829 resultados para Waiting


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The trend in modal extraction algorithms is to use all the available frequency response functions data to obtain a global estimate of the natural frequencies, damping ratio and mode shapes. Improvements in transducer and signal processing technology allow the simultaneous measurement of many hundreds of channels of response data. The quantity of data available and the complexity of the extraction algorithms make considerable demands on the available computer power and require a powerful computer or dedicated workstation to perform satisfactorily. An alternative to waiting for faster sequential processors is to implement the algorithm in parallel, for example on a network of Transputers. Parallel architectures are a cost effective means of increasing computational power, and a larger number of response channels would simply require more processors. This thesis considers how two typical modal extraction algorithms, the Rational Fraction Polynomial method and the Ibrahim Time Domain method, may be implemented on a network of transputers. The Rational Fraction Polynomial Method is a well known and robust frequency domain 'curve fitting' algorithm. The Ibrahim Time Domain method is an efficient algorithm that 'curve fits' in the time domain. This thesis reviews the algorithms, considers the problems involved in a parallel implementation, and shows how they were implemented on a real Transputer network.

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Objective: To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively. Design: Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups. Setting: Six primary care trusts in the West Midlands. Participants: Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses. Results: Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and preferred to consult their own GP, who listened and was willing to learn, rather than be referred to a different GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery. Conclusions: Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness.

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Service innovations in retailing have the potential to benefit consumers as well as retailers. This research models key factors associated with the trial and continuous use of a specific self-service technology (SST), the personal shopping assistant (PSA), and estimates retailer benefits from implementing that innovation. Based on theoretical insights from prior SST studies, diffusion of innovation literature, and the technology acceptance model (TAM), this study develops specific hypotheses and tests them on a sample of 104 actual users of the PSA and 345 nonusers who shopped at the retail store offering the PSA device. Results indicate that factors affecting initial trial are different from those affecting continuous use. More specifically, consumers' trust toward the retailer, novelty seeking, and market mavenism are positively related to trial, while technology anxiety hinders the likelihood of trying the PSA. Perceived ease of use of the device positively impacts continuous use while consumers' need for interaction in shopping environments reduces the likelihood of continuous use. Importantly, there is evidence on retailer benefits from introducing the innovation since consumers using the PSA tend to spend more during each shopping trip. However, given the high costs of technology, the payback period for recovery of investments in innovation depends largely upon continued use of the innovation by consumers. Important implications are provided for retailers considering investments in new in-store service innovations. Incorporation of technology within physical stores affords opportunities for the retailer to reduce costs, while enhancing service provided to consumers. Therefore, service innovations in retailing have the potential to benefit consumers as well as retailers. This research models key factors associated with the trial and continuous use of a specific SST in the retail context, the PSA, and estimates retailer benefits from implementing that innovation. In so doing, the study contributes to the nascent area of research on SSTs in the retail sector. Based on theoretical insights from prior SST studies, diffusion of innovation literature, and the TAM, this study develops specific hypotheses regarding the (1) antecedent effects of technological anxiety, novelty seeking, market mavenism, and trust in the retailer on trial of the service innovation; (2) the effects of ease of use, perceived waiting time, and need for interaction on continuous use of the innovation; and (3) the effect of use of innovation on consumer spending at the store. The hypotheses were tested on a sample of 104 actual users of the PSA and 345 nonusers who shopped at the retail store offering the PSA device, one of the early adopters of PSA in Germany. Data were analyzed using logistic regression (antecedents of trial), multiple regression (antecedents of continuous use), and propensity score matching (assessing retailer benefits). Results indicate that factors affecting initial trial are different from those affecting continuous use. More specifically, consumers' trust toward the retailer, novelty seeking, and market mavenism are positively related to trial, while technology anxiety hinders the likelihood of trying the PSA. Perceived ease of use of the device positively impacts continuous use, while consumers' need for interaction in shopping environments reduces the likelihood of continuous use. Importantly, there is evidence on retailer benefits from introducing the innovation since consumers using the PSA tend to spend more during each shopping trip. However, given the high costs of technology, the payback period for recovery of investments in innovation depends largely upon continued use of the innovation by consumers. Important implications are provided for retailers considering investments in new in-store service innovations. The study contributes to the literature through its (1) simultaneous examination of antecedents of trial and continuous usage of a specific SST, (2) the demonstration of economic benefits of SST introduction for the retailer, and (3) contribution to the stream of research on service innovation, as against product innovation.

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This paper is sponsored by the Ministry of Education and Research of the Republic of Bulgaria in the framework of project No 105 “Multimedia Packet Switching Networks Planning with Quality of Service and Traffic Management”.

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Signal processing is an important topic in technological research today. In the areas of nonlinear dynamics search, the endeavor to control or order chaos is an issue that has received increasing attention over the last few years. Increasing interest in neural networks composed of simple processing elements (neurons) has led to widespread use of such networks to control dynamic systems learning. This paper presents backpropagation-based neural network architecture that can be used as a controller to stabilize unsteady periodic orbits. It also presents a neural network-based method for transferring the dynamics among attractors, leading to more efficient system control. The procedure can be applied to every point of the basin, no matter how far away from the attractor they are. Finally, this paper shows how two mixed chaotic signals can be controlled using a backpropagation neural network as a filter to separate and control both signals at the same time. The neural network provides more effective control, overcoming the problems that arise with control feedback methods. Control is more effective because it can be applied to the system at any point, even if it is moving away from the target state, which prevents waiting times. Also control can be applied even if there is little information about the system and remains stable longer even in the presence of random dynamic noise.

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2000 MSC: 26A33, 33E12, 33E20, 44A10, 44A35, 60G50, 60J05, 60K05.

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On the morning of January 5, 1859, at the end of the liturgy in the Orthodox cathedral in Iaşi, the capital of the principality of Moldavia, Father Neofit Scriban addressed the congregation. He had given many sermons in the cathedral; however, on this par tic u lar date Father Neofit faced an unusual audience. Among the faithful who regularly worshipped at the relics of Saint Parascheva, the protector of Moldavia, were the members of the assembly who would decide the future of the principality. They had a specific mission: to elect a new prince, a key figure in their plan to unite Moldavia with the neighboring principality of Wallachia. Father Neofit, a supporter of the unionist cause and fully aware of the significance of the moment, stated: Brethren, Jesus Christ has said that "For where two or three have gathered together in My name, I am there in their midst." You, Brethren, are not two, or three, but a real gathering in the name of God. God is in your midst. You are here in the name of the Romanian nation [and] the Romanian nation is in your midst. On the flag under which you have assembled, the flag of the Romanian nation, great events, the Romanian faith, unity, are written in large letters. The church, which is founded on faith, blesses the flag of this faith⋯. You, Brethren, through the faith of the Romanian nation, by remaining faithful to this flag, will find the same strength as the church [finds] in its own saints. The faith of the Romanian nation was not, is not, and will not be anything else, but the unity of all Romanians in a single state, the only anchor of salvation, the only port in which the national boat could be saved from surrounding waves. You, Brethren, have gathered here in the church of Stephen the Great; looking at the altar that he raised to the God of your parents, I think that, through this [altar], you will be able to enter into the wishes of this hero of our nation. You, [remember that] by leaving this place, you are leaving [in order to fulfill] a great gesture that for many centuries has been lost for us; you are about to elect a successor to this great hero; therefore, as his true sons, you could not be anything other than the true expression of his wishes. Myself, [as] last year, from this altar, I said and I will continue to say that this great hero has told us that "the God of our parents will send us a Redeemer who will heal our wounds and accomplish our wishes." May your chosen leader today be the redeemer expected by the Romanian nation. May he heal its wounds and achieve its wishes. Therefore, Brethren, may your election today be that of a real Messiah of Romania. God and the world are looking at you, the church is blessing you and the whole Romanian nation is waiting for you!1 A few hours after Father Neofit's sermon, the assembly elected Alexandru Ioan Cuza to be the prince of the principality of Moldavia; a few days later, on January 24, 1859, the assembly of the neighboring principality of Wallachia decided that Cuza should also be their prince, thus confirming the unification of the two states. A new country was inscribed on the map of Southeastern Europe, titled "The United Principalities of Wallachia and Moldavia," also known as "The United Romanian Principalities".

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Key words: Markov-modulated queues, waiting time, heavy traffic.

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2000 Mathematics Subject Classification: primary: 60J80, 60J85, secondary: 62M09, 92D40

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2000 Mathematics Subject Classification: 60J45, 60K25

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2000 Mathematics Subject Classification: 60K05

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2000 Mathematics Subject Classification: Primary 60G55; secondary 60G25.

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Full text: Welcome to issue 1 of 2012 and a belated Happy New Year to all CLAE readers and BCLA members. The hardest job I had for this issue was to decide which papers to include and which papers to hang on to and save for issue 2 of 2012. At the end of December when I was choosing the content for this issue there were additional 5 papers that could have been included. The final choice came down to various factors; such as first come first served – i.e. which papers had been ready and waiting the longest; secondly which papers had been submitted the earliest; are there similar papers so that it may be beneficial to publish them alongside this paper; and also was the content something which needed to be out there quicker than other papers as it was a current hot topic? But it should be noted that once papers are proofed and deemed ready by authors they are published in the epub version and put online for others to see in their final version. An epub version is given a DOI number (digital object identifier) so that it can be cited by other authors. Apart from being on line the only other difference is that an epub version is essentially waiting to be assigned to a particular issue. So those papers that are being held off for issue 2 of this year are actually already available for you to read (and cite) on line. In this issue there is a paper related to the cost of different contact lens replacement schedules – this may be a topic that is debated more in the future since as a society we are thinking more ‘green’ and all trying to help by reducing our carbon footprint, whether that be by recycling or using less in the first place. A timely review paper on the management of allergic eye disease may help us to better manage those patients we see in the spring with pollen allergies. We have two papers looking at different aspects in keratoconus patients, another looking at a modified fluoret strip and its application in measuring tear break up time and a review paper on corneal erosions. Another interesting paper comes from Professor Harminder Dua and his team. Professor Dua is the UK Royal College of Ophthalmologists’ president and has been interested in corneal anatomy and physiology for much of his research career. Finally, an unusual case of an ocular injury related to a snake bite. Overall I would say there is enough to sink your ‘fangs’ into! Finally, it gives me great pleasure in announcing the newest person to join our Editorial Board, Dr Florence Malet. Dr Malet is an Ophthalmologist and since September 2000 she has been at the Bordeaux Hospital in France developing the Contact Lens Unit of in the Ophthalmology University Department. She is ex-president of the French Contact Lens Society and president of the European Contact Lens Society of Ophthalmologists.

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Queuing is one of the very important criteria for assessing the performance and efficiency of any service industry, including healthcare. Data Envelopment Analysis (DEA) is one of the most widely-used techniques for performance measurement in healthcare. However, no queue management application has been reported in the health-related DEA literature. Most of the studies regarding patient flow systems had the objective of improving an already existing Appointment System. The current study presents a novel application of DEA for assessing the queuing process at an Outpatients’ department of a large public hospital in a developing country where appointment systems do not exist. The main aim of the current study is to demonstrate the usefulness of DEA modelling in the evaluation of a queue system. The patient flow pathway considered for this study consists of two stages; consultation with a doctor and pharmacy. The DEA results indicated that waiting times and other related queuing variables included need considerable minimisation at both stages.

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Purpose – The purpose of this paper is to develop an integrated patient-focused analytical framework to improve quality of care in accident and emergency (A&E) unit of a Maltese hospital. Design/methodology/approach – The study adopts a case study approach. First, a thorough literature review has been undertaken to study the various methods of healthcare quality management. Second, a healthcare quality management framework is developed using combined quality function deployment (QFD) and logical framework approach (LFA). Third, the proposed framework is applied to a Maltese hospital to demonstrate its effectiveness. The proposed framework has six steps, commencing with identifying patients’ requirements and concluding with implementing improvement projects. All the steps have been undertaken with the involvement of the concerned stakeholders in the A&E unit of the hospital. Findings – The major and related problems being faced by the hospital under study were overcrowding at A&E and shortage of beds, respectively. The combined framework ensures better A&E services and patient flow. QFD identifies and analyses the issues and challenges of A&E and LFA helps develop project plans for healthcare quality improvement. The important outcomes of implementing the proposed quality improvement programme are fewer hospital admissions, faster patient flow, expert triage and shorter waiting times at the A&E unit. Increased emergency consultant cover and faster first significant medical encounter were required to start addressing the problems effectively. Overall, the combined QFD and LFA method is effective to address quality of care in A&E unit. Practical/implications – The proposed framework can be easily integrated within any healthcare unit, as well as within entire healthcare systems, due to its flexible and user-friendly approach. It could be part of Six Sigma and other quality initiatives. Originality/value – Although QFD has been extensively deployed in healthcare setup to improve quality of care, very little has been researched on combining QFD and LFA in order to identify issues, prioritise them, derive improvement measures and implement improvement projects. Additionally, there is no research on QFD application in A&E. This paper bridges these gaps. Moreover, very little has been written on the Maltese health care system. Therefore, this study contributes demonstration of quality of emergency care in Malta.