A comparative assessment of performance and productivity of health centres in Seychelles

Purpose - The purpose of this paper is to measure the technical and scale efficiency of health centres; to evaluate changes in productivity; and to highlight possible policy implications of the results for policy makers. Design/methodology/approach - Data envelopment analysis (DEA) is employed to assess the technical and scale efficiency, and productivity change over a four-year period among 17 public health centres. Findings - During the period of study, the results suggest that the public health centres in Seychelles have exhibited mean overall or technical efficiency of above 93 per cent. It was also found that the overall productivity increased by 2.4 per cent over 2001-2004. Research limitations/implications - Further research can be undertaken to gather data on the prices of the various inputs to facilitate an estimation of the allocative efficiency of clinics. If such an exercise were to be undertaken, researchers may also consider collecting data on quantities and prices of paramedical, administrative and support staff to ensure that the analysis is more comprehensive than the study reported in this paper. Institutionalization of efficiency monitoring would help to enhance further the already good health sector stewardship and governance. Originality/value - This paper provides new empirical evidence on a four-year trend in the efficiency and productivity of health centres in Seychelles. © Emerald Group Publishing Limited.

Seeing light vs dark lines: psychophysical performance is based on separate channels, limited by noise and uncertainty

Visual detection performance (d') is usually an accelerating function of stimulus contrast, which could imply a smooth, threshold-like nonlinearity in the sensory response. Alternatively, Pelli (1985 Journal of the Optical Society of America A 2 1508 - 1532) developed the 'uncertainty model' in which responses were linear with contrast, but the observer was uncertain about which of many noisy channels contained the signal. Such internal uncertainty effectively adds noise to weak signals, and predicts the nonlinear psychometric function. We re-examined these ideas by plotting psychometric functions (as z-scores) for two observers (SAW, PRM) with high precision. The task was to detect a single, vertical, blurred line at the fixation point, or identify its polarity (light vs dark). Detection of a known polarity was nearly linear for SAW but very nonlinear for PRM. Randomly interleaving light and dark trials reduced performance and rendered it non-linear for SAW, but had little effect for PRM. This occurred for both single-interval and 2AFC procedures. The whole pattern of results was well predicted by our Monte Carlo simulation of Pelli's model, with only two free parameters. SAW (highly practised) had very low uncertainty. PRM (with little prior practice) had much greater uncertainty, resulting in lower contrast sensitivity, nonlinear performance, and no effect of external (polarity) uncertainty. For SAW, identification was about v2 better than detection, implying statistically independent channels for stimuli of opposite polarity, rather than an opponent (light - dark) channel. These findings strongly suggest that noise and uncertainty, rather than sensory nonlinearity, limit visual detection.

Maintenance strategies affecting equipment performance

Proper maintenance of plant items is crucial for the safe and profitable operation of process plants, The relevant maintenance policies fall into the following four categories: (i) preventivejopportunistic/breakdown replacement policies, (ii) inspection/inspection-repair-replacernent policies, (iii) restorative maintenance policies, and (iv) condition based maintenance policies, For correlating failure times of component equipnent and complete systems, the Weibull failure distribution has been used, A new powerful method, SEQLIM, has been proposed for the estimation of the Weibull parameters; particularly, when maintenance records contain very few failures and many successful operation times. When a system consists of a number of replaceable, ageing components, an opporturistic replacernent policy has been found to be cost-effective, A simple opportunistic rrodel has been developed. Inspection models with various objective functions have been investigated, It was found that, on the assumption of a negative exponential failure distribution, all models converge to the same optimal inspection interval; provided the safety components are very reliable and the demand rate is low, When deterioration becomes a contributory factor to same failures, periodic inspections, calculated from above models, are too frequent, A case of safety trip systems has been studied, A highly effective restorative maintenance policy can be developed if the performance of the equipment under this category can be related to some predictive modelling. A novel fouling model has been proposed to determine cleaning strategies of condensers, Condition-based maintenance policies have been investigated. A simple gauge has been designed for condition monitoring of relief valve springs. A typical case of an exothermic inert gas generation plant has been studied, to demonstrate how various policies can be applied to devise overall maintenance actions.

Optical in-fiber Bragg grating sensor systems for medical applications

Two in-fiber Bragg grating (FBG) temperature sensor systems for medical applications are demonstrated: (1) an FBG flow-directed thermodilution catheter based on interferometric detection of wavelength shift that is used for cardiac monitoring; and (2) an FBG sensor system with a tunable Fabry-Perot filter for in vivo temperature profiling in nuclear magnetic resonance (NMR) machines. Preliminary results show that the FBG sensor is in good agreement with electrical sensors that are widely used in practice. A field test shows that the FBG sensor system is suitable for in situ temperature profiling in NMR machines for medical applications.

Reproducibility-repeatability of choroidal thickness calculation using optical coherence tomography

Purpose. To evaluate the repeatability and reproducibility of subfoveal choroidal thickness (CT) calculations performed manually using optical coherence tomography (OCT). Methods. The CT was imaged in vivo at each of two visits on 11 healthy volunteers (mean age, 35.72 ± 13.19 years) using the spectral domain OCT. CT was manually measured after applying ImageJ processing filters on 15 radial subfoveal scans. Each radial scan was spaced 12° from each other and contained 2500 A-scans. The coefficient of variability, coefficient of repeatability (CoR), coefficient of reproducibility, and intraclass correlation coefficient determined the reproducibility and repeatability of the calculation. Axial length (AL) and mean spherical equivalent refractive error were measured with the IOLMaster and an open view autorefractor to study their potential relationship with CT. Results. The within-visit and between-visit coefficient of variability, CoR, coefficient of reproducibility, and intraclass correlation coefficient were 0.80, 2.97% 2.44%, and 99%, respectively. The subfoveal CT correlated significantly with AL (R = -0.60, p = 0.05). Conclusions. The subfoveal CT could be measured manually in vivo using OCT and the readings obtained from the healthy subjects evaluated were repeatable and reproducible. It is proposed that OCT could be a useful instrument to perform in vivo assessment and monitoring of CT changes in retinal disease. The preliminary results suggest a negative correlation between subfoveal CT and AL in such a way that it decreases with increasing AL but not with refractive error.

Effect of light-emitting diode colour temperature on magnifier reading performance of the visually impaired

Background: As light-emitting diodes become more common as the light source for low vision aids, the effect of illumination colour temperature on magnifier reading performance was investigated. Methods: Reading ability (maximum reading speed, critical print size, threshold near visual acuity) using Radner charts and subjective preference was assessed for 107 participants with visual impairment using three stand magnifiers with light emitting diode illumination colour temperatures of 2,700 K, 4,500 K and 6,000 K. The results were compared with distance visual acuity, prescribed magnification, age and the primary cause of visual impairment. Results: Reading speed, critical print size and near visual acuity were unaffected by illumination colour temperature (p > 0.05). Reading metrics decreased with worsening acuity and higher levels of prescribed magnification but acuity was unaffected by age. Each colour temperature was preferred and disliked by a similar number of patients and was unrelated to distance visual acuity, prescribed magnification and age (p > 0.05). Patients had better near acuity (p = 0.002), critical print size (p = 0.034) and maximum reading speed (p <0.001), and the improvement in near from distance acuity was greater (p = 0.004) with their preferred rather than least-liked colour temperature illumination. Conclusion: A range of colour temperature illuminations should be offered to all visually impaired individuals prescribed with an optical magnifier for near tasks to optimise subjective and objective benefits.

Optical turbulence and spectral condensate in long-fiber lasers

We study optical wave turbulence using as a particular example recently created ultralong-fiber laser. We show that the sign of the cavity dispersion has a critical impact on the spectral and temporal properties of generated radiation that are directly relevant to the fiber laser performance. For a normal dispersion, we observe an intermediate state with an extremely narrow spectrum condensate, which experiences an instability and a sharp transition to a strongly fluctuating regime with a wide spectrum and increased probability of spontaneous generation of large-amplitude pulses.

All optical networking beyond 10 Gbits/s OTDM networks based on electro-optic modulators and fibre ring lasers

This thesis examines options for high capacity all optical networks. Specifically optical time division multiplexed (OTDM) networks based on electro-optic modulators are investigated experimentally, whilst comparisons with alternative approaches are carried out. It is intended that the thesis will form the basis of comparison between optical time division multiplexed networks and the more mature approach of wavelength division multiplexed networks. Following an introduction to optical networking concepts, the required component technologies are discussed. In particular various optical pulse sources are described with the demanding restrictions of optical multiplexing in mind. This is followed by a discussion of the construction of multiplexers and demultiplexers, including favoured techniques for high speed clock recovery. Theoretical treatments of the performance of Mach Zehnder and electroabsorption modulators support the design criteria that are established for the construction of simple optical time division multiplexed systems. Having established appropriate end terminals for an optical network, the thesis examines transmission issues associated with high speed RZ data signals. Propagation of RZ signals over both installed (standard fibre) and newly commissioned fibre routes are considered in turn. In the case of standard fibre systems, the use of dispersion compensation is summarised, and the application of mid span spectral inversion experimentally investigated. For green field sites, soliton like propagation of high speed data signals is demonstrated. In this case the particular restrictions of high speed soliton systems are discussed and experimentally investigated, namely the increasing impact of timing jitter and the downward pressure on repeater spacings due to the constraint of the average soliton model. These issues are each addressed through investigations of active soliton control for OTDM systems and through investigations of novel fibre types respectively. Finally the particularly remarkable networking potential of optical time division multiplexed systems is established, and infinite node cascadability using soliton control is demonstrated. A final comparison of the various technologies for optical multiplexing is presented in the conclusions, where the relative merits of the technologies for optical networking emerges as the key differentiator between technologies.

Advanced optical techniques for high capacity transmission

This thesis presents several advanced optical techniques that are crucial for improving high capacity transmission systems. The basic theory of optical fibre communications are introduced before optical solitons and their usage in optically amplified fibre systems are discussed. The design, operation, limitations and importance of the recirculating loop are illustrated. The crucial role of dispersion management in the transmission systems is then considered. Two of the most popular dispersion compensation methods - dispersion compensating fibres and fibre Bragg gratings - are emphasised. A tunable dispersion compensator is fabricated using the linear chirped fibre Bragg gratings and a bending rig. Results show that it is capable of compensating not only the second order dispersion, but also higher order dispersion. Stimulated Raman Scattering (SRS) are studied and discussed. Different dispersion maps are performed for all Raman amplified standard fibre link to obtain maximum transmission distances. Raman amplification is used in most of our loop experiments since it improves the optical signal-to-noise ratio (OSNR) and significantly reduces the nonlinear intrachannel effects of the transmission systems. The main body of the experimental work is concerned with nonlinear optical switching using the nonlinear optical loop mirrors (NOLMs). A number of different types of optical loop mirrors are built, tested and implemented in the transmission systems for noise suppression and 2R regeneration. Their results show that for 2R regeneration, NOLM does improve system performance, while NILM degrades system performance due to its sensitivity to the input pulse width, and the NALM built is unstable and therefore affects system performance.

Fibre-based devices for next generation photonics communication systems

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

Resonant cavity Fibre Bragg grating sensor interrogation

This thesis presents a novel high-performance approach to time-division-multiplexing (TDM) fibre Bragg grating (FBG) optical sensors, known as the resonant cavity architecture. A background theory of FBG optical sensing includes several techniques for multiplexing sensors. The limitations of current wavelength-division-multiplexing (WDM) schemes are contrasted against the technological and commercial advantage of TDM. The author’s hypothesis that ‘it should be possible to achieve TDM FBG sensor interrogation using an electrically switched semiconductor optical amplifier (SOA)’ is then explained. Research and development of a commercially viable optical sensor interrogator based on the resonant cavity architecture forms the remainder of this thesis. A fully programmable SOA drive system allows interrogation of sensor arrays 10km long with a spatial resolution of 8cm and a variable gain system provides dynamic compensation for fluctuating system losses. Ratiometric filter- and diffractive-element spectrometer-based wavelength measurement systems are developed and analysed for different commercial applications. The ratiometric design provides a low-cost solution that has picometre resolution and low noise using 4% reflective sensors, but is less tolerant to variation in system loss. The spectrometer design is more expensive, but delivers exceptional performance with picometre resolution, low noise and tolerance to 13dB system loss variation. Finally, this thesis details the interrogator’s peripheral components, its compliance for operation in harsh industrial environments and several examples of commercial applications where it has been deployed. Applications include laboratory instruments, temperature monitoring systems for oil production, dynamic control for wind-energy and battery powered, self-contained sub-sea strain monitoring.

Raman amplification and performance altering effects

This thesis presents an experimental investigation into several applications of the Raman scattering effect in communication optical fibres as well as how some of these applications can be modified to enhance the resulting performance. The majority of the work contained within is based on laboratory results using many commercially available components. The results can be divided into and presented in three main parts: Firstly, a novel application of a known effect is used to broaden Raman pump light in order to achieve a more continuous distribution of gain with respect to wavelength. Multiple experimental results are presented, all based around the prior spreading of the pump spectrum before being used in the desired transmission fibre. Gathered results show that a notable improvement can be obtained from applying such a technique along with the scope for further optimisation work. Secondly, an investigation into the interaction between the well known effect of Four Wave Mixing (FWM) and Raman scattering is provided. The work provides an introduction to the effect as well commenting on previous literature regarding the effect and its mitigation. In response to existing research experimental results are provided detailing some limitations of proposed schemes along with concepts of how further alleviation from the deleterious effects maybe obtained. Lastly, the distributed nature of the Raman gain process is explored. A novel technique on how a near constant distribution of gain can be employed is implemented practically. The application of distributed gain is then applied to the generation of optical pulses with special mathematical properties within a laboratory setting and finally the effect of pump noise upon distributed gain techniques is acknowledged.

Ultra-long haul optical fibre transmission systems

This thesis examines experimentally options for optical fibre transmission over oceanic distances. Its format follows the chronological evolution of ultra-long haul optical systems, commencing with opto-electronic regenerators as repeaters, progressing to optically amplified NRZ systems and finally solitonic propagation. In each case recirculating loop techniques are deployed to simplify the transmission experiments. Advances in high speed electronics have allowed regenerators operating at 10 Gbit/s to become a practical reality. By augmenting such devices with optical amplifiers it is possible to greatly enhance the repeater spacing. Work detailed in this thesis has culminated in the propagation of 10 Gbit/s data over 400,000 km with a repeater spacing of 160 km. System reliability and robustness are enhanced by the use of a directly modulated DFB laser transmitter and total insensitivity of the system to the signal state of polarisation. Optically amplified ultra-long haul NRZ systems have taken on particular importance with the impending deployment of TAT 12/13 and TPC 5. The performance of these systems is demonstrated to be primarily limited by analogue impairments such as the accumulation of amplifier noise, polarisation effects and optical non-linearities. These degradations may be reduced by the use of appropriate dispersion maps and by scrambling the transmitted state of signal polarisation. A novel high speed optically passive polarisation scrambler is detailed for the first time. At bit rates in excess of 10 Gbit/s it is shown that these systems are severely limited and do not offer the advantages that might be expected over regenerated links. Propagation using solitons as the data bits appears particularly attractive since the dispersive and non-linear effects of the fibre allow distortion free transmission. However, the generation of pure solitons is difficult but must be achieved if the uncontrolled transmission distance is to be maximised. This thesis presents a new technique for the stabilisation of an erbium fibre ring laser that has aUowed propagation of 2.5 Gbit/s solitons to the theoretical limit of ~ 18,000 km. At higher bit rates temporal jitter becomes a significant impairment and to aUow an increase in the aggregate line rate multiplexing in both time and polarisation domains has been proposed. These techniques are shown to be of only limited benefit in practical systems and ultimately some form of soliton transmission control is required. The thesis demonstrates synchronous retiming by amplitude modulation that has allowed 20 Gbit/s data to propagate 125,000 km error free with an amplifier spacing approaching the soliton period. Ultimately the speed of operation of such systems is limited by the electronics used and, thus, a new form of soliton control is demonstrated using all optical techniques to achieve synchronous phase modulation.

Low-cost interrogation of optical fibre Bragg grating sensors

Through the application of novel signal processing techniques we are able to measure physical measurands with both high accuracy and low noise susceptibility. The first interrogation scheme is based upon a CCD spectrometer. We compare different algorithms for resolving the Bragg wavelength from a low resolution discrete representation of the reflected spectrum, and present optimal processing methods for providing a high integrity measurement from the reflection image. Our second sensing scheme uses a novel network of sensors to measure the distributive strain response of a mechanical system. Using neural network processing methods we demonstrate the measurement capabilities of a scalable low-cost fibre Bragg grating sensor network. This network has been shown to be comparable with the performance of existing fibre Bragg grating sensing techniques, at a greatly reduced implementation cost.

Simulation of optical fibre communication systems influenced by stimulated brillouin scattering

Boyd's SBS model which includes distributed thermal acoustic noise (DTAN) has been enhanced to enable the Stokes-spontaneous density depletion noise (SSDDN) component of the transmitted optical field to be simulated, probably for the first time, as well as the full transmitted field. SSDDN would not be generated from previous SBS models in which a Stokes seed replaces DTAN. SSDDN becomes the dominant form of transmitted SBS noise as model fibre length (MFL) is increased but its optical power spectrum remains independent of MFL. Simulations of the full transmitted field and SSDDN for different MFLs allow prediction of the optical power spectrum, or system performance parameters which depend on this, for typical communication link lengths which are too long for direct simulation. The SBS model has also been innovatively improved by allowing the Brillouin Shift Frequency (BS) to vary over the model fibre length, for the nonuniform fibre model (NFM) mode, or to remain constant, for the uniform fibre model (UFM) mode. The assumption of a Gaussian probability density function (pdf) for the BSF in the NFM has been confirmed by means of an analysis of reported Brillouin amplified power spectral measurements for the simple case of a nominally step-index single-mode pure silica core fibre. The BSF pdf could be modified to match the Brillouin gain spectra of other fibre types if required. For both models, simulated backscattered and output powers as functions of input power agree well with those from a reported experiment for fitting Brillouin gain coefficients close to theoretical. The NFM and UFM Brillouin gain spectra are then very similar from half to full maximum but diverge at lower values. Consequently, NFM and UFM transmitted SBS noise powers inferred for long MFLs differ by 1-2 dB over the input power range of 0.15 dBm. This difference could be significant for AM-VSB CATV links at some channel frequencies. The modelled characteristic of Carrier-to-Noise Ratio (CNR) as a function of input power for a single intensity modulated subcarrier is in good agreement with the characteristic reported for an experiment when either the UFM or NFM is used. The difference between the two modelled characteristics would have been more noticeable for a higher fibre length or a lower subcarrier frequency.