Improving a regional chemotherapy service by learning from deaths occurring within 30 days of treatment with systemic anti-cancer therapy.

Background: Outwith clinical trials, patient outcomes specifically related to SACT (systemic anti-cancer therapy) are not well reported despite a significant proportion of patients receiving active treatment at the end of life. The NCEPOD reviewing deaths within 30 days of SACT found SACT caused or hastened death in 27% of cases.

Method: Across the Northern Ireland cancer network, 95 patients who died within 30 days of SACT for solid tumours were discussed at the Morbidity and Mortality monthly meeting during 2013. Using a structured template, each case was independently reviewed, with particular focus on whether SACT caused or hastened death.

Results: Lung, GI and breast cancers were the most common sites. Performance status was recorded in 92% at time of final SACT cycle (ECOG PS 0-2 89%).

In 57% the cause of death was progressive disease. Other causes included thromboembolism (13%) and infection (5% neutropenic sepsis, 6% non-neutropenic sepsis). In 26% with death from progressive disease, the patient was first cycle of first line treatment for metastatic disease. In the majority discussion regarding treatment aims and risks was documented. Only one patient was receiving SACT with curative intent, who died from appropriately managed neutropenic sepsis.

A definitive decision regarding SACT's role in death was made in 60%: in 49% SACT was deemed non-contributory and in 11% SACT was deemed the cause of death. In 40% SACT did not play a major role, but a definitive negative association could not be made.

Conclusion: Development of a robust review process of 30-day mortality after SACT established a benchmark for SACT delivery for future comparisons and identified areas for SACT service organisation improvement. Moreover it encourages individual practice reflection and highlights the importance of balancing patients' needs and concerns with realistic outcomes and risks, particularly in heavily pre-treated patients or those of poor performance status.

Reconciliation's Contributions to Quality Peace

In this chapter we ask what unique contributions reconciliation can make toward building quality peace. We begin by briefly reviewing some of the diverse approaches to understanding the term reconciliation, and settle on a formulation consistent with the emerging perspective of a quality of peace. We then identify three levels – international, state-citizen, intergroup – at which reconciliation can impact peace. We explore how reconciliation may function at each level and how specific factors may advance a more robust and lasting peace process. We synthesize this analysis by identifying key aspects of reconciliation that advance our understanding of a quality of peace: inclusive participation, balancing symbolic and material actions, integrating psychosocial processes, and emphasizing generational approaches. The chapter concludes with suggestions of possible indicators and future research that may support the links between reconciliation and peace processes.

Resource Efficient Configuration of an Aircraft Assembly Line

The design of efficient assembly systems can significantly contribute to the profitability of products and the competitiveness of manufacturing industries. The configuration of a an efficient assembly line can be supported by suitable methodologies and techniques, such as design for manufacture and assembly, assembly sequence planning, assembly line balancing, lean manufacturing and optimization techniques. In this paper, these methods are applied with reference to the industrial case study of the assembly line of a Skycar light aircraft. The assembly process sequence is identified taking into account the analysis of the assembly structure and the required precedence constraints, and diverse techniques are applied to optimize the assembly line performance. Different line configurations are verified through discrete event simulation to assess the potential increase of efficiency and throughput in a digital environment and propose the most suitable configuration of the assembly line.

Managing the Entanglement: Complexity Leadership in Public Sector Systems

Abstract
Complexity and environmental uncertainty in public sector systems requires leaders to balance the administrative practices necessary to be aligned and efficient in the management of routine challenges, and the adaptive practices required to respond to complex and dynamic circumstances. Conventional notions of leadership in the field of public administration do not fully explain the role of leadership in enabling and balancing the entanglement of formal, top-down, administrative functions and informal, emergent, adaptive functions within public sector settings with different levels of complexity. Drawing on and extending existing complexity leadership constructs, this paper explores how change was enabled over the duration of three urban regeneration projects, each representing high, medium and low levels of project complexity. The data reveals six distinct yet interconnected functions of enabling leadership that were identified within the three urban regeneration projects. The paper contributes to our understanding of how leadership is enacted and poses questions for those engaged in leading in complex public sector settings.

Network virtualisation from an operator perspective

Network virtualisation is seen as a promising approach to overcome the so-called “Internet impasse” and bring innovation back into the Internet, by allowing easier migration towards novel networking approaches as well as the coexistence of complementary network architectures on a shared infrastructure in a commercial context. Recently, the interest from the operators and mainstream industry in network virtualisation has grown quite significantly, as the potential benefits of virtualisation became clearer, both from an economical and an operational point of view. In the beginning, the concept has been mainly a research topic and has been materialized in small-scale testbeds and research network environments. This PhD Thesis aims to provide the network operator with a set of mechanisms and algorithms capable of managing and controlling virtual networks. To this end, we propose a framework that aims to allocate, monitor and control virtual resources in a centralized and efficient manner. In order to analyse the performance of the framework, we performed the implementation and evaluation on a small-scale testbed. To enable the operator to make an efficient allocation, in real-time, and on-demand, of virtual networks onto the substrate network, it is proposed a heuristic algorithm to perform the virtual network mapping. For the network operator to obtain the highest profit of the physical network, it is also proposed a mathematical formulation that aims to maximize the number of allocated virtual networks onto the physical network. Since the power consumption of the physical network is very significant in the operating costs, it is important to make the allocation of virtual networks in fewer physical resources and onto physical resources already active. To address this challenge, we propose a mathematical formulation that aims to minimize the energy consumption of the physical network without affecting the efficiency of the allocation of virtual networks. To minimize fragmentation of the physical network while increasing the revenue of the operator, it is extended the initial formulation to contemplate the re-optimization of previously mapped virtual networks, so that the operator has a better use of its physical infrastructure. It is also necessary to address the migration of virtual networks, either for reasons of load balancing or for reasons of imminent failure of physical resources, without affecting the proper functioning of the virtual network. To this end, we propose a method based on cloning techniques to perform the migration of virtual networks across the physical infrastructure, transparently, and without affecting the virtual network. In order to assess the resilience of virtual networks to physical network failures, while obtaining the optimal solution for the migration of virtual networks in case of imminent failure of physical resources, the mathematical formulation is extended to minimize the number of nodes migrated and the relocation of virtual links. In comparison with our optimization proposals, we found out that existing heuristics for mapping virtual networks have a poor performance. We also found that it is possible to minimize the energy consumption without penalizing the efficient allocation. By applying the re-optimization on the virtual networks, it has been shown that it is possible to obtain more free resources as well as having the physical resources better balanced. Finally, it was shown that virtual networks are quite resilient to failures on the physical network.

Participação ativa no desenvolvimento de comunidades online

Esta tese tem como objetivos identificar e caraterizar os modos de Comunicação Mediada por Computador (CMC) utilizados nas Comunidades Online (CO), relevantes para a prática de criação visual, contextualizando-os na produção de Type Design (TD). E concetualizar um modelo de CO de prática, desenvolvida segundo uma metodologia participativa, avaliando as estratégias de dinamização e viabilização no contexto nacional. Atualmente, com a disseminação das tecnologias de informação e comunicação a prática de TD, uma atividade isolada e individual, está sujeita a um paradigma de mudança—tornar-se uma atividade de partilha cada vez maior. A investigação dividiu-se em três fases. Na primeira fase procura perceber os modos relevantes de CMC para a prática de TD. Para isso, observa-se as motivações e comportamentos dos utilizadores nestas plataformas, apoiado pela recolha de dados sobre o uso destas plataformas no contexto académico. Juntamente com o desenvolvimento e avaliação de uma experiência preliminar numa plataforma online existente. Na segunda fase, apresenta-se o modelo concetual de uma CO para a produção de TD apoiado na identificação e caraterização das Virtual Community of Practice de TD existentes. E o respetivo desenvolvimento e implementação de um protótipo funcional. Na terceira fase o protótipo foi avaliado recorrendo à participação dos utilizadores—uma amostra de Type Designers profissionais portugueses—no desenvolvimento das estratégias comunitárias segundo uma abordagem participativa de Community-Centered Development. A utilização de um Focus Group de dimensões reduzidas, e as limitações temporais da investigação prática não permitem generalizar os resultados encontrados. No entanto, os resultados revelam que quanto mais específica for a atividade da prática partilhada na CO, mais especializados e restritos devem ser os modos de CMC implementados para a comunicação e interação dos membros online. A integração dos modos de CMC sobre a comunicação assíncrona através de artefactos visuais tem um potencial de comunicação mais eficaz e satisfatório para estes utilizadores. E as barreiras à participação, apesar de poderem ser minimizadas através da inovação nos modos implementados, são um desafio de sociabilização que devem ser geridos, equilibrando a comunicação explícita, os usos, perceções e expectativas dos diferentes papéis dos membros da comunidade.

Reliable and energy efficient routing for ad hoc networks

In Mobile Ad hoc NETworks (MANETs), where cooperative behaviour is mandatory, there is a high probability for some nodes to become overloaded with packet forwarding operations in order to support neighbor data exchange. This altruistic behaviour leads to an unbalanced load in the network in terms of traffic and energy consumption. In such scenarios, mobile nodes can benefit from the use of energy efficient and traffic fitting routing protocol that better suits the limited battery capacity and throughput limitation of the network. This PhD work focuses on proposing energy efficient and load balanced routing protocols for ad hoc networks. Where most of the existing routing protocols simply consider the path length metric when choosing the best route between a source and a destination node, in our proposed mechanism, nodes are able to find several routes for each pair of source and destination nodes and select the best route according to energy and traffic parameters, effectively extending the lifespan of the network. Our results show that by applying this novel mechanism, current flat ad hoc routing protocols can achieve higher energy efficiency and load balancing. Also, due to the broadcast nature of the wireless channels in ad hoc networks, other technique such as Network Coding (NC) looks promising for energy efficiency. NC can reduce the number of transmissions, number of re-transmissions, and increase the data transfer rate that directly translates to energy efficiency. However, due to the need to access foreign nodes for coding and forwarding packets, NC needs a mitigation technique against unauthorized accesses and packet corruption. Therefore, we proposed different mechanisms for handling these security attacks by, in particular by serially concatenating codes to support reliability in ad hoc network. As a solution to this problem, we explored a new security framework that proposes an additional degree of protection against eavesdropping attackers based on using concatenated encoding. Therefore, malicious intermediate nodes will find it computationally intractable to decode the transitive packets. We also adopted another code that uses Luby Transform (LT) as a pre-coding code for NC. Primarily being designed for security applications, this code enables the sink nodes to recover corrupted packets even in the presence of byzantine attacks.

Protecting children from sex offenders online: when strangers become 'virtual friends'

This article describes findings from research funded by the Metropolitan Police and Crimestoppers which aimed to explore children's online experiences. A non-random, stratified sample of 200 London school children aged 10- 13 participated in focus groups. Preliminary findings are also presented from unpublished ongoing PhD research, which seeks to explore sex offender behaviour online and the policing of the internet (Martellozzo, 2005 ongoing). The findings are discussed in the context of sex offender's use of the internet. This research indicates that children do have some basic knowledge about 'stranger danger' but are not necessarily applying these lessons to cyberspace. The children in this study had sufficient awareness to not give personal details to strangers on the internet, and would not arrange to meet them. However, they made a distinction between 'strangers' and 'virtual friends' and this is an important point. Preliminary findings also highlight the difficulty of policing the internet and serve to illustrate the manner in which the Sexual Offences Act 2003 is applied to internet sexual offending in practice.

MASCEM: electricity markets simulation with strategic agents

Electricity markets are complex environments, involving numerous entities trying to obtain the best advantages and profits while limited by power-network characteristics and constraints.1 The restructuring and consequent deregulation of electricity markets introduced a new economic dimension to the power industry. Some observers have criticized the restructuring process, however, because it has failed to improve market efficiency and has complicated the assurance of reliability and fairness of operations. To study and understand this type of market, we developed the Multiagent Simulator of Competitive Electricity Markets (MASCEM) platform based on multiagent simulation. The MASCEM multiagent model includes players with strategies for bid definition, acting in forward, day-ahead, and balancing markets and considering both simple and complex bids. Our goal with MASCEM was to simulate as many market models and player types as possible. This approach makes MASCEM both a short- and mediumterm simulation as well as a tool to support long-term decisions, such as those taken by regulators. This article proposes a new methodology integrated in MASCEM for bid definition in electricity markets. This methodology uses reinforcement learning algorithms to let players perceive changes in the environment, thus helping them react to the dynamic environment and adapt their bids accordingly.

Optimal methodology for distribution systems reconfiguration based on OPF and solved by decomposition technique

This paper presents a new and efficient methodology for distribution network reconfiguration integrated with optimal power flow (OPF) based on a Benders decomposition approach. The objective minimizes power losses, balancing load among feeders and subject to constraints: capacity limit of branches, minimum and maximum power limits of substations or distributed generators, minimum deviation of bus voltages and radial optimal operation of networks. The Generalized Benders decomposition algorithm is applied to solve the problem. The formulation can be embedded under two stages; the first one is the Master problem and is formulated as a mixed integer non-linear programming problem. This stage determines the radial topology of the distribution network. The second stage is the Slave problem and is formulated as a non-linear programming problem. This stage is used to determine the feasibility of the Master problem solution by means of an OPF and provides information to formulate the linear Benders cuts that connect both problems. The model is programmed in GAMS. The effectiveness of the proposal is demonstrated through two examples extracted from the literature.

Simulação, em software adequado, da sintomatologia vibracional de avarias mecânicas de máquinas rotativas

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica na Área de Manutenção e Produção

Modelo de data mining para detecção de tumores em exames de rastreio

Dissertação para obtenção do grau de Mestre em Engenharia Informática

Avaliação do efeito de um probiótico na performance zootécnica e microbiota entérica em coelhos (Oryctolagus cuniculus) de produção

A cunicultura é uma atividade pecuária em crescente desenvolvimento e isso traduz-se em novos desafios. Durante muitos anos a criação de coelhos recorreu em demasia ao uso de antimicrobianos com o objetivo de tratar e prevenir o aparecimento de diversas doenças. Paralelamente, estes compostos foram também usados como “promotores de crescimento”, visando essencialmente uma melhoria da eficiência digestiva. Porém, o uso indiscriminado destas substâncias levantou questões de saúde pública, como a emergência de estirpes bacterianas multirresistentes e a inerente disseminação de genes de resistência, possivelmente transferíveis ao Homem através da cadeia alimentar. No presente, existe uma enorme pressão para a adoção de estratégias que possibilitem uma redução massiva na quantidade de antimicrobianos administrados a espécies pecuárias. Este trabalho visou contribuir para o estudo de uma alternativa ao uso de antimicrobianos - os probióticos – enquanto suplementos alimentares constituídos por microrganismos vivos capazes de equilibrar a microbiota intestinal do hospedeiro. Para tal, foram constituídos dois grupos de coelhos com base na alimentação: i) grupo antibiótico, com acesso a um alimento composto suplementado com antibióticos e ii) o grupo probiótico alimentado com a mesma dieta, mas sem antibióticos e inoculado com um probiótico constituído por Escherichia coli e Enterococcus spp.. Ao longo de 22 dias de estudo foram monitorizados alguns indicadores produtivos e efetuadas recolhas periódicas de fezes para estudo microbiológico. A análise dos resultados zootécnicos permitiram verificar que o uso de probióticos em detrimento de antibióticos parece promover o crescimento de coelhos, tornando-se um método mais rentável na produção cunícula. Através de genotipagem por ERIC-PCR e PFGE, pretendeu-se verificar se as estirpes estranhas ao trato gastrointestinal dos coelhos seriam capazes de coloniza-lo, permanecendo ao longo do tempo de estudo. O facto de as estirpes inoculadas no probiótico terem sido encontradas ao longo dos dias de estudo nos coelhos aos quais foram administradas, sugere que os efeitos observados na performance zootécnica estejam relacionados com as estirpes administradas no probiótico, pelo que este poderá ser um sistema viável na substituição de antibióticos na alimentação de coelhos de produção.

Estágio na empresa SPECMAN para a prática de técnicas de controlo da condição

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica

Ventilação mista em edifícios de habitação

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