Cost accountancy and cost control in hospitals

It is a fact that there now exists a sound framework of accounting theory to ascertain the working results and the investment status of hospitals. Yet, there is no system of accounting in practice to conduct its activities with utmost efficiency. No attempts have hitherto been made for the continuous improvement in the servics rendered by hospitals. Personal investments in hospitals have made the interaction of business to some extent.Planning, decision making and control assume increasing importance as hospitals grow in size and complexity. Moreover, wise and effective utilisation of resources should be ensured. The importance of cost cannot be overlooked in this context. Cost is the most effective factor in the determination of the prices of hospital services rendered. The important managerial functions have to rely heavily on accurate and timely cost information. More people can be provided with services if no services cost more than what is a must to provide the necessary level of care. The price paid for high cost technology for a few is no technology at all for the many. Hence no pains must be spared in ascertaining, presenting, controlling and reducing costs. An effective system of Cost Accountancy and Cost Control is imperative for the survival of hospitals in the intensely competitive conditions of today. The valuable objective of "better patient care" can be attained only if the management can make use of the various tools and techniques to ascertain, control and reduce each item of cost in hospitals. Constant efforts must be made by the management to continuously improve their services and bring down costs and prices of all hospital services. Cost Accountancy has made its impresssive impact on almost all the spheres of human activities. It is high time a comprehensive Cost Accountancy and Cost Control system be implemented in hospitals. The problem under study thus is the designing of a sound and full-fledged Cost Accountancy and Cost Control system that suits the requirements of hospitals. It is for the first time in India during the evolution of Cost Accountancy that a comprehensive cost system is tried in hospitals.

Polyphase Implementation of Non-recursive Comb Decimators for Sigma-Delta A/D Converters

In a sigma-delta analog to digital (A/D) As most of the sigma-delta ADC applications require converter, the most computationally intensive block is decimation filters with linear phase characteristics, the decimation filter and its hardware implementation symmetric Finite Impulse Response (FIR) filters are may require millions of transistors. Since these widely used for implementation. But the number of FIR converters are now targeted for a portable application, filter coefficients will be quite large for implementing a a hardware efficient design is an implicit requirement. narrow band decimation filter. Implementing decimation In this effect, this paper presents a computationally filter in several stages reduces the total number of filter efficient polyphase implementation of non-recursive coefficients, and hence reduces the hardware complexity cascaded integrator comb (CIC) decimators for and power consumption [2]. Sigma-Delta Converters (SDCs). The SDCs are The first stage of decimation filter can be operating at high oversampling frequencies and hence implemented very efficiently using a cascade of integrators require large sampling rate conversions. The filtering and comb filters which do not require multiplication or and rate reduction are performed in several stages to coefficient storage. The remaining filtering is performed reduce hardware complexity and power dissipation. either in single stage or in two stages with more complex The CIC filters are widely adopted as the first stage of FIR or infinite impulse response (IIR) filters according to decimation due to its multiplier free structure. In this the requirements. The amount of passband aliasing or research, the performance of polyphase structure is imaging error can be brought within prescribed bounds by compared with the CICs using recursive and increasing the number of stages in the CIC filter. The non-recursive algorithms in terms of power, speed and width of the passband and the frequency characteristics area. This polyphase implementation offers high speed outside the passband are severely limited. So, CIC filters operation and low power consumption. The polyphase are used to make the transition between high and low implementation of 4th order CIC filter with a sampling rates. Conventional filters operating at low decimation factor of '64' and input word length of sampling rate are used to attain the required transition '4-bits' offers about 70% and 37% of power saving bandwidth and stopband attenuation. compared to the corresponding recursive and Several papers are available in literature that deals non-recursive implementations respectively. The same with different implementations of decimation filter polyphase CIC filter can operate about 7 times faster architecture for sigma-delta ADCs. Hogenauer has than the recursive and about 3.7 times faster than the described the design procedures for decimation and non-recursive CIC filters.

Hybrid Background Subtraction in Video using Bi-level CodeBook Model

Detection of Objects in Video is a highly demanding area of research. The Background Subtraction Algorithms can yield better results in Foreground Object Detection. This work presents a Hybrid CodeBook based Background Subtraction to extract the foreground ROI from the background. Codebooks are used to store compressed information by demanding lesser memory usage and high speedy processing. This Hybrid method which uses Block-Based and Pixel-Based Codebooks provide efficient detection results; the high speed processing capability of block based background subtraction as well as high Precision Rate of pixel based background subtraction are exploited to yield an efficient Background Subtraction System. The Block stage produces a coarse foreground area, which is then refined by the Pixel stage. The system’s performance is evaluated with different block sizes and with different block descriptors like 2D-DCT, FFT etc. The Experimental analysis based on statistical measurements yields precision, recall, similarity and F measure of the hybrid system as 88.74%, 91.09%, 81.66% and 89.90% respectively, and thus proves the efficiency of the novel system.

Fliesslochformen und Gewindefurchen in dünne Bleche und Rohre aus Kupfer und Kupferlegierungen

This thesis in Thermal Flow Drilling and Flowtap in thin metal sheet and pipes of copper and copper alloys had as objectives to know the comportment of copper and copper alloys sheet metal during the Thermal Flow Drill processes with normal tools, to know the best Speed and Feed machine data for the best bushing quality, to known the best Speed for Form Tapping processes and to know the best bush long in pure copper pipes for water solar interchange equipment. Thermal Flow Drilling (TFD) and Form Tapping (FT) is one of the research lines of the Institute of Production and Logistics (IPL) at University of Kassel. At December 1995, a work meeting of IPL, Santa Catarina University, Brazil, Buenos Aires University, Argentine, Tarapacá University (UTA), Chile members and the CEO of Flowdrill B.V. was held in Brazil. The group decided that the Manufacturing Laboratory (ML) of UTA would work with pure copper and brass alloys sheet metal and pure copper pipes in order to develop a water interchange solar heater. The Flowdrill BV Company sent tools to Tarapacá University in 1996. In 1999 IPL and the ML carried out an ALECHILE research project promoted by the DAAD and CONICyT in copper sheet metal and copper pipes and sheet metal a-brass alloys. The normal tools are lobed, conical tungsten carbide tool. When rotated at high speed and pressed with high axial force into sheet metal or thin walled tube generated heat softens the metal and allows the drill to feed forward produce a hole and simultaneously form a bushing from the displacement material. In the market exist many features but in this thesis is used short and longs normal tools of TFD. For reach the objectives it was takes as references four qualities of the frayed end bushing, where the best one is the quality class I. It was used pure copper and a-brass alloys sheet metals, with different thickness. It was used different TFD drills diameter for four thread type, from M-5 to M10. Similar to the Aluminium sheet metals studies it was used the predrilling processes with HSS drills around 30% of the TFD diameter (1,5 – 3,0 mm D). In the next step is used only 2,0 mm thick metal sheet, and 9,2 mm TFD diameter for M-10 thread. For the case of pure commercial copper pipes is used for ¾” inch diameter and 12, 8 mm (3/8”) TFD drill for holes for 3/8” pipes and different normal HSS drills for predrilling processes. The chemical sheet metal characteristics were takes as reference for the material behaviour. The Chilean pure copper have 99,35% of Cu and 0,163% of Zinc and the Chilean a-brass alloys have 75,6% of Cu and 24,0% of Zinc. It is used two German a-brass alloys; Nº1 have 61,6% of Cu, 36,03 % of Zinc and 2,2% of Pb and the German a-brass alloys Nº2 have 63,1% of Cu, 36,7% of Zinc and 0% of Pb. The equipments used were a HAAS CNC milling machine centre, a Kistler dynamometer, PC Pentium II, Acquisition card, TESTPOINT and XAct software, 3D measurement machine, micro hardness, universal test machine, and metallographic microscope. During the test is obtained the feed force and momentum curves that shows the material behaviour with TFD processes. In general it is take three phases. It was possible obtain the best machining data for the different sheet of copper and a-brass alloys thick of Chilean materials and bush quality class I. In the case of a-brass alloys, the chemical components and the TFD processes temperature have big influence. The temperature reach to 400º Celsius during the TFD processes and the a-brass alloys have some percents of Zinc the bush quality is class I. But when the a-brass alloys have some percents of Lead who have 200º C melting point is not possible to obtain a bush, because the Lead gasify and the metallographic net broke. During the TFD processes the recrystallization structures occur around the Copper and a-brass alloy bush, who gives more hardness in these zones. When the threads were produce with Form Tapping processes with Flowtap tools, this hardness amount gives a high limit load of the thread when hey are tested in a special support that was developed for it. For eliminated the predrilling processes with normal HSS drills it was developed a compound tool. With this new tool it was possible obtain the best machining data for quality class I bush. For the copper pipes it is made bush without predrilling and the quality class IV was obtained. When it is was used predrilling processes, quality classes I bush were obtained. Then with different HSS drill diameter were obtained different long bush, where were soldering with four types soldering materials between pipes with 3/8” in a big one as ¾”. Those soldering unions were tested by traction test and all the 3/8” pipes broken, and the soldering zone doesn’t have any problem. Finally were developed different solar water interchange heaters and tested. As conclusions, the present Thesis shows that the Thermal Flow Drilling in thinner metal sheets of cooper and cooper alloys needs a predrilling process for frayed end quality class I bushings, similar to thinner sheets of aluminium bushes. The compound tool developed could obtain quality class I bushings and excludes predrilling processes. The bush recrystalization, product of the friction between the tool and the material, the hardness grows and it is advantageous for the Form Tapping. The methodology developed for commercial copper pipes permits to built water solar interchange heaters.

Concurrent Aggregates (CA): An Object-Oriented Language for Fine-Grained Message-Passing Machines

Fine-grained parallel machines have the potential for very high speed computation. To program massively-concurrent MIMD machines, programmers need tools for managing complexity. These tools should not restrict program concurrency. Concurrent Aggregates (CA) provides multiple-access data abstraction tools, Aggregates, which can be used to implement abstractions with virtually unlimited potential for concurrency. Such tools allow programmers to modularize programs without reducing concurrency. I describe the design, motivation, implementation and evaluation of Concurrent Aggregates. CA has been used to construct a number of application programs. Multi-access data abstractions are found to be useful in constructing highly concurrent programs.

Bubble Behavior in a Taylor Vortex

We present an experimental study on the behavior of bubbles captured in a Taylor vortex. The gap between a rotating inner cylinder and a stationary outer cylinder is filled with a Newtonian mineral oil. Beyond a critical rotation speed (ω[subscript c]), Taylor vortices appear in this system. Small air bubbles are introduced into the gap through a needle connected to a syringe pump. These are then captured in the cores of the vortices (core bubble) and in the outflow regions along the inner cylinder (wall bubble). The flow field is measured with a two-dimensional particle imaging velocimetry (PIV) system. The motion of the bubbles is monitored by using a high speed video camera. It has been found that, if the core bubbles are all of the same size, a bubble ring forms at the center of the vortex such that bubbles are azimuthally uniformly distributed. There is a saturation number (N[subscript s]) of bubbles in the ring, such that the addition of one more bubble leads eventually to a coalescence and a subsequent complicated evolution. Ns increases with increasing rotation speed and decreasing bubble size. For bubbles of non-uniform size, small bubbles and large bubbles in nearly the same orbit can be observed to cross due to their different circulating speeds. The wall bubbles, however, do not become uniformly distributed, but instead form short bubble-chains which might eventually evolve into large bubbles. The motion of droplets and particles in a Taylor vortex was also investigated. As with bubbles, droplets and particles align into a ring structure at low rotation speeds, but the saturation number is much smaller. Moreover, at high rotation speeds, droplets and particles exhibit a characteristic periodic oscillation in the axial, radial and tangential directions due to their inertia. In addition, experiments with non-spherical particles show that they behave rather similarly. This study provides a better understanding of particulate behavior in vortex flow structures.

G+: Enhanced Traffic Grooming in WDM Mesh Networks using Lighttours

In this article, a new technique for grooming low-speed traffic demands into high-speed optical routes is proposed. This enhancement allows a transparent wavelength-routing switch (WRS) to aggregate traffic en route over existing optical routes without incurring expensive optical-electrical-optical (OEO) conversions. This implies that: a) an optical route may be considered as having more than one ingress node (all inline) and, b) traffic demands can partially use optical routes to reach their destination. The proposed optical routes are named "lighttours" since the traffic originating from different sources can be forwarded together in a single optical route, i.e., as taking a "tour" over different sources towards the same destination. The possibility of creating lighttours is the consequence of a novel WRS architecture proposed in this article, named "enhanced grooming" (G+). The ability to groom more traffic in the middle of a lighttour is achieved with the support of a simple optical device named lambda-monitor (previously introduced in the RingO project). In this article, we present the new WRS architecture and its advantages. To compare the advantages of lighttours with respect to classical lightpaths, an integer linear programming (ILP) model is proposed for the well-known multilayer problem: traffic grooming, routing and wavelength assignment The ILP model may be used for several objectives. However, this article focuses on two objectives: maximizing the network throughput, and minimizing the number of optical-electro-optical conversions used. Experiments show that G+ can route all the traffic using only half of the total OEO conversions needed by classical grooming. An heuristic is also proposed, aiming at achieving near optimal results in polynomial time

Tren d’alta velocitat i desenvolupament local urbà. Aportacions a una nova base teòrica

Una de les finalitats principals del tren d’alta velocitat és la d’aportar desenvolupament local en aquelles ciutats i territoris on se’n construeixi una estació. Per aquesta raó, calen reflexions teòriques que ajudin els agents i les institucions a planificar correctament l’arribada de la nova gran infraestructura de transport, especialment en els aspectes relacionats amb la capacitat d’organització dels actors territorials. La teoria reticular pot ser una base teòrica útil per evitar concepcions deterministes de la relació entre infraestructura i territori, per explicar com es produeix el procés de desenvolupament local i per demostrar la importància dels agents territorials en aquest procés

Identificación de factores de riesgo asociados a fatiga en personal de enfermería en una clínica del sector privado de la ciudad de Bogotá, Colombia

La fatiga asociada a la carga de trabajo impuesta en trabajadores del sector salud es un factor directamente relacionado con el nivel de desempeño del trabajador y por lo tanto de la seguridad del paciente. El objetivo del presente estudio es realizar una evaluación multidimensional de la fatiga laboral percibida del personal de enfermería de una Institución Prestadora de Servicios de Salud (IPS) de IV nivel la ciudad de Bogotá. Para la valoración de fatiga se aplicó la versión en español del Inventario Sueco de Fatiga Ocupacional (SOFI-S) acompañado de preguntas abstraídas de la batería de riesgo psicosocial del Ministerio de la Protección Social y un cuestionario demográfico. Se encuestaron 60 enfermeras (3,3% hombres, 96,7% mujeres). Los principales factores asociados a la generación de fatiga son las horas de sueño, el turno y las actividades del hogar. La agrupación factorial genera 4 dimensiones de fatiga y no 5 como comúnmente se agrupa el cuestionario SOFI.

Identificación y descripción de las características de un líder global

El liderazgo ha sido definido de diferentes maneras por cientos de autores debido al contexto en el que estudian este concepto. Ninguna de estas definiciones es errónea pero algunas han tomado mayor importancia debido a los diferentes factores que enfrenta la sociedad. Desde hace unos años los países se han abierto a diferentes mercados lo cual les ha permitido eliminar las barreras políticas, económicas y culturales existentes. Esto ha llevado a que los líderes deban evaluar la nueva forma de dirigir y direccionar las organizaciones. Este es tan solo uno de los ejemplos que han llevado a modificar el concepto de liderazgo, añadiendo los nuevos retos a los que se ven enfrentados los líderes. En este trabajo de grado se estudia el que se considera uno de los mayores retos de los siglos XX y XXI: la globalización. Este fenómeno ha acercado al mundo a través del intercambio de información, de bienes, de servicios, de conocimientos y sobre todo de cultura. Esto se ha logrado a través de nuevas tecnologías, nuevos servicios de comunicación y transporte, de la ciencia y los avances de la industria. El nuevo líder debe romper la barrera nacional y abrirse a mercados extranjeros, para esto debe contar con ciertas características que le permitirán entender los diferentes mercados y a las personas que se encuentran en este. En este trabajo se identifican las que se consideran las principales características de un líder global; estas son el resultado de la investigación de diferentes autores y estudios.

Análisis de la relación entre la accidentalidad y el incremento de trabajo en un proyecto de la construcción en Colombia durante los años 2012 y 2013

La construcción es una de las industrias que mayores accidentes laborales genera, en esta investigación se realizó un análisis retrospectivo para determinar si existe alguna relación entre la ocurrencia de accidentes y la fecha de entrega de una meta, debido al incremento en la cantidad de trabajo expresado por la cantidad de días y horas extras trabajados, se cuenta con información de la accidentalidad de cinco empresas constructoras de un gran proyecto vial en Colombia en los años de 2012 y 2013. Se analizó la información correspondiente a la nómina de las mismas empresas, con el valor de la nómina mensual, el valor de las incapacidades mensuales y la cantidad de trabajadores por cada empresa en cada periodo. El manejo de los datos se hizo con EXCEL y el análisis estadístico con STATA 11.1, se usó la correlación de Spearman para encontrar la relación entre la cantidad de accidentes acumulados y: la cantidad acumulada de días trabajados en cada mes, la cantidad acumulada de horas extras trabajadas mensualmente y el costo acumulado en porcentaje de la nómina mensual, encontrándose en todos los casos una relación lineal. Por otra parte, se realizó una prueba binomial para establecer la relación de la fecha de entrega de la meta con la accidentalidad 30 días antes y después, encontrando que la accidentalidad aumenta en la proximidad previa a la entrega de la meta

A Monte Carlo method for accelerating the computation of animated radiosity sequences

Realistic rendering animation is known to be an expensive processing task when physically-based global illumination methods are used in order to improve illumination details. This paper presents an acceleration technique to compute animations in radiosity environments. The technique is based on an interpolated approach that exploits temporal coherence in radiosity. A fast global Monte Carlo pre-processing step is introduced to the whole computation of the animated sequence to select important frames. These are fully computed and used as a base for the interpolation of all the sequence. The approach is completely view-independent. Once the illumination is computed, it can be visualized by any animated camera. Results present significant high speed-ups showing that the technique could be an interesting alternative to deterministic methods for computing non-interactive radiosity animations for moderately complex scenarios

La organización de los actores en el desarrollo territorial: el tren de alta velocidad en la ciudad intermedia

If we want to evaluate the degree of local development that High-Speed Train (HST) provides in a city it is fundamental to observe the capacity of the actors of territory of organizing themselves to make use of their endogenous resources. Through the elaboration of a new methodology, the study of the process of development of three medium-sized cities with HST, Lérida (Spain), Avignon (France) and Novara (Italy), is suggested. As conclusion certain characteristic problems of intermediate city are shown in the execution of its local project, basically the existence of a troublesome multiscalar relationship and of a weak network of local actors. The fragility of this urban context is owed to the lack of correct processes of internal and external governance

Stability lobes diagram identification and surface roughness monitoring in milling processes

La millora de la productivitat i la qualitat són indubtablement dues de les principals exigències del sector productiu modern i factors clau per la competitivitat i la supervivència. Dins aquest sector,la fabricació per arrancada de material juga encara avui en dia un paper protagonista tot i l'aparició de noves tècniques de conformat per addició.Indústries com l'aeronàutica, l'automobilística,la del motlle o l'energètica, depenen en bona part de les prestacions de les màquines-eina. Aquesta Tesi aborda dos aspectes rellevants quan es tracta de millorar de la productivitat i la qualitat del sector productiu: el problema del fimbrament, més conegut per la denominació anglosaxona chatter,i la monitorització de la rugositat superficial en el mecanitzat a alta velocitat.

Les grans infrastructures de transport i el desenvolupament de la ciutat mitjana. El Tren d'Alta Velocitat a les ciutats de Lleida, Avinyó i Novara

L'objectiu central de la tesi és estudiar els processos que permeten aconseguir un desenvolupament local a llarg termini de les ciutats mitjanes a partir de la implantació d'una gran infrastructura com el Tren d'Alta Velocitat (TAV). Es parteix de la hipòtesi que el desenvolupament local urbà a partir del TAV depèn de factors objectius i de factors subjectius (dels subjectes), uns factors que prenen una forma particular en el desenvolupament de les ciutats mitjanes. La tesi es divideix en una primera part teòrica i segona de més aplicada. Diversos autors han arribat a la conclusió que la relació tradicional que s'ha donat entre les infrastructures de transport i territori parteix d'uns paradigmes deterministes, que s'exemplifiquen amb una relació de "causa-efecte". Per aquest motiu, s'han criticat els estudis sobre els efectes socioeconòmics de les infrastructures de transport, així com el mateix concepte d'"efecte". Aquesta crítica es repeteix els estudis sobre el TAV i les ciutats mitjanes, que arriben a la conclusió que el desenvolupament econòmic no és un fet automàtic i que no es poden predir les conseqüències a mig i llarg termini del TAV. El desenvolupament local a partir del TAV, doncs, estaria relacionat amb tres elements principals. En primer lloc, entendre que la ciutat -i el territori- és un fenomen complex i, com a tal, cal abordar-lo des de la teoria dels sistemes complexos. En segon lloc, la gran infrastructura ha de convertir-se en un recurs endogen (interconnexió amb la xarxa local d'actors i territorialització en el milieu de la ciutat) per a que pugui contribuir al desenvolupament. En tercer lloc, la dinàmica de governance dels actors és primordial, i es divideix en la gestió interna de la xarxa local (projecte local) i la gestió multinivell de les administracions. En base als referents teòrics, es construeix una metodologia per avaluar el grau de desenvolupament local que ha comportat el TAV en tres ciutats mitjanes de l'arc mediterrani europeu, Lleida, Avinyó i Novara, situades respectivament a Espanya, França i Itàlia. La metodologia preveu l'estudi d'aspectes tècnics de la ciutat com els de transport (Posició territorial de la ciutat a partir del TAV, Característiques de l'estació TAV), urbanístics (Model urbanístic a escala municipal/urbana, Model urbanístic a escala de l'estació) i econòmics (Diferents projectes econòmics de la ciutat relacionats amb el TAV). També preveu l'estudi d'aspectes organitzatius externs (Els agents supralocals i els seus projectes, Grau de conflictivitat i cooperació en les relacions dels agents locals i supralocals) i interns (Capacitat de creació d'un projecte de ciutat a partir del TAV, Agents que participen en el projecte local i la seva dinàmica, Àmbit territorial dels projectes). Finalment s'efectua una avaluació del procés i dels resultats del desenvolupament local. Com a conclusió es demostra que el procés de desenvolupament local a partir de les grans infrastructures de transport depèn, en bon part, de la capacitat de governance. Depèn, per un cantó, de la capacitat dels agents locals d'elaborar un projecte de desenvolupament i liderar unes estratègies d'aprofitament i, de l'altre, de la capacitat dels agents del territori (estatals, regionals, locals) de crear aliances i cooperació per planificar la infrastructura de transport. Finalment es presenten un seguit de recomanacions a les ciutats que volen planificar l'arribada del TAV per a que contribueixi a un desenvolupament amb les característiques d'eficàcia, sostenibilitat, productivitat i equitat.