Modelling the Performance of Irish Credit Unions, 2002 to 2010

This study undertakes a modeling based performance assessment of all Irish credit unions between 2002 and 2010, a particularly turbulent period in their history. The analysis explicitly addresses the current challenges faced by credit unions in that the modeling approach used rewards credit unions for reducing undesirable outputs (impaired loans and investments) as well as for increasing desirable outputs (loans, earning assets and members’ funds) and decreasing inputs (labour expenditure, capital expenditure and fund expenses). The main findings are: credit unions are subject to increasing returns to scale; technical regression occurred in the years after 2007; there is significant scope for an improvement in efficiency through expansion of desirable outputs and contraction of undesirable outputs and inputs; and that larger credit unions, that are better capitalised and pay a higher dividend to members are more efficient than their smaller, less capitalised, and lower dividend paying counterparts.

Hospital antibiotic use and its relationship to age-adjusted comorbidity and alcohol-based hand rub consumption

SUMMARY The objective of this study was to evaluate the effect of age-adjusted comorbidity and alcohol-based hand rub on monthly hospital antibiotic usage, retrospectively. A multivariate autoregressive integrated moving average (ARIMA) model was built to relate the monthly use of all antibiotics grouped together with age-adjusted comorbidity and alcohol-based hand rub over a 5-year period (April 2005-March 2010). The results showed that monthly antibiotic use was positively related to the age-adjusted comorbidity index (concomitant effect, coefficient 1·103, P = 0·0002), and negatively related to the use of alcohol-based hand rub (2-month delay, coefficient -0·069, P = 0·0533). Alcohol-based hand rub is considered a modifiable factor and as such can be identified as a target for quality improvement programmes. Time-series analysis may provide a suitable methodology for identifying possible predictive variables that explain antibiotic use in healthcare settings. Future research should examine the relationship between infection control practices and antibiotic use, identify other infection control predictive factors for hospital antibiotic use, and evaluate the impact of enhancing different infection control practices on antibiotic use in a healthcare setting.

Voltage and power quality improvement strategy for a DFIG wind turbine during variable wind conditions

This paper presents a voltage and power quality enhancement scheme for a doubly-fed induction generator (DFIG) wind farm during variable wind conditions. The wind profiles were derived considering the measured data at a DFIG wind farm located in Northern Ireland (NI). The aggregated DFIG wind farm model was validated using measured data at a wind farm during variable generation. The voltage control strategy was developed considering the X/R ratio of the wind farm feeder which connects the wind farm and the grid. The performance of the proposed strategy was evaluated for different X/R ratios, and wind profiles with different characteristics. The impact of flicker propagation along the wind farm feeder and effectiveness of the proposed strategy is also evaluated with consumer loads connected to the wind farm feeder. It is shown that voltage variability and short-term flicker severity is significantly reduced following implementation of the novel strategy described.

Efficiency improvement study for small wind turbines through flow control

In this study, a constant suction technique for controlling boundary layer separation at low Reynolds numbers was designed and tested. This was later implemented on small wind turbines. Small wind turbines need to operate in low wind speeds, that is, in low Reynolds number regimes – typically in the range 104–105. Airfoils are prone to boundary layer separation in these conditions, leading to a substantial drop in aerodynamic performance of the blades. Under these conditions turbines will have reduced energy output. This paper presents experimental results of applying surface-suction over the suction-surface of airfoils for controlling boundary layer separation. The Reynolds numbers for the experiments are kept in the range 8×104–5×105. The air over the surface of the airfoil is drawn into the airfoil through a slit. It is found that the lift coefficient of the airfoils increases and the drag reduces. Based on the improved airfoil characteristics, an analysis of increase in Coefficient of Power (CP), versus input power for a small wind turbine blade with constant suction is presented.

Exercise rehabilitation following intensive care unit discharge for recovery from critical illness

Background: Skeletal muscle wasting and weakness are significant complications of critical illness, associated with the degree of illness severity and periods of reduced mobility during mechanical ventilation. They contribute to the profound physical and functional deficits observed in survivors. These impairments may persist for many years following discharge from the intensive care unit (ICU) and may markedly influence health-related quality of life. Rehabilitation is a key strategy in the recovery of patients following critical illness. Exercise based interventions are aimed at targeting this muscle wasting and weakness. Physical rehabilitation delivered during ICU admission has been systematically evaluated and shown to be beneficial. However its effectiveness when initiated after ICU discharge has yet to be established. Objectives: To assess the effectiveness of exercise rehabilitation programmes, initiated after ICU discharge, on functional exercise capacity and health-related quality of life in adult ICU survivors who have been mechanically ventilated for more than 24 hours. Search methods:We searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), OvidSP MEDLINE, Ovid SP EMBASE, and CINAHL via EBSCO host to 15th May 2014. We used a specific search strategy for each database. This included synonyms for ICU and critical illness, exercise training and rehabilitation. We searched the reference lists of included studies and contacted primary authors to obtain further information regarding potentially eligible studies. We also searched major clinical trials registries (Clinical Trials and Current Controlled Trials) and the personal libraries of the review authors. We applied no language or publication restriction. We reran the search in February 2015. We will deal with any studies of interest when we update the review.  Selection criteria:We included randomized controlled trials (RCTs), quasi-RCTs, and controlled clinical trials (CCTs) that compared an exercise interventioninitiated after ICU discharge to any other intervention or a control or ‘usual care’ programme in adult (≥18years) survivors ofcritical illness. Data collection and analysis:We used standard methodological procedures expected by The Cochrane Collaboration. Main results:We included six trials (483 adult ICU participants). Exercise-based interventions were delivered on the ward in two studies; both onthe ward and in the community in one study; and in the community in three studies. The duration of the intervention varied according to the length of stay in hospital following ICU discharge (up to a fixed duration of 12 weeks).Risk of bias was variable for all domains across all trials. High risk of bias was evident in all studies for performance bias, although blinding of participants and personnel in therapeutic rehabilitation trials can be pragmatically challenging. Low risk of bias was at least 50% for all other domains across all trials, although high risk of bias was present in one study for random sequence generation (selection bias), incomplete outcome data (attrition bias) and other sources. Risk of bias was unclear for remaining studies across the domains.All six studies measured effect on the primary outcome of functional exercise capacity, although there was wide variability in natureof intervention, outcome measures and associated metrics, and data reporting. Overall quality of the evidence was very low. Only two studies using the same outcome measure for functional exercise capacity, had the potential for pooling of data and assessment of heterogeneity. On statistical advice, this was considered inappropriate to perform this analysis and study findings were therefore qualitatively described. Individually, three studies reported positive results in favour of the intervention. A small benefit (versus. control)was evident in anaerobic threshold in one study (mean difference, MD (95% confidence interval, CI), 1.8 mlO2/kg/min (0.4 to 3.2),P value = 0.02), although this effect was short-term, and in a second study, both incremental (MD 4.7 (95% CI 1.69 to 7.75) Watts, P value = 0.003) and endurance (MD 4.12 (95% CI 0.68 to 7.56) minutes, P value = 0.021) exercise testing demonstrated improvement.Finally self-reported physical function increased significantly following a rehabilitation manual (P value = 0.006). Remaining studies found no effect of the intervention.Similar variability in with regard findings for the primary outcome of health-related quality of life were also evident. Only two studies evaluated this outcome. Following statistical advice, these data again were considered inappropriate for pooling to determine overall effect and assessment of heterogeneity. Qualitative description of findings was therefore undertaken. Individually, neither study reported differences between intervention and control groups for health-related quality of life as a result of the intervention. Overall quality of the evidence was very low.Mortality was reported by all studies, ranging from 0% to 18.8%. Only one non-mortality adverse event was reported across all patients in all studies (a minor musculoskeletal injury). Withdrawals, reported in four studies, ranged from 0% to 26.5% in control groups,and 8.2% to 27.6% in intervention groups. Loss to follow-up, reported in all studies, ranged from 0% to 14% in control groups, and 0% to 12.5% in intervention groups. Authors’ conclusions:We are unable, at this time, to determine an overall effect on functional exercise capacity, or health-related quality of life, of an exercise based intervention initiated after ICU discharge in survivors of critical illness. Meta-analysis of findings was not appropriate. This was due to insufficient study number and data. Individual study findings were inconsistent. Some studies reported a beneficial effect of the intervention on functional exercise capacity, and others not. No effect was reported on health-related quality of life. Methodological rigour was lacking across a number of domains influencing quality of the evidence. There was also wide variability in the characteristics of interventions, outcome measures and associated metrics, and data reporting.If further trials are identified, we may be able to determine the effect of exercise-based interventions following ICU discharge, on functional exercise capacity and health-related quality of life in survivors of critical illness.

Musculoskeletal (MSK) and Sport and Exercise Medicine (SEM) in General Practice (GP): A Novel GP-based MSK and SEM Clinic for Managing Musculoskeletal symptoms in a GP

Musculoskeletal (MSK) complaints are common within primary care (1) (2) (3) but some General Practitioners (GPs)/family physicians do not feel comfortable managing these symptoms (3), preferring to refer onto hospital specialists or Integrated Clinical Assessment and Treatment Services (ICATs). Long waiting times for hospital outpatient reviews are a major cause of patient inconvenience and complaints (4). We therefore aimed to establish a GP-ran MSK and sport and exercise medicine (SEM) clinic based within a Belfast GP surgery that would contribute to a sustainable improvement in managing these common conditions within primary care as well as reducing waiting times for patients with these conditions to see a specialist. This shift from hospital-based to community-based management is in-keeping with recent policy changes within the UK health-system, including Transforming Your Care within Northern Ireland (NI) (5). The GP-ran MSK and SEM clinic was held monthly within a Belfast GP practice, staffed by one GP with a specialist interest in MSK and SEM conditions and its performance was reviewed over a three month period. Parameters audited included cases seen, orthopaedic and x-ray referral rates and secondary care referrals comparing the GP practice’s performance to the same time period in the previous year as well as patient satisfaction questionnaires.

Generating Data Augmented Spectroscopic Data For Performance Enhancement

The application of chemometrics in food science has revolutionized the field by allowing the creation of models able to automate a broad range of applications such as food authenticity and food fraud detection. In order to create effective and general models able to address the complexity of real life problems, a vast amount of varied training samples are required. Training dataset has to cover all possible types of sample and instrument variability. However, acquiring a varied amount of samples is a time consuming and costly process, in which collecting samples representative of the real world variation is not always possible, specially in some application fields. To address this problem, a novel framework for the application of data augmentation techniques to spectroscopic data has been designed and implemented. This is a carefully designed pipeline of four complementary and independent blocks which can be finely tuned depending on the desired variance for enhancing model's robustness: a) blending spectra, b) changing baseline, c) shifting along x axis, and d) adding random noise.
This novel data augmentation solution has been tested in order to obtain highly efficient generalised classification model based on spectroscopic data. Fourier transform mid-infrared (FT-IR) spectroscopic data of eleven pure vegetable oils (106 admixtures) for the rapid identification of vegetable oil species in mixtures of oils have been used as a case study to demonstrate the influence of this pioneering approach in chemometrics, obtaining a 10% improvement in classification which is crucial in some applications of food adulteration.

Qualidade em saúde: que trajetos de formação dos enfermeiros?

ENQUADRAMENTO: A avaliação da qualidade dos serviços de saúde, a crescente melhoria do desempenho dos profissionais, e a monitorização sistemática das atividades desenvolvidas pelas instituições de saúde, potenciam a qualidade dos cuidados prestados. A intervenção dos enfermeiros e dos restantes profissionais de saúde é imprescindível na promoção desta qualidade conforme defendem os diversos modelos da sua gestão. Para a generalidade destes, considera-se que a supervisão clínica em enfermagem e a formação dos profissionais são ferramentas de eleição para a promoção da excelência clínica. OBJETIVO: Analisar as principais dimensões a considerar num processo de supervisão e formação para a avaliação e acreditação da qualidade duma instituição hospitalar, numa perspetiva ecológica. MÉTODO: Trata-se de um estudo de caso que abrange uma unidade de cuidados de um hospital. Para a colheita de dados recorreu-se a um conjunto de técnicas e instrumentos, entre as quais a observação participante, entrevistas semiestruturadas e um questionário, aplicados aos enfermeiros dessa unidade. A informação obtida foi submetida à análise qualitativa e quantitativa, com recurso aos programas NUD*IST QSR N6 e SPSS 17, respetivamente. RESULTADOS E DISCUSSÃO: Os resultados obtidos permitiram caracterizar quatro dimensões: i) Processos de qualidade; ii) Práticas supervisivas; iii) Formação em contexto de trabalho; e iv) Relações interpessoais. A partir destas compreendeu-se que a acreditação deve ser um processo contínuo e documentado da análise das atividades de enfermagem, visando a realização de mudanças nos processos de gestão, na orientação das atividades de aperfeiçoamento dos recursos humanos, na pesquisa de respostas às dificuldades no ato de cuidar enfrentadas e identificadas, e nas atividades administrativas ligadas às modificações de processos assistenciais e de gestão. O cruzamento dos dados com os referenciais teóricos veio corroborar a importância da implementação de um processo de gestão de qualidade para os cuidados de enfermagem, num hospital, onde são decisivos os processos supervisivos e formativos, assim como se tornou emergente atender-se às relações interpessoais nas equipas.

Expressividade e performance pianística

Esta tese consiste em uma pesquisa empírica sobre a expressividade musical. Os principais objetivos foram: identificar padrões e estratégias para o aprimoramento expressivo aplicados por profissionais de excelência; identificar como os performers conceitualizam a expressividade; identificar os principais componentes da expressividade; verificar relações entre a expressividade e o momento da performance; elaborar estratégias de estudo a partir das informações obtidas e aplicar estas estratégias na prática; verificar a sua pertinência e realizar uma avaliação qualitativa; e elaborar um modelo prático de estudo para a expressividade. Foram realizadas entrevistas com pianistas profissionais a fim de obter dados consistentes acerca da expressividade, e posteriormente foi conduzido um estudo de caso no qual estratégias de estudo sistematizadas a partir do relato dos pianistas foram aplicadas em um trabalho apoiado na autoetnografia, a fim de verificar a pertinência e realizar uma avaliação qualitativa sobre tais estratégias. Em termos gerais, os resultados indicaram que a expressividade consiste em um fenômeno de comunicação influenciado pela capacidade do intérprete em transmitir a mensagem e estrutura musical, cujos principais componentes compreendem elementos como o caráter, articulação e o fraseado. Além disso, os performers geralmente relacionam a expressividade a "modas" e tendências estético-interpretativas específicas e a elementos extramusicais. As principais estratégias pertinentes ao aprimoramento expressivo relacionam-se ao fraseado, realização de contrastes e sonoridade. A priorizar estes elementos, foi construído um modelo de estudo.

Adding value to performance measurement by using system dynamics and multicriteria analysis

Tese de dout., Filosofia, Department of Management Science, University of Strathclyde, 2004

Performance of an adaptive homodyne receiver in the presence of multipath, Rayleigh-fading and time-varying quadrature errors

In this paper, we carry out a detailed performance analysis of the blind source separation based I/Q corrector operating at the baseband. Performance of the digital I/Q corrector is evaluated not only under time-varying phase and gain errors but also in the presence of multipath and Rayleigh fading channels. Performance under low-SNR and different modulation formats and constellation sizes is also evaluated. What is more, BER improvement after correction is illustrated. The results indicate that the adaptive algorithm offers adequate performance for most communication applications hence, reducing the matching requirements of the analog front-end enabling higher levels of integration.

Estágio no Serviço de Dietética e Nutrição e no Departamento de Neurologia no Hospital de Santa Maria, Centro Hospitalar Lisboa Norte

Relatório de estágio de mestrado, Nutrição Clínica, Universidade de Lisboa, Faculdade de Medicina, 2015

Business Process Modelling based on formal temporal theory with an application to hospital patient flows

Existing Workflow Management Systems (WFMSs) follow a pragmatic approach. They often use a proprietary modelling language with an intuitive graphical layout. However the underlying semantics lack a formal foundation. As a consequence, analysis issues, such as proving correctness i.e. soundness and completeness, and reliable execution are not supported at design level. This project will be using an applied ontology approach by formally defining key terms such as process, sub-process, action/task based on formal temporal theory. Current business process modelling (BPM) standards such as Business Process Modelling Notation (BPMN) and Unified Modelling Language (UML) Activity Diagram (AD) model their constructs with no logical basis. This investigation will contribute to the research and industry by providing a framework that will provide grounding for BPM to reason and represent a correct business process (BP). This is missing in the current BPM domain, and may result in reduction of the design costs and avert the burden of redundant terms used by the current standards. A graphical tool will be introduced which will implement the formal ontology defined in the framework. This new tool can be used both as a modelling tool and at the same time will serve the purpose of validating the model. This research will also fill the existing gap by providing a unified graphical representation to represent a BP in a logically consistent manner for the mainstream modelling standards in the fields of business and IT. A case study will be conducted to analyse a catalogue of existing ‘patient pathways’ i.e. processes, of King’s College Hospital NHS Trust including current performance statistics. Following the application of the framework, a mapping will be conducted, and new performance statistics will be collected. A cost/benefits analysis report will be produced comparing the results of the two approaches.

A general framework for Business Process Modelling (BPM) based on Formal Temporal Theory with an application to Hospital Patient flows

Existing Workflow Management Systems (WFMSs) follow a pragmatic approach. They often use a proprietary modelling language with an intuitive graphical layout. However the underlying semantics lack a formal foundation. As a consequence, analysis issues, such as proving correctness i.e. soundness and completeness, and reliable execution are not supported at design level. This project will be using an applied ontology approach by formally defining key terms such as process, sub-process, action/task based on formal temporal theory. Current business process modelling (BPM) standards such as Business Process Modelling Notation (BPMN) and Unified Modelling Language (UML) Activity Diagram (AD) model their constructs with no logical basis. This investigation will contribute to the research and industry by providing a framework that will provide grounding for BPM to reason and represent a correct business process (BP). This is missing in the current BPM domain, and may result in reduction of the design costs and avert the burden of redundant terms used by the current standards. A graphical tool will be introduced which will implement the formal ontology defined in the framework. This new tool can be used both as a modelling tool and at the same time will serve the purpose of validating the model. This research will also fill the existing gap by providing a unified graphical representation to represent a BP in a logically consistent manner for the mainstream modelling standards in the fields of business and IT. A case study will be conducted to analyse a catalogue of existing ‘patient pathways’ i.e. processes, of King’s College Hospital NHS Trust including current performance statistics. Following the application of the framework, a mapping will be conducted, and new performance statistics will be collected. A cost/benefits analysis report will be produced comparing the results of the two approaches.

Performance of microstrip antennas in the presence of EBG in an indoor localization system

Indoor localization systems in nowadays is a huge area of interest not only at academic but also at industry and commercial level. The correct location in these systems is strongly influenced by antennas performance which can provide several gains, bandwidths, polarizations and radiation patterns, due to large variety of antennas types and formats. This paper presents the design, manufacture and measurement of a compact microstrip antenna, for a 2.4 GHZ frequency band, enhanced with the use of Electromagnetic Band-Gap (EBG) structures, which improve the electromagnetic behavior of the conventional antennas. The microstrip antenna with an EBG structure integrated allows an improvement of the location system performance in about 25% to 30% relatively to a conventional microstrip antenna.