Care delivery value chains for ophthalmic clinics in Switzerland

Perceived patient value is often not aligned with the emerging expenses for health care services. In other words, the costs are often supposed as rising faster than the actual value for the patients. This fact is causing major concerns to governments, health plans, and individuals. Attempts to solve the problem have habitually been on the operational effectiveness side: increasing patient volume, minimizing costs, rationing, or closing hospitals, usually resulting in a zero-sum game. Only few approaches come from the strategic positioning side and "competition" among hospitals is still perceived rather as a danger than as a chance to create a positive-sum game and stimulate patient value. In their 2006 book, "Redefining Health Care", the renowned Harvard strategy professor Michael E. Porter and hospital management expert Professor Elizabeth Olmsted Teisberg approach the challenge from the positive-sum perspective: they propose to form Integrated Practice Units (IPUs) and manage hospitals in a modern, patient value oriented way. They argue that creating value-based competition on results should have the same effect on the health care sector like transparency and competition turned other industries with out-dated management models (like recently the inert telecommunication industry) into highly competitive and customer value creating businesses. The objective of this paper is to elaborate Care Delivery Value Chains for Integrated Practice Units in ophthalmic clinics and gather a first feedback from Swiss hospital managers, ophthalmologists, and patients, if such an approach could be a realistic way to improve health care management. First, Porter's definition of competitiveness (distinction between operational effectiveness and strategic positioning) is explained. Then, the Care Delivery Value Chain is introduced as a key element for understanding value-based management, followed by three practice examples for ophthalmic clinics. Finally, recommendations are given how the Care Delivery Value Chain can be managed efficiently and how the obstacles of becoming a patient-oriented organization can be overcome. The conclusion is that increased transparency and value-based competition on results has the potential to change the mindset of hospital managers-which will align patient value with the emerging health care expenses. Early adapters of this management approach will gain a competitive advantage. [Author, p. 6]

Spin-offien vaikutus omistaja-arvoon

Perusteluna spin-offien toteuttamisen taustalta löytyy pyrkimys omistaja-arvon kasvattamiseen. Tämän tutkielman tarkoituksena on selvittää spin-offien vaikutusta omistaja-arvoon lyhyellä ja pitkällä aikavälillä. Aluksi tutkielmassa on tehty selkoa ulkomaisista tutkimustuloksista, joissa käsitellään spin-offien vaikutusta omistaja-arvoon. Saatuja tuloksia on verrattu lopuksi kolmeen suomalaiseen spin-offiin. Aikasempien tutkimusten tuloksiksista käy ilmi että spin-offien toteuttamisella on positiivinen vaikutus omistaja-arvoon sekä lyhyellä että pitkällä aikavälillä. Samanlainen positiivinen vaikutus voidaan todeta myös tässä tutkielmassa tutkituissa kolmessa suomalaisessa spin-off-tapauksessa. Omistaja-arvoon vaikuttavina tekijöinä otettiin huomioon yhtiöiden osakekurssien kehitys, jaetut osingot, osakkeiden jakamiset ja mahdolliset pääomanpalautukset. Tutkittavien suomalaisten yhtiöiden omistaja-arvojen kehitystä mitattiin spin-offin ilmoituspäivän läheisyydessä sekä noin yhdestä kolmeen vuotta spin-offin toteutuksen jälkeen. Saatuja tuloksia verrattiin kotimaisilta osakemarkkinoilta saatuihin keskimääräisiin tuottoihin.

Filmes de titânio-silício preparados por "spin" e "dip-coating"

The conditions for the preparation of luminescent materials, consisting of Eu3+ ions entrapped in a titanium matrix, in the forma of a thin film, using the sol-gel process, are described. The films were obtained from sols prepared with TEOS and TEOT, in the presence of acetylacetone as the hidrolysis-retarding agent, using the dip-coating and spin-coating techniques. The influence of these techniques on the films based on titanium and silicon are presented. The Eu3+ was used as a luminescent probe. The films have been characterized by luminescence, reflection and transmittance. The thickness of the films could be related to the preparation procedure. Transparent thin films have been prepared by dip-coating technique.

Non-Markovian Dynamics of the Spin-Boson Model

Avointen kvanttisysteemien teoria tutkii, miten vuorovaikutus laajan ympäristön kanssa muuttaa kvanttisysteemin dynamiikkaa. Kaikki kvanttisysteemit ovat pohjimmiltaan avoimia, joten tällaisten systeemien ymmärtäminen on välttämätöntä kvanttimaailman ymmärtämiseksi. Spin-bosoni -malli kuvaa avointa kaksitasosysteemiä, joka vuorovaikuttaa bosoneista koostuvan ympäristön kanssa. Useat fysikaaliset systeemit käyttäytyvät kaksitasosysteemin tavoin matalissa lämpötiloissa, jonka vuoksi spin-bosoni -mallilla on merkittävä rooli avointen kvanttisysteemien tutkimuksessa. Tutkielman ensimmäinen luku käsittelee yleistä avointen kvanttisysteemien teoriaa ja menetelmiä ei-Markovisen liikeyhtälön johtamiseksi. Ei-Markovinen liikeyhtälö kuvaa ympäristöstä systeemiin takaisin virtaavan informaation vaikutusta systeemin dynamiikkaan. Toisessa luvussa on johdettu spin-bosoni -mallille ei-Markovinen liikeyhtälö ja tarkasteltu spin-systeemin dynamiikkaa joissain erityistapauksissa. Kolmannessa luvussa on esitelty kvanttihyppymenetelmiä avointen systeemien dynamiikan ratkaisemiseksi ja sovellettu ei-Markovisten kvanttihyppyjen teoriaa spinbosoni -mallin tutkimiseksi. Ei-Markovisten kvanttihyppyjen teoriaa käyttämällä voidaan selittää spin-systeemin tiheysmatriisin populaatioissa ja koherensseissa havaittavien ei-Markovisten efektien alkuperä käännettyjen kvanttihyppyjen avulla. Tutkielman viimeisessä osassa esitellään muutamia spin-bosoni -mallin sovellutuksia fysiikan eri alueilta.

"Spin-Off" acadêmico: criando riquezas a partir de conhecimento e pesquisa

Technology companies created from University research are known as "Academic Spin-Off" (ASO). These innovative companies play an important role for the technological, economical and social development of a country. This work discusses some aspects of ASO companies and their importance to Universities. It is also presented a fictitious history of Prof. João, a chemical researcher who will create an ASO company from his academic research work illustrating the basic steps involved in this process.

Galvanomagnetic Phenomena in Ga1_xMnxAs

In this work temperature dependences of resistivity in zero field have been obtained for epitaxially grown Ga1_xMnxAs thin films with 6 % and 8 % Mn content in 50 300 K temperature range. Decrease of resistivity has been observed. Negative magnetoresistance has been explained by empirical spin dependent hopping model. Hall effect has been studied and anomalous Hall effect, inherent to ferromagnetic materials, has been observed. Both normal and anomalous Hall coefficients have been calculated from experimental data, as well as hole densities. Activation energy of impurity level has been estimated.

Electrical and magnetic properties of new compounds of the conductor anion [Ni(dmit)2]- and nitronyl nitroxide magnetic radicals

Three compounds have been synthesized with formulae [3-MeRad][Ni(dmit)2] (1), [4-MeRad][Ni(dmit)2] (2) and [4-PrRad][Ni(dmit)2] (3) where [Ni(dmit)2]- is an anionic pi-radical (dmit = 1,3-dithiol-2-thione-4,5-dithiolate) and [3-MeRad]+ is 3-N-methylpyridinium alpha-nitronyl nitroxide, [4-MeRad]+ is 4-N-methylpyridinium alpha-nitronyl nitroxide and [4-PrRad]+ is 4-N-propylpyridinium alpha-nitronyl nitroxide. The temperature-dependent magnetic susceptibility of 1 revealed that an antiferromagnetic interaction operates between the 3-MeRad+ radical cations with exchange coupling constants of J1 = - 1.72 cm-1 and antiferromagnetism assigned to the spin ladder chains of the Ni(dmit)2 radical anions. Compound 1 exhibits semiconducting behavior and 3 presents capacitor behavior in the temperature range studied (4 - 300 K).

Electron paramagnetic resonance (EPR) spectral components of spin-labeled lipids in saturated phospholipid bilayers: effect of cholesterol

Electron paramagnetic resonance (EPR) spectroscopy was used to study the main structural accommodations of spin labels in bilayers of saturated phosphatidylcholines with acyl chain lengths ranging from 16 to 22 carbon atoms. EPR spectra allowed the identification of two distinct spectral components in thermodynamic equilibrium at temperatures below and above the main phase transition. An accurate analysis of EPR spectra, using two fitting programs, enabled determination of the thermodynamic profile for these major probe accommodations. Focusing the analysis on two-component EPR spectra of a spin-labeled lipid, the influence of 40 mol % cholesterol in DPPC was studied.

Dispersion of Hybrid Electromagnetic-Spin Waves in the Slotline

The presented thesis is devoted to investigation of wave processes in hybrid ferrite / ferroelectric structures. Spin wave devices based on ferrite films have such disadvantages, as huge size of the magnetic systems, low tuning velocity, considerable power inputs for parameters control that limits possible device applications. The considered layered structures allow to overcome the disadvantages mentioned and to promote the development of novel class of tunable microwave devices. The proposed theoretical analysis is intended to construct a model of hybrid electromagnetic-spin waves. Based on the theoretical analysis the experimental investigations were carried out. The experimental resonance characteristics of ferrite / ferroelectric resonator were obtained and their tunability by means of magnetic and electric field was demonstrated.

Magnetic and transport properties of LaMnO3+δ, La1-xCaxMnO3, La1-xCaxMn1-yFeyO3 and La1-xSrxMn1-yFeyO3

Interest to hole-doped mixed-valence manganite perovskites is connected to the ‘colossal’ magnetoresistance. This effect or huge drop of the resistivity, ρ, in external magnetic field, B, attains usually the maximum value near the ferromagnetic Curie temperature, TC. In this thesis are investigated conductivity mechanisms and magnetic properties of the manganite perovskite compounds LaMnO3+, La1-xCaxMnO3, La1-xCaxMn1-yFeyO3 and La1- xSrxMn1-yFeyO3. When the present work was started the key role of the phase separation and its influence on the properties of the colossal magnetoresistive materials were not clear. Our main results are based on temperature dependencies of the magnetoresistance and magnetothermopower, investigated in the temperature interval of 4.2 - 300 K in magnetic fields up to 10 T. The magnetization was studied in the same temperature range in weak (up to 0.1 T) magnetic fields. LaMnO3+δ is the parent compound for preparation of the hole-doped CMR materials. The dependences of such parameters as the Curie temperature, TC, the Coulomb gap, Δ, the rigid gap, γ, and the localization radius, a, on pressure, p, are observed in LaMnO3+δ. It has been established that the dependences above can be interpreted by increase of the electron bandwidth and decrease of the polaron potential well when p is increased. Generally, pressure stimulates delocalization of the electrons in LaMnO3+δ. Doping of LaMnO3 with Ca, leading to La1-xCaxMnO3, changes the Mn3+/Mn4+ ratio significantly and brings an additional disorder to the crystal lattice. Phase separation in a form of mixture of the ferromagnetic and the spin glass phases was observed and investigated in La1- xCaxMnO3 at x between 0 and 0.4. Influence of the replacement of Mn by Fe is studied in La0.7Ca0.3Mn1−yFeyO3 and La0.7Sr0.3Mn1−yFeyO3. Asymmetry of the soft Coulomb gap and of the rigid gap in the density of localized states, small shift of the centre of the gaps with respect to the Fermi level and cubic asymmetry of the density of states are obtained in La0.7Ca0.3Mn1−yFeyO3. Damping of TC with y is connected to breaking of the double-exchange interaction by doping with Fe, whereas the irreversibility and the critical behavior of the magnetic susceptibility are determined by the phase separation and the frustrated magnetic state of La0.7Sr0.3Mn1−yFeyO3.

Some defects in two-dimensional spin-1/2 Heisenberg antiferromagnets: a numerical study of magnetic effects

En del av de intressantaste fenomenen inom dagens materialfysik uppstår ur ett intrikat samspel mellan myriader av elektroner. Högtemperatursupraledare är det mest berömda exemplet. Varken klassiska teorier eller modeller där elektronerna är oberoende av varandra kan förklara de häpnadsväckande effekterna i de starkt korrelerade elektronsystemen. I vissa kopparoxider, till exempel La2CuO4, är det känt att valenselektronerna till följd av en stark ömsesidig växelverkan lokaliseras en och en till kopparatomerna i föreningens CuO2 plan. Laddningarnas inneboende magnetiska moment—spinnet—får då en avgörande roll för materialets elektriska och magnetiska egenskaper, vilka i exemplets fall kan beskrivas med Heisenbergmodellen som är den grundläggande teoretiska modellen för mikroskopisk magnetism. Men exakt varför föreningarna kan bli supraledande då de dopas med överskottsladdningar är än så länge en obesvarad fråga. Min avhandling undersöker orenheters inverkan på Heisenbergmodellens magnetiska egenskaper—ett problem av både experimentell och teoretisk relevans. En etablerad numerisk metod har använts—en kvantmekanisk Monte Carlo teknik—för att utföra omfattande datorsimuleringar av den matematiska modellen på två dedikerade Linux datorkluster. Arbetet hör till området beräkningsfysik. De teoretiska modellerna för starkt korrelerade elektronsystem, däribland Heisenbergmodellen, är ytterst invecklade matematiskt sett och de kan inte lösas exakt. Analytiska utredningar bygger för det mesta på antaganden och förenklingar vars inverkningar på slutresultatet är ofta oklara. I det avseende kan numeriska studier vara exakta, det vill säga de kan behandla modellerna som de är. Oftast behövs bägge tillvägagångssätten. Den röda tråden i arbetet har varit att numeriskt testa vissa högaktuella analytiska förutsägelser rörande effekterna av orenheter i Heisenbergmodellen. En del av dem har vi på basen av mycket noggranna data kunnat bekräfta. Men våra resultat har också påvisat felaktigheter i de analytiska prognoserna som sedermera delvis reviderats. En del av avhandlingens numeriska upptäckter har i sin tur stimulerat till helt nya teoretiska studier.

Ferromagnetic properties of pyrolytic nanocarbon

The work reported in this thesis is dedicated to irreversible magnetic properties in pyrolytic nanocarbon samples. Based on atomic force microscope images, the samples consist of carbon clusters with radius 30..120 nm. These are treated as single-domain nanoparticles. Magnetic hysteresis, field cooled, zero field cooled and thermoremanent magnetization measurements were performed using an RF SQUID magnetometer and ferromagnetic behaviour was observed. Analysis suggests that the ferromagnetic ordering is associated with defects in a thin surface layer, whose thickness is independent of particle size. Critical radius for single-domain particles, critical radius for coherent rotation, magnetic layer thickness, distance between elementary magnetic moments, saturation magnetization, exchange stiffness constant and anisotropy energy density are also presented.

Information exchange and disruption risk in multimodal maritime supply chains

Supply chains are becoming increasingly dependent on information ex-change in today’s world, and any disruption can cause severe repercus-sions to the flow of materials in the chain. The speed, accuracy and amount of information are key factors. The aim in this thesis is to address a gap in the research by focusing on information exchange and the risks related to it in a multimodal wood supply chain operating between the Baltic States and Finland. The study involved interviewing people engaged in logistics management in the supply chain in question. The main risk the interviewees identified arose from the sea logistics system, which held a lot of different kinds of information. The threat of breakdown in the Internet connection was also found to hinder the operations significantly. A vulnerability analysis was carried out in order to identify the main actors and channels of infor-mation flow in the supply chain. The analysis revealed that the most important and therefore most vulnerable information-exchange channels were those linking the terminal superintendent, the operative managers and the mill managers. The study gives a holistic picture of the investigated supply chain. Information-exchange-related risks varied greatly. One of the most frequently mentioned was the risk of information inaccuracy, which was usually due to the fact that those in charge of the various functions did not fully understand the consequences for the entire chain.