Equity in regional service provision

Most transportation agencies stipulate that an important planning goal is to provide equitable and just public transport services. However, who is to be served and the type of service that should be provided has been ambiguous. This paper develops a methodology for examining equity in the provision of public transportation services. An approach for identifying areas in need of public transport is developed based upon the use of socio-demographic and economic information. Public transport need is then related to levels of access to service. This approach makes it possible to establish the degree to which public transport services may be considered equitable in relation to need and suitable access. A detailed analysis of the southeast Queensland region of Australia illustrates how this approach may be used to inform public transport decision making.

MR image-based measurement of rates of change in volumes of brain structures. Part 1: Method and validation

A detailed analysis procedure is described for evaluating rates of volumetric change in brain structures based on structural magnetic resonance (MR) images. In this procedure, a series of image processing tools have been employed to address the problems encountered in measuring rates of change based on structural MR images. These tools include an algorithm for intensity non-uniforniity correction, a robust algorithm for three-dimensional image registration with sub-voxel precision and an algorithm for brain tissue segmentation. However, a unique feature in the procedure is the use of a fractional volume model that has been developed to provide a quantitative measure for the partial volume effect. With this model, the fractional constituent tissue volumes are evaluated for voxels at the tissue boundary that manifest partial volume effect, thus allowing tissue boundaries be defined at a sub-voxel level and in an automated fashion. Validation studies are presented on key algorithms including segmentation and registration. An overall assessment of the method is provided through the evaluation of the rates of brain atrophy in a group of normal elderly subjects for which the rate of brain atrophy due to normal aging is predictably small. An application of the method is given in Part 11 where the rates of brain atrophy in various brain regions are studied in relation to normal aging and Alzheimer's disease. (C) 2002 Elsevier Science Inc. All rights reserved.

Clinical aspects of gestational trophoblastic disease: A review based partly on 25-year experience of a statewide registry

Background: Gestational trophoblastic disease is a fascinating group of pregnancy disorders characterised by abnormal proliferation of trophoblast, ranging from benign to malignant. Because the disease is uncommon, there is a need to formulate management with the assistance of collective information. Methodology: A review of available information from English written literature was undertaken especially data reported by registries around the world (Charing Cross Hospital in England, the North-western University and the New England area in the USA as well as our own experience in Queensland, Australia). Where possible, collated data from relevant studies were analysed to answer some of the questions posed in clinical practice, with reference to metastatic disease to liver and brain, twinning of molar gestation and coexisting fetus, and placental-site tumour. Results: We found that molar gestation can be classified according to its clinical presentation which influences the time taken to reach human chorionic gonadotropin (HCG) 'negativity' and the risk of persisting disease. Categorisation of risk is the basis for choice of chemotherapy to achieve good outcomes. Metastases to liver and brain remain problems in management; the development of 'new' metastases during chemotherapy is a very poor prognostic factor. In the variant of twinning with molar gestation and coexisting fetus, it is important to elucidate the fetal karyotype in planning management: a 69XXX fetus is not salvageable but a normal 46XX or 46XY fetus faces the prospect of early preterm delivery. The placental-site tumour is very rare; localised disease is curable by surgery; chemotherapy is less effective in disseminated disease. From collated worldwide data, the recurrence rate after one mole is 1.3% and after two or more is 20%. Reproductive outcome in subsequent pregnancies, even after multidrug chemotherapy, is not different from the general population. Because of the increased risk long-term of second tumours after multidrug chemotherapy a closer surveillance of these patients is necessary Conclusion: In general, the disease in its persisting or malignant form is 'a cancer model par excellence' because of an identifiable precursor condition, a reliable HCG marker, and sensitivity of the disease to cytotoxic drugs. With current management, retention of fertility is possible and normal reproductive outcome assured.

O plano plurianual: resultados da mais recente reforma do planejamento e or??amento no Brasil

O artigo visa apresentar o debate acerca das transforma????es oriundas da ??ltima reforma do planejamento e or??amento no Brasil, a qual introduziu o novo desenho do Plano Plurianual (PPA). Inicialmente, os princ??pios do modelo de or??amento por resultados ou desempenho que balizaram a formula????o do novo PPA s??o discutidos. Com base nos planos de gest??o das experi??ncias recentes do Plano e na proposta do pr??ximo PPA (2008-2011), s??o apresentadas as inova????es da configura????o do processo or??ament??rio no pa??s. Por fim, o artigo aborda os avan??os e restri????es da implementa????o do novo desenho do PPA e conclui que, apesar de formalmente institu??dos, os instrumentos do or??amento por resultados n??o atingem a finalidade prec??pua do modelo: melhoria da efetividade e efici??ncia nos gastos p??blicos.

Real-time 3D interactive segmentation of echocardiographic data through user-based deformation of B-spline explicit active surfaces

Image segmentation is an ubiquitous task in medical image analysis, which is required to estimate morphological or functional properties of given anatomical targets. While automatic processing is highly desirable, image segmentation remains to date a supervised process in daily clinical practice. Indeed, challenging data often requires user interaction to capture the required level of anatomical detail. To optimize the analysis of 3D images, the user should be able to efficiently interact with the result of any segmentation algorithm to correct any possible disagreement. Building on a previously developed real-time 3D segmentation algorithm, we propose in the present work an extension towards an interactive application where user information can be used online to steer the segmentation result. This enables a synergistic collaboration between the operator and the underlying segmentation algorithm, thus contributing to higher segmentation accuracy, while keeping total analysis time competitive. To this end, we formalize the user interaction paradigm using a geometrical approach, where the user input is mapped to a non-cartesian space while this information is used to drive the boundary towards the position provided by the user. Additionally, we propose a shape regularization term which improves the interaction with the segmented surface, thereby making the interactive segmentation process less cumbersome. The resulting algorithm offers competitive performance both in terms of segmentation accuracy, as well as in terms of total analysis time. This contributes to a more efficient use of the existing segmentation tools in daily clinical practice. Furthermore, it compares favorably to state-of-the-art interactive segmentation software based on a 3D livewire-based algorithm.

Utilização do método Multicritério AHP, na aquisição de um sistema ERP

The selection of an Enterprise Resource Planning (ERP) system is one of the most sensitive and highest impact processes in the area of information systems and technologies, because it supports and integrates the whole business of an organization. Hence the importance of deciding the best solution in order to contribute to the organization's competitiveness in a global and increasingly demanding market. Therefore, it is essential to provide tools to support decision making, turning complex and often intangible decisions into simple and quantifiable scenarios. This study addressed the adoption of the Analytical Hierarchy Process (AHP) multicriteria decision method to support the selection of an ERP system. The literature review was the source used to obtain the set of the most relevant criteria to be considered in this decision, which were subsequently validated through systematic application of various surveys of experts and people related to the field of ERP systems. To support the application of AHP, according to the model obtained in the study, it was developed a web application that will be available to the general public. The responsible for the acquisition of ERP systems can use it to easily apply the AHP method based on validated decision model. On the other hand, the web application can be used as a validation tool, allowing collecting data for future developments of the decision model.

O planejamento econômico no Brasil: considerações críticas

In the past thirty years, a series of plans have been developed by successive Brazilian governments in a continuing effort to maximize the nation's resources for economic and social growth. This planning history has been quantitatively rich but qualitatively poor. The disjunction has stimulated Professor Mello e Souza to address himself to the problem of national planning and to offer some criticisms of Brazilian planning experience. Though political instability has obviously been a factor promoting discontinuity, his criticisms are aimed at the attitudes and strategic concepts which have sought to link planning to national goals and administration. He criticizes the fascination with techniques and plans to the exclusion of proper diagnosis of the socio-political reality, developing instruments to coordinate and carry out objectives, and creating an administrative structure centralized enough to make national decisions and decentralized enough to perform on the basis of those decisions. Thus, fixed, quantified objectives abound while the problem of functioning mechanisms for the coordinated, rational use of resources has been left unattended. Although his interest and criticism are focused on the process and experience of national planning, he recognized variation in the level and results of Brazilian planning. National plans have failed due to faulty conception of the function of planning. Sectorial plans, save in the sector of the petroleum industry under government responsibility, ha e not succeeded in overcoming the problems of formulation and execution thereby repeating old technical errors. Planning for the private sector has a somewhat brighter history due to the use of Grupos Executivos which has enabled the planning process to transcend the formalism and tradition-bound attitudes of the regular bureaucracy. Regional planning offers two relatively successful experiences, Sudene and the strategy of the regionally oriented autarchy. Thus, planning history in Brazil is not entirely black but a certain shade of grey. The major part of the article, however, is devoted to a descriptive analysis of the national planning experience. The plans included in this analysis are: The Works and Equipment Plan (POE); The Health, Food, Transportation and Energy Plan (Salte); The Program of Goals; The Trienal Plan of Economic and Social Development; and the Plan of Governmental Economic Action (Paeg). Using these five plans for his historical experience the author sets out a series of errors of formulation and execution by which he analyzes that experience. With respect to formulation, he speaks of a lack of elaboration of programs and projects, of coordination among diverse goals, and of provision of qualified staff and techniques. He mentions the absence of the definition of resources necessary to the financing of the plan and the inadequate quantification of sectorial and national goals due to the lack of reliable statistical information. Finally, he notes the failure to coordinate the annual budget with the multi-year plans. He sees the problems of execution as beginning in the absence of coordination between the various sectors of the public administration, the failure to develop an operative system of decentralization, the absence of any system of financial and fiscal control over execution, the difficulties imposed by the system of public accounting, and the absence of an adequate program of allocation for the liberation of resources. He ends by pointing to the failure to develop and use an integrated system of political economic tools in a mode compatible with the objective of the plans. The body of the article analyzes national planning experience in Brazil using these lists of errors as rough model of criticism. Several conclusions emerge from this analysis with regard to planning in Brazil and in developing countries, in general. Plans have generally been of little avail in Brazil because of the lack of a continuous, bureaucratized (in the Weberian sense) planning organization set in an instrumentally suitable administrative structure and based on thorough diagnoses of socio-economic conditions and problems. Plans have become the justification for planning. Planning has come to be conceived as a rational method of orienting the process of decisions through the establishment of a precise and quantified relation between means and ends. But this conception has led to a planning history rimmed with frustration, and failure, because of its rigidity in the face of flexible and changing reality. Rather, he suggests a conception of planning which understands it "as a rational process of formulating decisions about the policy, economy, and society whose only demand is that of managing the instrumentarium in a harmonious and integrated form in order to reach explicit, but not quantified ends". He calls this "planning without plans": the establishment of broad-scale tendencies through diagnosis whose implementation is carried out through an adjustable, coherent instrumentarium of political-economic tools. Administration according to a plan of multiple, integrated goals is a sound procedure if the nation's administrative machinery contains the technical development needed to control the multiple variables linked to any situation of socio-economic change. Brazil does not possess this level of refinement and any strategy of planning relevant to its problems must recognize this. The reforms which have been attempted fail to make this recognition as is true of the conception of planning informing the Brazilian experience. Therefore, unworkable plans, ill-diagnosed with little or no supportive instrumentarium or flexibility have been Brazil's legacy. This legacy seems likely to continue until the conception of planning comes to live in the reality of Brazil.

Leanness na manutenção aeronáutica: o caso FAP

Os sistemas de armas da Força Aérea Portuguesa (FAP) têm por missão a defesa militar de Portugal, através de operações aéreas e da defesa do espaço aéreo nacional, sendo o F-16 o principal avião de ataque em uso nesta organização. Neste sentido, e tendo em conta o actual contexto económico mundial, as organizações devem rentabilizar todos os recursos disponíveis, custos associados e optimizar processos de trabalho. Tendo por base os pressupostos anteriores, o presente estudo pretende analisar a implementação de lean na FAP, uma vez que esta filosofia assenta na eliminação de desperdícios com vista a uma melhoria da qualidade e diminuição de tempos e custos. Posto isto, a análise deste trabalho vai recair sobre a área de manutenção do F-16, em concreto na Inspeção de Fase (IF), um tipo de manutenção que esta aeronave realiza a cada trezentas horas de voo. O estudo de caso vai incidir em dois momentos da IF: o primeiro ponto relaciona-se com o processamento da recolha de dados para a reunião preliminar onde são definidas, para as áreas de trabalho executantes, as ações de manutenção a realizar com a paragem da aeronave. Deste modo, pretende-se averiguar as causas inerentes aos atrasos verificados para a realização desta reunião. O segundo ponto em observação compreende a informação obtida através da aplicação informática SIAGFA, em uso na FAP, para o processamento de dados de manutenção das quatro aeronaves que inauguraram a IF com a filosofia lean. Esta análise permitiu perceber o número de horas de trabalho dispendidas (em média pelas quatro aeronaves) por cada uma das cartas de trabalho, verificando-se que as cartas adicionais comportam mais horas; foi possível compreender quais as áreas de trabalho consideradas críticas; foram identificados os dias de trabalho realizado e tempos de paragem sem qualquer tipo de intervenção. Foi ainda avaliado, por aeronave, o número de horas de trabalho realizadas na IF e quais os constrangimentos que se verificaram nas aeronaves, que não realizaram a IF no tempo definido para tal.

Avaliação do projecto - Formalização da consulta de enfermagem em pneumologia

Mestrado em Intervenção Sócio-Organizacional na Saúde - Área de especialização: Políticas de Administração e Gestão de Serviços de Saúde.

Learning to manage in knowledge based organizations: the role of portfolios

Paper presented at the 8th European Conference on Knowledge Management, Barcelona, 6-7 Sep. 2008 URL: http://www.academic-conferences.org/eckm/eckm2007/eckm07-home.htm

ANN-Based LMP forecasting in a distribution network with large penetration of DG

In recent years, power systems have experienced many changes in their paradigm. The introduction of new players in the management of distributed generation leads to the decentralization of control and decision-making, so that each player is able to play in the market environment. In the new context, it will be very relevant that aggregator players allow midsize, small and micro players to act in a competitive environment. In order to achieve their objectives, virtual power players and single players are required to optimize their energy resource management process. To achieve this, it is essential to have financial resources capable of providing access to appropriate decision support tools. As small players have difficulties in having access to such tools, it is necessary that these players can benefit from alternative methodologies to support their decisions. This paper presents a methodology, based on Artificial Neural Networks (ANN), and intended to support smaller players. In this case the present methodology uses a training set that is created using energy resource scheduling solutions obtained using a mixed-integer linear programming (MIP) approach as the reference optimization methodology. The trained network is used to obtain locational marginal prices in a distribution network. The main goal of the paper is to verify the accuracy of the ANN based approach. Moreover, the use of a single ANN is compared with the use of two or more ANN to forecast the locational marginal price.

ANN based support for distributed energy resources scheduling in smart grids

The future scenarios for operation of smart grids are likely to include a large diversity of players, of different types and sizes. With control and decision making being decentralized over the network, intelligence should also be decentralized so that every player is able to play in the market environment. In the new context, aggregator players, enabling medium, small, and even micro size players to act in a competitive environment, will be very relevant. Virtual Power Players (VPP) and single players must optimize their energy resource management in order to accomplish their goals. This is relatively easy to larger players, with financial means to have access to adequate decision support tools, to support decision making concerning their optimal resource schedule. However, the smaller players have difficulties in accessing this kind of tools. So, it is required that these smaller players can be offered alternative methods to support their decisions. This paper presents a methodology, based on Artificial Neural Networks (ANN), intended to support smaller players’ resource scheduling. The used methodology uses a training set that is built using the energy resource scheduling solutions obtained with a reference optimization methodology, a mixed-integer non-linear programming (MINLP) in this case. The trained network is able to achieve good schedule results requiring modest computational means.

A data-mining based methodology for wind forecasting

In many countries the use of renewable energy is increasing due to the introduction of new energy and environmental policies. Thus, the focus on the efficient integration of renewable energy into electric power systems is becoming extremely important. Several European countries have already achieved high penetration of wind based electricity generation and are gradually evolving towards intensive use of this generation technology. The introduction of wind based generation in power systems poses new challenges for the power system operators. This is mainly due to the variability and uncertainty in weather conditions and, consequently, in the wind based generation. In order to deal with this uncertainty and to improve the power system efficiency, adequate wind forecasting tools must be used. This paper proposes a data-mining-based methodology for very short-term wind forecasting, which is suitable to deal with large real databases. The paper includes a case study based on a real database regarding the last three years of wind speed, and results for wind speed forecasting at 5 minutes intervals.

ANN based day-ahead spinning reserve forecast for electricity market simulation

Electricity market players operating in a liberalized environment require adequate decision support tools, allowing them to consider all the business opportunities and take strategic decisions. Ancillary services represent a good negotiation opportunity that must be considered by market players. This paper deals with short-term predication of day-ahead spinning reserve (SR) requirement that helps the ISO to make effective and timely decisions. Based on these forecasted information, market participants can use strategic bidding for day-ahead SR market. The proposed concepts and methodologies are implemented in MASCEM, a multi-agent based electricity market simulator. A case study based on California ISO (CAISO) data is included; the forecasted results are presented and compared with CAISO published forecast.