanswered. In other words, there is little or no evidence to indicate whether real estate should play a consistent role in the mixed-asset portfolio over short- and long-term investment horizons. Consistency in this context refers to the ability of an asset to maintain a positive allocation in an efficient portfolio over different holding periods. Such consistency is a desirable trait for any investment, but takes on particular significance when real estate is considered, as the asset class is generally perceived to be a long-term investment due to illiquidity. From an institutional investor’s perspective, it is therefore crucial to determine whether real estate can be reasonably expected to maintain a consistent allocation in the mixed-asset portfolio in both the short and long run and at what percentage. To address the question of consistency the allocation of real estate in the mixed-asset portfolio was calculated over different holding periods varying from 5- to 25-years.

In vitro fermentation of lactulose-derived oligosaccharides by mixed fecal microbiota

Fermentation properties of oligosaccharides derived from lactulose (OsLu) and lactose (GOS) have been assessed in pH-controlled anaerobic batch cultures using lactulose and Vivinal-GOS as reference carbohydrates. Changes in gut bacterial populations and their metabolic activities were monitored over 24 h by fluorescent in situ hybridization (FISH) and by measurement of short-chain fatty acid (SCFA) production. Lactulose-derived oligosaccharides were selectively fermented by Bifidobacterium and lactic acid bacterial populations producing higher SCFA concentrations compared to GOS. The highest total SCFA production was from Vivinal-GOS > lactulose > OsLu > GOS. Longer incubation periods produced a selective fermentation of OsLu when they were used as a carbon source reaching the highest selective index scores. The new oligosaccharides may constitute a good alternative to lactulose, and they could belong to a new generation of prebiotics to be used as a functional ingredient for improving the composition of gut microflora.

Intercomparison and validation of the mixed layer depth fields of global ocean syntheses

Intercomparison and evaluation of the global ocean surface mixed layer depth (MLD) fields estimated from a suite of major ocean syntheses are conducted. Compared with the reference MLDs calculated from individual profiles, MLDs calculated from monthly mean and gridded profiles show negative biases of 10–20 m in early spring related to the re-stratification process of relatively deep mixed layers. Vertical resolution of profiles also influences the MLD estimation. MLDs are underestimated by approximately 5–7 (14–16) m with the vertical resolution of 25 (50) m when the criterion of potential density exceeding the 10-m value by 0.03 kg m−3 is used for the MLD estimation. Using the larger criterion (0.125 kg m−3) generally reduces the underestimations. In addition, positive biases greater than 100 m are found in wintertime subpolar regions when MLD criteria based on temperature are used. Biases of the reanalyses are due to both model errors and errors related to differences between the assimilation methods. The result shows that these errors are partially cancelled out through the ensemble averaging. Moreover, the bias in the ensemble mean field of the reanalyses is smaller than in the observation-only analyses. This is largely attributed to comparably higher resolutions of the reanalyses. The robust reproduction of both the seasonal cycle and interannual variability by the ensemble mean of the reanalyses indicates a great potential of the ensemble mean MLD field for investigating and monitoring upper ocean processes.