A performance assessment method for hospitals:the case of municipal hospitals in Angola

Over 60% of the recurrent budget of the Ministry of Health (MoH) in Angola is spent on the operations of the fixed health care facilities (health centres plus hospitals). However, to date, no study has been attempted to investigate how efficiently those resources are used to produce health services. Therefore the objectives of this study were to assess the technical efficiency of public municipal hospitals in Angola; assess changes in productivity over time with a view to analyzing changes in efficiency and technology; and demonstrate how the results can be used in the pursuit of the public health objective of promoting efficiency in the use of health resources. The analysis was based on a 3-year panel data from all the 28 public municipal hospitals in Angola. Data Envelopment Analysis (DEA), a non-parametric linear programming approach, was employed to assess the technical and scale efficiency and productivity change over time using Malmquist index.The results show that on average, productivity of municipal hospitals in Angola increased by 4.5% over the period 2000-2002; that growth was due to improvements in efficiency rather than innovation. © 2008 Springer Science+Business Media, LLC.

Causality and synchronisation in complex systems with applications to neuroscience

This thesis presents an investigation, of synchronisation and causality, motivated by problems in computational neuroscience. The thesis addresses both theoretical and practical signal processing issues regarding the estimation of interdependence from a set of multivariate data generated by a complex underlying dynamical system. This topic is driven by a series of problems in neuroscience, which represents the principal background motive behind the material in this work. The underlying system is the human brain and the generative process of the data is based on modern electromagnetic neuroimaging methods . In this thesis, the underlying functional of the brain mechanisms are derived from the recent mathematical formalism of dynamical systems in complex networks. This is justified principally on the grounds of the complex hierarchical and multiscale nature of the brain and it offers new methods of analysis to model its emergent phenomena. A fundamental approach to study the neural activity is to investigate the connectivity pattern developed by the brain’s complex network. Three types of connectivity are important to study: 1) anatomical connectivity refering to the physical links forming the topology of the brain network; 2) effective connectivity concerning with the way the neural elements communicate with each other using the brain’s anatomical structure, through phenomena of synchronisation and information transfer; 3) functional connectivity, presenting an epistemic concept which alludes to the interdependence between data measured from the brain network. The main contribution of this thesis is to present, apply and discuss novel algorithms of functional connectivities, which are designed to extract different specific aspects of interaction between the underlying generators of the data. Firstly, a univariate statistic is developed to allow for indirect assessment of synchronisation in the local network from a single time series. This approach is useful in inferring the coupling as in a local cortical area as observed by a single measurement electrode. Secondly, different existing methods of phase synchronisation are considered from the perspective of experimental data analysis and inference of coupling from observed data. These methods are designed to address the estimation of medium to long range connectivity and their differences are particularly relevant in the context of volume conduction, that is known to produce spurious detections of connectivity. Finally, an asymmetric temporal metric is introduced in order to detect the direction of the coupling between different regions of the brain. The method developed in this thesis is based on a machine learning extensions of the well known concept of Granger causality. The thesis discussion is developed alongside examples of synthetic and experimental real data. The synthetic data are simulations of complex dynamical systems with the intention to mimic the behaviour of simple cortical neural assemblies. They are helpful to test the techniques developed in this thesis. The real datasets are provided to illustrate the problem of brain connectivity in the case of important neurological disorders such as Epilepsy and Parkinson’s disease. The methods of functional connectivity in this thesis are applied to intracranial EEG recordings in order to extract features, which characterize underlying spatiotemporal dynamics before during and after an epileptic seizure and predict seizure location and onset prior to conventional electrographic signs. The methodology is also applied to a MEG dataset containing healthy, Parkinson’s and dementia subjects with the scope of distinguishing patterns of pathological from physiological connectivity.

Biology of sensory systems

Since publication of the first edition, huge developments have taken place in sensory biology research and new insights have been provided in particular by molecular biology. These show the similarities in the molecular architecture and in the physiology of sensory cells across species and across sensory modality and often indicate a common ancestry dating back over half a billion years. Biology of Sensory Systems has thus been completely revised and takes a molecular, evolutionary and comparative approach, providing an overview of sensory systems in vertebrates, invertebrates and prokaryotes, with a strong focus on human senses. Written by a renowned author with extensive teaching experience, the book covers, in six parts, the general features of sensory systems, the mechanosenses, the chemosenses, the senses which detect electromagnetic radiation, other sensory systems including pain, thermosensitivity and some of the minority senses and, finally, provides an outline and discussion of philosophical implications. New in this edition: - Greater emphasis on molecular biology and intracellular mechanisms - New chapter on genomics and sensory systems - Sections on TRP channels, synaptic transmission, evolution of nervous systems, arachnid mechanosensitive sensilla and photoreceptors, electroreception in the Monotremata, language and the FOXP2 gene, mirror neurons and the molecular biology of pain - Updated passages on human olfaction and gustation. Over four hundred illustrations, boxes containing supplementary material and self-assessment questions and a full bibliography at the end of each part make Biology of Sensory Systems essential reading for undergraduate students of biology, zoology, animal physiology, neuroscience, anatomy and physiological psychology. The book is also suitable for postgraduate students in more specialised courses such as vision sciences, optometry, neurophysiology, neuropathology, developmental biology.

Fibre-based devices for next generation photonics communication systems

The future broadband information network will undoubtedly integrate the mobility and flexibility of wireless access systems with the huge bandwidth capacity of photonics solutions to enable a communication system capable of handling the anticipated demand for interactive services. Towards wide coverage and low cost implementations of such broadband wireless photonics communication networks, various aspects of the enabling technologies are continuingly generating intense research interest. Among the core technologies, the optical generation and distribution of radio frequency signals over fibres, and the fibre optic signal processing of optical and radio frequency signals, have been the subjects for study in this thesis. Based on the intrinsic properties of single-mode optical fibres, and in conjunction with the concepts of optical fibre delay line filters and fibre Bragg gratings, a number of novel fibre-based devices, potentially suitable for applications in the future wireless photonics communication systems, have been realised. Special single-mode fibres, namely, the high birefringence (Hi-Bi) fibre and the Er/Yb doped fibre have been employed so as to exploit their merits to achieve practical and cost-effective all-fibre architectures. A number of fibre-based complex signal processors for optical and radio frequencies using novel Hi-Bi fibre delay line filter architectures have been illustrated. In particular, operations such as multichannel flattop bandpass filtering, simultaneous complementary outputs and bidirectional nonreciprocal wavelength interleaving, have been demonstrated. The proposed configurations featured greatly reduced environmental sensitivity typical of coherent fibre delay line filter schemes, reconfigurable transfer functions, negligible chromatic dispersions, and ease of implementation, not easily achievable based on other techniques. A number of unique fibre grating devices for signal filtering and fibre laser applications have been realised. The concept of the superimposed fibre Bragg gratings has been extended to non-uniform grating structures and into Hi-Bi fibres to achieve highly useful grating devices such as overwritten phase-shifted fibre grating structure and widely/narrowly spaced polarization-discriminating filters that are not limited by the intrinsic fibre properties. In terms of the-fibre-based optical millimetre wave transmitters, unique approaches based on fibre laser configurations have been proposed and demonstrated. The ability of the dual-mode distributed feedback (DFB) fibre lasers to generate high spectral purity, narrow linewidth heterodyne signals without complex feedback mechanisms has been illustrated. A novel co-located dual DFB fibre laser configuration, based on the proposed superimposed phase-shifted fibre grating structure, has been further realised with highly desired operation characteristics without the need for costly high frequency synthesizers and complex feedback controls. Lastly, a novel cavity mode condition monitoring and optimisation scheme for short length, linear-cavity fibre lasers has been proposed and achieved. Based on the concept and simplicity of the superimposed fibre laser cavities structure, in conjunction with feedback controls, enhanced output performances from the fibre lasers have been achieved. The importance of such cavity mode assessment and feedback control for optimised fibre laser output performance has been illustrated.

An expert system for the development of a health and safety policy/risk assessment in the plastics industry

Health and safety policies may be regarded as the cornerstone for positive prevention of occupational accidents and diseases. The Health and Safety at Work, etc Act 1974 makes it a legal duty for employers to prepare and revise a written statement of a general policy with respect to the health and safety at work of employees as well as the organisation and arrangements for carrying out that policy. Despite their importance and the legal equipment to prepare them, health and safety policies have been found, in a large number of plastics processing companies (particularly small companies), to be poorly prepared, inadequately implemented and monitored. An important cause of these inadequacies is the lack of necessary health and safety knowledge and expertise to prepare, implement and monitor policies. One possible way of remedying this problem is to investigate the feasibility of using computers to develop expert system programs to simulate the health and safety (HS) experts' task of preparing the policies and assisting companies implement and monitor them. Such programs use artificial intelligence (AI) techniques to solve this sort of problems which are heuristic in nature and require symbolic reasoning. Expert systems have been used successfully in a variety of fields such as medicine and engineering. An important phase in the feasibility of development of such systems is the engineering of knowledge which consists of identifying the knowledge required, eliciting, structuring and representing it in an appropriate computer programming language.

Developments in assessment and teaching methodologies in modern languages in England and France in response to educational reform (1975-1985)

This comparative study considers the main causative factors for change in recent years in the teaching of modern languages in England and France and seeks to contribute, in a general sense, to the understanding of change in comparable institutions. In England by 1975 the teaching of modern languages in the comprehensive schools was seen to be inappropriate to the needs of children of the whole ability-range. A combination of the external factor of the Council of Europe initiative in devising a needs-based learning approach for adult learners, and the internal factor of teacher-based initiatives in developing a graded-objectives learning approach for the less-able, has reversed this situation to some extent. The study examines and evaluates this reversal, and, in addition, assesses teachers' attitudes towards, and understanding of, the changes involved. In France the imposition of `la reforme Haby' in 1977 and the creation of `le college unique' were the main external factors for change. The subsequent failure of the reform and the socialist government's support of decentralisation policies returning the initiative for renewal to schools are examined and evaluated, as are the internal factors for changes in language-teaching - `groupes de niveau' and the creation of `equipes pedagogiques'. In both countries changes in the function of examinations at 15/16 plus are examined. The final chapter compared the changes in both education systems.

A systems approach to strategic manpower planning for technological development under conditions of manpower scarcity and centralised control

This thesis deals with the integration of the manpower criterion with the strategic decision making processes of technological projects in developing countries. This integration is to be achieved by ensuring the involvement of the actors, who have relevant roles and responsibilities along the whole life cycle of the project, in the strategic decision making phases of the project. The relevance of the actors is ascertained by the use of a responsibility index which relates their responsibility to the project's constituent stages. In the context of a technological project in a typical centrally-planned developing environment, the actors are identified as Arbiters, Planners, Implementors and Operators and their roles, concerns and objectives are derived. In this context, the actors are usually government and non-government organisations. Hence, decision making will involve multiple agencies as well as multiple criteria. A methodology covering the whole decision-making process, from options generation to options selection, and adopting Saaty's Analytical Hierarchy Process as an operational tool is proposed to deal with such multiple-criteria, multipleagency decision situations. The methodology is intended to integrate the consideration of the relevant criteria, the prevailing environmental and policy factors, and the concerns and objectives of the relevant actors into a unifying decision-making process which strives to facilitate enlightened decision making and to enhance learning and interaction. An extensive assessment of the methodology's feasibility, based on a specific technological project within the Iraqi oil industry is included, and indicates that the methodology should be both useful and implementable.

Assessment of the impact of discharges from surface water sewers on receiving water quality

A broad based approach has been used to assess the impact of discharges to rivers from surface water sewers, with the primary objective of determining whether such discharges have a measurable impact on water quality. Three parameters, each reflecting the effects of intermittent pollution, were included in a field work programme of biological and chemical sampling and analysis which covered 47 sewer outfall sites. These parameters were the numbers and types of benthic macroinvertebrates upstream and downstream of the outfalls, the concentrations of metals in sediments, and the concentrations of metals in algae upstream and downstream of the outfalls. Information on the sewered catchments was collected from Local Authorities and by observation of the time of sampling, and includes catchment areas, land uses, evidence of connection to the foul system, and receiving water quality classification. The methods used for site selection, sampling, laboratory analysis and data analysis are fully described, and the survey results presented. Statistical and graphical analysis of the biological data, with the aid of BMWP scores, showed that there was a small but persistent fall in water quality downstream of the studied outfalls. Further analysis including the catchment information indicated that initial water quality, sewered catchment size, receiving stream size, and catchment land use were important factors in determining the impact. Finally, the survey results were used to produce guidelines for the estimation of surface water sewer discharge impacts from knowledge of the catchment characteristics, so that planning authorities can consider water quality when new drainage systems are designed.

User interface design support for the development of knowledge-based systems

The present scarcity of operational knowledge-based systems (KBS) has been attributed, in part, to an inadequate consideration shown to user interface design during development. From a human factors perspective the problem has stemmed from an overall lack of user-centred design principles. Consequently the integration of human factors principles and techniques is seen as a necessary and important precursor to ensuring the implementation of KBS which are useful to, and usable by, the end-users for whom they are intended. Focussing upon KBS work taking place within commercial and industrial environments, this research set out to assess both the extent to which human factors support was presently being utilised within development, and the future path for human factors integration. The assessment consisted of interviews conducted with a number of commercial and industrial organisations involved in KBS development; and a set of three detailed case studies of individual KBS projects. Two of the studies were carried out within a collaborative Alvey project, involving the Interdisciplinary Higher Degrees Scheme (IHD) at the University of Aston in Birmingham, BIS Applied Systems Ltd (BIS), and the British Steel Corporation. This project, which had provided the initial basis and funding for the research, was concerned with the application of KBS to the design of commercial data processing (DP) systems. The third study stemmed from involvement on a KBS project being carried out by the Technology Division of the Trustees Saving Bank Group plc. The preliminary research highlighted poor human factors integration. In particular, there was a lack of early consideration of end-user requirements definition and user-centred evaluation. Instead concentration was given to the construction of the knowledge base and prototype evaluation with the expert(s). In response to this identified problem, a set of methods was developed that was aimed at encouraging developers to consider user interface requirements early on in a project. These methods were then applied in the two further projects, and their uptake within the overall development process was monitored. Experience from the two studies demonstrated that early consideration of user interface requirements was both feasible, and instructive for guiding future development work. In particular, it was shown a user interface prototype could be used as a basis for capturing requirements at the functional (task) level, and at the interface dialogue level. Extrapolating from this experience, a KBS life-cycle model is proposed which incorporates user interface design (and within that, user evaluation) as a largely parallel, rather than subsequent, activity to knowledge base construction. Further to this, there is a discussion of several key elements which can be seen as inhibiting the integration of human factors within KBS development. These elements stem from characteristics of present KBS development practice; from constraints within the commercial and industrial development environments; and from the state of existing human factors support.

Substances hazardous to health:the nature of the expertise associated with competent risk assessment

This research investigated expertise in hazardous substance risk assessment (HSRA). Competent pro-active risk assessment is needed to prevent occupational ill-health caused by hazardous substance exposure occurring in the future. In recent years there has been a strong demand for HSRA expertise and a shortage of expert practitioners. The discipline of Occupational Hygiene was identified as the key repository of knowledge and skills for HSRA and one objective of this research was to develop a method to elicit this expertise from experienced occupational hygienists. In the study of generic expertise, many methods of knowledge elicitation (KE) have been investigated, since this has been relevant to the development of 'expert systems' (thinking computers). Here, knowledge needed to be elicited from human experts, and this stage was often a bottleneck in system development, since experts could not explain the basis of their expertise. At an intermediate stage, information collected was used to structure a basic model of hazardous substance risk assessment activity (HSRA Model B) and this formed the basis of tape transcript analysis in the main study with derivation of a 'classification' and a 'performance matrix'. The study aimed to elicit the expertise of occupational hygienists and compare their performance with other health and safety professionals (occupational health physicians, occupational health nurses, health and safety practitioners and trainee health and safety inspectors), as evaluated using the matrix. As a group, the hygienists performed best in the exercise, and this group were particularly good at process elicitation and at recommending specific control measures, although the other groups also performed well in selected aspects of the matrix and the work provided useful findings and insights. From the research, two models of HSRA have been derived, an HSRA aid, together with a novel videotape KE technique and interesting research findings. The implications of this are discussed with respect to future training of HS professionals and wider application of the videotape KE method.

A techno-economic assessment of the use of fast pyrolysis bio-oil from UK energy crops in the production of electricity and combined heat and power

This thesis investigates the cost of electricity generation using bio-oil produced by the fast pyrolysis of UK energy crops. The study covers cost from the farm to the generator’s terminals. The use of short rotation coppice willow and miscanthus as feedstocks was investigated. All costs and performance data have been taken from published papers, reports or web sites. Generation technologies are compared at scales where they have proved economic burning other fuels, rather than at a given size. A pyrolysis yield model was developed for a bubbling fluidised bed fast pyrolysis reactor from published data to predict bio-oil yields and pyrolysis plant energy demands. Generation using diesel engines, gas turbines in open and combined cycle (CCGT) operation and steam cycle plants was considered. The use of bio-oil storage to allow the pyrolysis and generation plants to operate independently of each other was investigated. The option of using diesel generators and open cycle gas turbines for combined heat and power was examined. The possible cost reductions that could be expected through learning if the technology is widely implemented were considered. It was found that none of the systems analysed would be viable without subsidy, but with the current Renewable Obligation Scheme CCGT plants in the 200 to 350 MWe range, super-critical coal fired boilers co-fired with bio-oil, and groups of diesel engine based CHP schemes supplied by a central pyrolysis plant would be viable. It was found that the cost would reduce with implementation and the planting of more energy crops but some subsidy would still be needed to make the plants viable.

Integrated assessment of bioelectricity technology options

Power generation from biomass is a sustainable energy technology which can contribute to substantial reductions in greenhouse gas emissions, but with greater potential for environmental, economic and social impacts than most other renewable energy technologies. It is important therefore in assessing bioenergy systems to take account of not only technical, but also environmental, economic and social parameters on a common basis. This work addresses the challenge of analysing, quantifying and comparing these factors for bioenergy power generation systems. A life-cycle approach is used to analyse the technical, environmental, economic and social impacts of entire bioelectricity systems, with a number of life-cycle indicators as outputs to facilitate cross-comparison. The results show that similar greenhouse gas savings are achieved with the wide variety of technologies and scales studied, but land-use efficiency of greenhouse gas savings and specific airborne emissions varied substantially. Also, while specific investment costs and electricity costs vary substantially from one system to another the number of jobs created per unit of electricity delivered remains roughly constant. Recorded views of stakeholders illustrate that diverging priorities exist for different stakeholder groups and this will influence appropriate choice of bioenergy systems for different applications.

Techno-economic assessment and uncertainty analysis of thermochemical processes for second generation biofuels

Biomass-To-Liquid (BTL) is one of the most promising low carbon processes available to support the expanding transportation sector. This multi-step process produces hydrocarbon fuels from biomass, the so-called “second generation biofuels” that, unlike first generation biofuels, have the ability to make use of a wider range of biomass feedstock than just plant oils and sugar/starch components. A BTL process based on gasification has yet to be commercialized. This work focuses on the techno-economic feasibility of nine BTL plants. The scope was limited to hydrocarbon products as these can be readily incorporated and integrated into conventional markets and supply chains. The evaluated BTL systems were based on pressurised oxygen gasification of wood biomass or bio-oil and they were characterised by different fuel synthesis processes including: Fischer-Tropsch synthesis, the Methanol to Gasoline (MTG) process and the Topsoe Integrated Gasoline (TIGAS) synthesis. This was the first time that these three fuel synthesis technologies were compared in a single, consistent evaluation. The selected process concepts were modelled using the process simulation software IPSEpro to determine mass balances, energy balances and product distributions. For each BTL concept, a cost model was developed in MS Excel to estimate capital, operating and production costs. An uncertainty analysis based on the Monte Carlo statistical method, was also carried out to examine how the uncertainty in the input parameters of the cost model could affect the output (i.e. production cost) of the model. This was the first time that an uncertainty analysis was included in a published techno-economic assessment study of BTL systems. It was found that bio-oil gasification cannot currently compete with solid biomass gasification due to the lower efficiencies and higher costs associated with the additional thermal conversion step of fast pyrolysis. Fischer-Tropsch synthesis was the most promising fuel synthesis technology for commercial production of liquid hydrocarbon fuels since it achieved higher efficiencies and lower costs than TIGAS and MTG. None of the BTL systems were competitive with conventional fossil fuel plants. However, if government tax take was reduced by approximately 33% or a subsidy of £55/t dry biomass was available, transport biofuels could be competitive with conventional fuels. Large scale biofuel production may be possible in the long term through subsidies, fuels price rises and legislation.

Fuzzy assessment of performance of a decision making units using DEA:a non-radical approach

Data Envelopment Analysis (DEA) is recognized as a modern approach to the assessment of performance of a set of homogeneous Decision Making Units (DMUs) that use similar sources to produce similar outputs. While DEA commonly is used with precise data, recently several approaches are introduced for evaluating DMUs with uncertain data. In the existing approaches many information on uncertainties are lost. For example in the defuzzification, the a-level and fuzzy ranking approaches are not considered. In the tolerance approach the inequality or equality signs are fuzzified but the fuzzy coefficients (inputs and outputs) are not treated directly. The purpose of this paper is to develop a new model to evaluate DMUs under uncertainty using Fuzzy DEA and to include a-level to the model under fuzzy environment. An example is given to illustrate this method in details.

Can computer-based testing achieve quality and efficiency in assessment?

This paper reports findings of a two year study concerning the development and implementation of a general-purpose computer-based assessment (CBA) system at a UK University. Data gathering took place over a period of nineteen months, involving a number of formative and summative assessments. Approximately 1,000 students, drawn from undergraduate courses, were involved in the exercise. The techniques used in gathering data included questionnaires, observation, interviews and an analysis of student scores in both conventional examinations and computer-based assessments. Comparisons with conventional assessment methods suggest that the use of CBA techniques may improve the overall performance of students. However it is clear that the technique must not be seen as a "quick fix" for problems such as rising student numbers. If one accepts that current systems test only a relatively narrow range of skills, then the hasty implementation of CBA systems will result in a distorted and inaccurate view of student performance. In turn, this may serve to reduce the overall quality of courses and - ultimately - detract from the student learning experience. On the other hand, if one adopts a considered and methodical approach to computer-based assessment, positive benefits might include increased efficiency and quality, leading to improved student learning.