Has DRG payment influenced the technical efficiency and productivity of diagnostic technologies in Portuguese public hospitals? An empirical analysis using parametric and non‐parametric methods

The use of Diagnosis Related Groups (DRG) as a mechanism for hospital financing is a currently debated topic in Portugal. The DRG system was scheduled to be initiated by the Health Ministry of Portugal on January 1, 1990 as an instrument for the allocation of public hospital budgets funded by the National Health Service (NHS), and as a method of payment for other third party payers (e.g., Public Employees (ADSE), private insurers, etc.). Based on experience from other countries such as the United States, it was expected that implementation of this system would result in more efficient hospital resource utilisation and a more equitable distribution of hospital budgets. However, in order to minimise the potentially adverse financial impact on hospitals, the Portuguese Health Ministry decided to gradually phase in the use of the DRG system for budget allocation by using blended hospitalspecific and national DRG casemix rates. Since implementation in 1990, the percentage of each hospitals budget based on hospital specific costs was to decrease, while the percentage based on DRG casemix was to increase. This was scheduled to continue until 1995 when the plan called for allocating yearly budgets on a 50% national and 50% hospitalspecific cost basis. While all other nonNHS third party payers are currently paying based on DRGs, the adoption of DRG casemix as a National Health Service budget setting tool has been slower than anticipated. There is now some argument in both the political and academic communities as to the appropriateness of DRGs as a budget setting criterion as well as to their impact on hospital efficiency in Portugal. This paper uses a twostage procedure to assess the impact of actual DRG payment on the productivity (through its components, i.e., technological change and technical efficiency change) of diagnostic technology in Portuguese hospitals during the years 1992–1994, using both parametric and nonparametric frontier models. We find evidence that the DRG payment system does appear to have had a positive impact on productivity and technical efficiency of some commonly employed diagnostic technologies in Portugal during this time span.

A longitudinal study of the diffusion of the ISO/IEC information resource dictionary system standard (IRDS.)

The IRDS standard is an international standard produced by the International Organisation for Standardisation (ISO). In this work the process for producing standards in formal standards organisations, for example the ISO, and in more informal bodies, for example the Object Management Group (OMG), is examined. This thesis examines previous models and classifications of standards. The previous models and classifications are then combined to produce a new classification. The IRDS standard is then placed in a class in the new model as a reference anticipatory standard. Anticipatory standards are standards which are developed ahead of the technology in order to attempt to guide the market. The diffusion of the IRDS is traced over a period of eleven years. The economic conditions which affect the diffusion of standards are examined, particularly the economic conditions which prevail in compatibility markets such as the IT and ICT markets. Additionally the consequences of the introduction of gateway or converter devices into a market where a standard has not yet been established is examined. The IRDS standard did not have an installed base and this hindered its diffusion. The thesis concludes that the IRDS standard was overtaken by new developments such as object oriented technologies and middleware. This was partly because of the slow development process of developing standards in traditional organisations which operate on a consensus basis and partly because the IRDS standard did not have an installed base. Also the rise and proliferation of middleware products resulted in exchange mechanisms becoming dominant rather than repository solutions. The research method used in this work is a longitudinal study of the development and diffusion of the ISO/EEC IRDS standard. The research is regarded as a single case study and follows the interpretative epistemological point of view.

River basin surveillance using remotely sensed data: a water resources information management system

This thesis describes the development of an operational river basin water resources information management system. The river or drainage basin is the fundamental unit of the system; in both the modelling and prediction of hydrological processes, and in the monitoring of the effect of catchment management policies. A primary concern of the study is the collection of sufficient and sufficiently accurate information to model hydrological processes. Remote sensing, in combination with conventional point source measurement, can be a valuable source of information, but is often overlooked by hydrologists, due to the cost of acquisition and processing. This thesis describes a number of cost effective methods of acquiring remotely sensed imagery, from airborne video survey to real time ingestion of meteorological satellite data. Inexpensive micro-computer systems and peripherals are used throughout to process and manipulate the data. Spatial information systems provide a means of integrating these data with topographic and thematic cartographic data, and historical records. For the system to have any real potential the data must be stored in a readily accessible format and be easily manipulated within the database. The design of efficient man-machine interfaces and the use of software enginering methodologies are therefore included in this thesis as a major part of the design of the system. The use of low cost technologies, from micro-computers to video cameras, enables the introduction of water resources information management systems into developing countries where the potential benefits are greatest.

Shaping acoustic fields as a toolset for microfluidic manipulations in diagnostic technologies

Ultrasonics offers the possibility of developing sophisticated fluid manipulation tools in lab-on-a-chip technologies. Here we demonstrate the ability to shape ultrasonic fields by using phononic lattices, patterned on a disposable chip, to carry out the complex sequence of fluidic manipulations required to detect the rodent malaria parasite Plasmodium berghei in blood. To illustrate the different tools that are available to us, we used acoustic fields to produce the required rotational vortices that mechanically lyse both the red blood cells and the parasitic cells present in a drop of blood. This procedure was followed by the amplification of parasitic genomic sequences using different acoustic fields and frequencies to heat the sample and perform a real-time PCR amplification. The system does not require the use of lytic reagents nor enrichment steps, making it suitable for further integration into lab-on-a-chip point-of-care devices. This acoustic sample preparation and PCR enables us to detect ca. 30 parasites in a microliter-sized blood sample, which is the same order of magnitude in sensitivity as lab-based PCR tests. Unlike other lab-on-a-chip methods, where the sample moves through channels, here we use our ability to shape the acoustic fields in a frequency-dependent manner to provide different analytical functions. The methods also provide a clear route toward the integration of PCR to detect pathogens in a single handheld system.

Cognitive Approach to e-Learning in Sciences and Technologies

This article describes the approach adopted and the results obtained by the international team developing WBLST (Web Based Learning in Sciences and Technologies) a Web-based application for e-learning, developed for the students of “UVPL: Université Virtuelle des Pays de la Loire”. The developed e-learning system covers three levels of learning activities - content, exercises, and laboratory. The delivery model is designed to operate with domain concepts as relevant providers of semantic links. The aim is to facilitate the overview and to help the establishment of a mental map of the learning material. The implemented system is strongly based on the organization of the instruction in virtual classes. The obtained quality of the system is evaluated on the bases of feedback form students and professors.

Use of Dynamic Technologies for Web-enabled Database Management Systems

In this paper we consider two computer systems and the dynamic Web technologies they are using. Different contemporary dynamic web technologies are described in details and their advantages and disadvantages have been shown. Specific applications are developed, clinic and studying systems, and their programming models are described. Finally we implement these two applications in the students education process: Online studying has been tested in the Technical University – Varna, Web based clinic system has been used for practical education of the students in the Medical College - Sofia, branch V. Tarnovo

Use of the Maple System in Math Tuition at Universities

The following article explores the application of educational technologies at a University level and their contribution in enhancing the educational effectiveness. It discusses the capabilities of computer algebra systems, such as Maple. It is integrated in the math tuition of the Technical University (TU) in Varna and is used by its students during laboratory exercises.

Enabling transparent technologies for the development of highly granular flexible optical cross-connects

Flexible optical networking is identified today as the solution that offers smooth system upgradability towards Tb/s capacities and optimized use of network resources. However, in order to fully exploit the potentials of flexible spectrum allocation and networking, the development of a flexible switching node is required capable to adaptively add, drop and switch tributaries with variable bandwidth characteristics from/to ultra-high capacity wavelength channels at the lowest switching granularity. This paper presents the main concept and technology solutions envisioned by the EU funded project FOX-C, which targets the design, development and evaluation of the first functional system prototype of flexible add-drop and switching cross-connects. The key developments enable ultra-fine switching granularity at the optical subcarrier level, providing end-to-end routing of any tributary channel with flexible bandwidth down to 10Gb/s (or even lower) carried over wavelength superchannels, each with an aggregated capacity beyond 1Tb/s. © 2014 IEEE.

An Intelligent System for Investigations and Provision of Safety for Complex Constructions

Methodology of computer-aided investigation and provision of safety for complex constructions and a prototype of the intelligent applied system, which implements it, are considered. The methodology is determined by the model of the object under scrutiny, by the structure and functions of investigation of safety as well as by a set of research methods. The methods are based on the technologies of object-oriented databases, expert systems and on the mathematical modeling. The intelligent system’s prototype represents component software, which provides for support of decision making in the process of safety investigations and investigation of the cause of failure. Support of decision making is executed by analogy, by determined search for the precedents (cases) with respect to predicted (on the stage of design) and observed (on the stage of exploitation) parameters of the damage, destruction and malfunction of a complex hazardous construction.

Viable Model of the Enterprise – a Cybernetic Approach for Implementing the Information Technologies in Management

The purpose of the current paper is to present the developed methodology of viable model based enterprise management, which is needed for modern enterprises to survive and growth in the information age century. The approach is based on Beer’s viable system model and uses it as a basis of the information technology implementation and development. The enterprise is viewed as a cybernetic system which functioning is controlled from the same rules as for every living system.

Multi-Agent Security System based on Neural Network Model of User's Behavior

It is proposed an agent approach for creation of intelligent intrusion detection system. The system allows detecting known type of attacks and anomalies in user activity and computer system behavior. The system includes different types of intelligent agents. The most important one is user agent based on neural network model of user behavior. Proposed approach is verified by experiments in real Intranet of Institute of Physics and Technologies of National Technical University of Ukraine "Kiev Polytechnic Institute”.

Intelligent System for Computer Aided Assembly Process Planning

This paper presents the concepts of the intelligent system for aiding of the module assembly technology. The first part of this paper presents a project of intelligent support system for computer aided assembly process planning. The second part includes a coincidence description of the chosen aspects of implementation of this intelligent system using technologies of artificial intelligence (artificial neural networks, fuzzy logic, expert systems and genetic algorithms).

The Complex Unified Evolutionary Approach to the Creation of the Multilevel Distributed Control System of a Gas-transport Company

The objects of a large-scale gas-transport company (GTC) suggest a complex unified evolutionary approach, which covers basic building concepts, up-to-date technologies, models, methods and means that are used in the phases of design, adoption, maintenance and development of the multilevel automated distributed control systems (ADCS).. As a single methodological basis of the suggested approach three basic Concepts, which contain the basic methodological principles and conceptual provisions on the creation of distributed control systems, were worked out: systems of the lower level (ACS of the technological processes based on up-to-date SCADA), of the middle level (ACS of the operative-dispatch production control based on MES-systems) and of the high level (business process control on the basis of complex automated systems ERP).

Developing of Distributed Virtual Laboratories for Smart Sensor System Design Based on Multi-Dimensional Access Method

In the article it is considered preconditions and main principles of creation of virtual laboratories for computer-aided design, as tools for interdisciplinary researches. Virtual laboratory, what are offered, is worth to be used on the stage of the requirements specification or EFT-stage, because it gives the possibility of fast estimating of the project realization, certain characteristics and, as a result, expected benefit of its applications. Using of these technologies already increase automation level of design stages of new devices for different purposes. Proposed computer technology gives possibility to specialists from such scientific fields, as chemistry, biology, biochemistry, physics etc, to check possibility of device creating on the basis of developed sensors. It lets to reduce terms and costs of designing of computer devices and systems on the early stages of designing, for example on the stage of requirements specification or EFT-stage. An important feature of this project is using the advanced multi-dimensional access method for organizing the information base of the Virtual laboratory.

Facilitating intuitive-guided learning in a serious game through integration with a learning content management system

Increased global uptake of entertainment gaming has the potential to lead to high expectations of engagement and interactivity from users of technology-enhanced learning environments. Blended approaches to implementing game-based learning as part of distance or technology-enhanced education have led to demonstrations of the benefits they might bring, allowing learners to interact with immersive technologies as part of a broader, structured learning experience. In this article, we explore how the integration of a serious game can be extended to a learning content management system (LCMS) to support a blended and holistic approach, described as an 'intuitive-guided' method. Through a case study within the EU-Funded Adaptive Learning via Intuitive/Interactive, Collaborative and Emotional Systems (ALICE) project, a technical integration of a gaming engine with a proprietary LCMS is demonstrated, building upon earlier work and demonstrating how this approach might be realized. In particular, how this method can support an intuitive-guided approach to learning is considered, whereby the learner is given the potential to explore a non-linear environment whilst scaffolding and blending provide guidance ensuring targeted learning objectives are met. Through an evaluation of the developed prototype with 32 students aged 14-16 across two Italian schools, a varied response from learners is observed, coupled with a positive reception from tutors. The study demonstrates that challenges remain in providing high-fidelity content in a classroom environment, particularly as an increasing gap in technology availability between leisure and school times emerges.