Regional governance: strategies and disputes in health region management

OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes.METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics.RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee’s permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table). The study determined that “facilitators” under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical) services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System.CONCLUSIONS The characteristics identified a regionalized system with a conflictive pattern of governance and intermediate institutionalism. The regional interagency committee’s managerial routine needs to incorporate more democratic devices for connecting with educational institutions, devices that are more permeable to social demands relating to regional policy making.

Lean management: aplicação a uma pequena empresa de construção civil

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Civil Especialização em Edificações

Contract-program evaluation: Impact of the DRG classification system on hospitals' outputs

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Psychological contract in non-governmental organizations

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Life cycle analysis of zero waste management for Jonggol green city

A Zero waste management is believed to be one of methods to gain sustainability in urban areas. Take advantages of resources as enough as the needs and process it until the last part to be wasted is a contribution to take care the environment for the next generation. Reduce, reuse, and recycle are three simplesactivities which are until nowadays consideredas the back bone of zero waste. Jonggolgreen city is a new urban area in Indonesia with a 100 ha of surface area zoned as education tourism area. It is an independent area with pure natural resources of water, air, and land to be managed and protected. It is planned as green city through zero waste management since2013. In this preliminary period, a monitoring tool is being prepared by applying a Life Cycle Analysis (LCA) for urban areas [1]. This paper will present an explanatory assessment ofthe zero waste management for Jonggolgreen city. The existing situation will be examined through LCA and afterwards,the new program and the proposed green design to gain the next level of zero waste will be discussed. The purpose is to track the persistence of the commitment and the perception of the necessary innovationsin order to achieve the ideal behavior level of LCA.

Toward integrated management of cerebral aneurysms

In the last few years, some of the visionary concepts behind the virtual physiological human began to be demonstrated on various clinical domains, showing great promise for improving healthcare management. In the current work, we provide an overview of image- and biomechanics-based techniques that, when put together, provide a patient-specific pipeline for the management of intracranial aneurysms. The derivation and subsequent integration of morphological, morphodynamic, haemodynamic and structural analyses allow us to extract patient-specific models and information from which diagnostic and prognostic descriptors can be obtained. Linking such new indices with relevant clinical events should bring new insights into the processes behind aneurysm genesis, growth and rupture. The development of techniques for modelling endovascular devices such as stents and coils allows the evaluation of alternative treatment scenarios before the intervention takes place and could also contribute to the understanding and improved design of more effective devices. A key element to facilitate the clinical take-up of all these developments is their comprehensive validation. Although a number of previously published results have shown the accuracy and robustness of individual components, further efforts should be directed to demonstrate the diagnostic and prognostic efficacy of these advanced tools through large-scale clinical trials.

@neurIST infrastructure for advanced disease management through integration of heterogeneous data, computing, and complex processing services

The increasing volume of data describing humandisease processes and the growing complexity of understanding, managing, and sharing such data presents a huge challenge for clinicians and medical researchers. This paper presents the@neurIST system, which provides an infrastructure for biomedical research while aiding clinical care, by bringing together heterogeneous data and complex processing and computing services. Although @neurIST targets the investigation and treatment of cerebral aneurysms, the system’s architecture is generic enough that it could be adapted to the treatment of other diseases.Innovations in @neurIST include confining the patient data pertaining to aneurysms inside a single environment that offers cliniciansthe tools to analyze and interpret patient data and make use of knowledge-based guidance in planning their treatment. Medicalresearchers gain access to a critical mass of aneurysm related data due to the system’s ability to federate distributed informationsources. A semantically mediated grid infrastructure ensures that both clinicians and researchers are able to seamlessly access andwork on data that is distributed across multiple sites in a secure way in addition to providing computing resources on demand forperforming computationally intensive simulations for treatment planning and research.

Reporting for account and sales management

Tutkimuksen tavoitteena oli kerätä Elcoteq Network Oyj:n myyntihenkilöiden tietotarpeet ja konkretisoida ne raportoinnin kautta. Tutkimus keskittyi asiakasvirran eri vaiheissa tarvittavaan asiakas- ja projektikohtaiseen tietoon. Tarkoituksena oli parantaa raportointia vastaamaan asiakkaan ja sales case:n hallintaa alkaen asiakasvirran uusasiakasvaiheesta ja projektin arvioinnista. Tietotarpeet kerättiin haastattelujen avulla ja osallistumalla aiheeseen liittyviin projekteihin. Haastattelujen ja teorian avulla projektiliiketoiminnan avainpiirteet ja asiakaskannattavuuteen vaikuttavat tekijät kerättiin yhteen ja muutettiin konkretiaksi raportoinnin parannusehdotuksien kautta. Tutkimus osoitti, että myyntihenkilöiden näkökulmasta olisi muodostettava uudet raportit tukemaan asiakkaan ja projektin hallintaa. Ennustettu voidaan verrata toteutuneeseen ja sekä asikkuuden, että sales case:n seuranta paranee uusien raporttien avulla. Budjetit, sekä asiakaskohtaiset tavoitteet voidaan laatia luotettavimmin ja kokonaiskuva asiakkuuden ja projektin kannattavuudesta pystytään näkemään ko. raporteista sekä graafein, että numeerisena tietona.

Requirement management in nuclear power projects

Diplomityön tarkoituksena oli tutkia vaatimusten hallintaa suunnittelu- ja konsultointiyrityksen kannalta Suomen ydinvoimaprojekteissa keskittyen ydinturvallisuus- ja laatuvaatimuksiin. Ydinvoimaprojekteissa toimiminen on edellyttänyt menettelyohjeiden ja laatujärjestelmän uudelleen organisointia yrityksessä ja esiin on noussut haasteita liittyen muun muassa vaatimusten tunnistamiseen ja todentamiseen erityyppisissä ja erilaajuisissa projekteissa. Työ toteutettiin perehtymällä ydinvoimaan liittyvään lainsäädäntöön Suomessa, ohjeisiin ja standardeihin sekä haastattelemalla yrityksen omia asiantuntijoita. Viimeaikaisista sekä meneillään olevista projekteista kerättiin kokemuksia sekä arvioitiin ydinvoima projekteja varten laaditun projektin toteutusohjeen toimivuutta ja käytettävyyttä esimerkkiprojektin avulla. Suurimmiksi haasteiksi tunnistettiin lainsäädännöllisten vaatimusten, kuten ydinvoima- laitosohjeiden (YVL) muuttuminen ja tulkinnanvaraisuus sekä asiakkaiden perehtymät- tömyys Suomen lainsäädäntöön ja vaatimustasoon liittyen ydinturvallisuuteen. Työn tuloksena tunnistettiin hyviä vaatimusten hallintaan liittyviä projektinhallintaa ja ydin- turvallisuutta edistäviä asioita, kuten vaatimusten täsmentäminen jo sopimustasolla sekä niiden täyttymisen seuranta projektin aikana. Erillisen vaatimustietokannan luomista ydinvoimaprojekteja varten tutkittiin, mutta siitä luovuttiin teknisten vaatimusten osalta kannattamattomana, sillä standardien ja vaatimusten määrä kasvoi niin suureksi, että niiden hallitseminen vaatisi enemmän työtä kuin mitä projektien taso yleensä sallisi.

Service Productization and Product Servitization in The Contract Manufacturing Company

The role of contract manufacturing and subcontracting has been seen in black and white in product and service point of view. It used to be seen either as a product or a service. In the thesis product-service system, offering combining products and services, was discussed. Theory was created from two perspectives; Service productization via Business Model generation and product servitization via New Service Development process. Target for the case study was to point out new ways of service thinking and ways for changing business environment in contract manufacturing, especially in customer satisfaction and profitability point of view. The case study is following the New Service Development process phases. First ideas were collected from literature and via sales management interviews. Service offering and tool for service requirement evaluation was created. Last financial results of example service scenarios were calculated. It is recommended to take service offering into internal use and further develop it into modular service model. It is also recommended to take created customer service requirement evaluation tool into use for capturing customer service needs but also for communicating those internally.

Droit du transport intermodal international de marchandises : une perspective « supply chain management ».

La thèse propose d’introduire une perspective globale dans le traitement juridique du transport intermodal international qui prendrait racine dans la stratégie logistique des entreprises. La conception juridique se heurte, en effet, aux évolutions opérationnelles et organisationnelles des transports et aboutit à une incertitude juridique. Les transporteurs ont dû s’adapter aux exigences d’optimisation des flux des chargeurs dont les modes de production et de distribution reposent sur le supply chain management (SCM). Ce concept est le fruit de la mondialisation et des technologies de l’information. La concurrence induite par la mondialisation et le pilotage optimal des flux ont impulsé de nouvelles stratégies de la part des entreprises qui tentent d’avoir un avantage concurrentiel sur le marché. Ces stratégies reposent sur l’intégration interfonctionnelle et interoganisationnelle. Dans cette chaîne logistique globale (ou SCM) l’intermodal est crucial. Il lie et coordonne les réseaux de production et de distribution spatialement désagrégés des entreprises et, répond aux exigences de maîtrise de l’espace et du temps, à moindre coût. Ainsi, le transporteur doit d’une part, intégrer les opérations de transport en optimisant les déplacements et, d’autre part, s’intégrer à la chaîne logistique du client en proposant des services de valeur ajoutée pour renforcer la compétitivité de la chaîne de valeur. Il en découle une unité technique et économique de la chaîne intermodale qui est pourtant, juridiquement fragmentée. Les Conventions internationales en vigueur ont été élaborées pour chaque mode de transport en faisant fi de l’interaction entre les modes et entre les opérateurs. L’intermodal est considéré comme une juxtaposition des modes et des régimes juridiques. Ce dépeçage juridique contraste avec la gestion de la chaîne intermodale dont les composantes individuelles s’effacent au profit de l’objectif global à atteindre. L’on expose d’abord l’ampleur de l’incertitude juridique due aux difficultés de circonscrire le champ d’opérations couvert par les Conventions en vigueur. Une attention est portée aux divergences d’interprétations qui débouchent sur la « désunification » du droit du transport. On s’intéresse ensuite aux interactions entre le transport et la chaîne logistique des chargeurs. Pour cela, on retrace l’évolution des modes de production et de distribution de ces derniers. C’est effectivement de la stratégie logistique que découle la conception de la chaîne intermodale. Partant de ce système, on identifie les caractéristiques fondamentales de l’intermodal. La thèse aboutit à dissiper les confusions liées à la qualification de l’intermodal et qui sont à la base des divergences d’interprétations et de l’incertitude juridique. De plus, elle met en exergue l’unité économique du contrat de transport intermodal qui devrait guider la fixation d’un régime de responsabilité dédié à ce système intégré de transport. Enfin, elle initie une approche ignorée des débats juridiques.

Transaction costs of farmers’ participation in forest management: Policy implications of payments for environmental services schemes in Vietnam

Recent research on payments for environmental services (PES) has observed that high transaction costs (TCs) are incurred through the implementation of PES schemes and farmer participation. TCs incurred by households are considered to be an obstacle to the participation in and efficiency of PES policies. This study aims to understand transactions related to previous forest plantation programmes and to estimate the actual TCs incurred by farmers who participated in these programmes in a mountainous area of northwestern Vietnam. In addition, this study examines determinants of households’ TCs to test the hypothesis of whether the amount of TCs varies according to household characteristics. Results show that average TCs are not likely to be a constraint for participation since they are about 200,000 VND (USD 10) per household per contract, which is equivalent to one person’s average earnings for about two days of labour. However, TCs amount to more than one-third of the programmes’ benefits, which is relatively high compared to PES programmes in developed countries. This implies that rather than aiming to reduce TCs, an appropriate agenda for policy improvement is to balance the level of TCs with PES programme benefits to enhance the overall attractiveness of afforestation programmes for smallholder farmers. Regression analysis reveals that education, gender and perception towards PES programmes have significant effects on the magnitude of TCs. The analyses also points out the importance of local conditions on the level of TCs, with some unexpected results.

Construction management contracts: law and practice

The context of construction management (CM) reveals that this method of procurement is as much a management philosophy as a contract structure. It is important to consider legal and contractual issues in this context. The interplay between management and law is complex and often misunderstood. Before considering specific issues, the use of contractual remedies in business agreements is discussed. In addition, the extent to which standardising a form of contract detracts or contributes to the success of projects is also considered. The dearth of judicial decisions, and the lack of a standard form, render it difficult to be specific about legal issues. Therefore, the main discussion of legal issues is centred around a recently completed research project which involved eliciting the views of a cross-section of experienced construction management clients, consultants and trade contractors. These interviews are used as the basis for highlighting some of the most important legal points to consider when setting up CM projects. The interviews revealed that the advantage of CM is the proximity of the client to the trade contractors and the disadvantage is that it depends on a high degree of professionalism and experience; qualities which are unfortunately difficult to find in the UK construction industry.

The impact of contract duration on the cost of cash retention

Cash retention is a common means of protecting an employer from a contractor's insolvency as well as ensuring that contractors finish the work that they start. Similarly, contractors withhold part of payments due to their sub-contractors. Larger contracts tend to be subjected to smaller rates of retention. By calculating the cost of retention as an amount per year of a contract, it is shown that retention is far more expensive for firms whose work consists of short contracts. The extra cost is multiplied when the final payment is delayed, as it often is for those whose work takes place at the beginning of a project. This may explain why it is that main contractors are a lot less interested than sub-contractors in alternatives to cash retention, such as retention bonds

Construction contracts: law and management (3rd edition)

This book is aimed primarily at students for whom the study of building or civil engineering contracts forms part of a construction-based course. We have had in mind the syllabus requirements for first degrees in Building, Civil Engineering, Architecture, Quantity Surveying and Building Surveying, as well as those of postgraduate courses in Construction Management and Project Management. We have also assumed that such students will already have been introduced to the general principles of English law, especially those relating to contract and tort. As a result, while aspects of those subjects that are of particular relevance to construction are dealt with here, the reader must look elsewhere for the general legal background. In producing this third edition, we have again been greatly assisted by the many helpful comments made by reviewers and users of its predecessor. Nonetheless, our basic aim is identical to that which underpinned the first edition: to provide an explanation of the fundamental principles of construction contract law, rather than a clause-by-clause analysis of any particular standard-form contract. As a result, while we draw most frequently upon JCT 98 for our illustrations of particular points, this merely reflects the pre-eminent position occupied by that particular form of contract in the UK construction industry. We conclude by repeating our previous warning as to the dangers inherent in a little learning. Neither this book, nor the courses for which it is intended, seek to produce construction lawyers. The objective is rather to enable those who are not lawyers to resolve simple construction disputes before they become litigious, and to recognize when matters require professional legal advice. It should be the aim of every construction student to understand the legal framework sufficiently that they can instruct and brief specialist lawyers, and this book is designed to help them towards that understanding.