A systematic review of economic evaluations of the use of robotic assisted laparoscopy in surgery compared with open or laparoscopic surgery

Peer reviewed

A systematic review of economic evaluations of the use of robotic assisted laparoscopy in surgery compared with open or laparoscopic surgery

Peer reviewed

A systematic review of economic evaluations of the use of robotic assisted laparoscopy in surgery compared with open or laparoscopic surgery

Peer reviewed

Élaboration et validation d'un instrument préliminaire mesurant les connaissances, les attitudes, les croyances, les normes subjectives et les intentions d'agir des professionnels de la santé sur le don d'organes

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

The development and validity of a functional assessment instrument for persons with major mental disorders

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

High accuracy mobile robot positioning using an external large volume metrology instrument

A method of accurately controlling the position of a mobile robot using an external Large Volume Metrology (LVM) instrument is presented in this paper. Utilizing a LVM instrument such as the laser tracker in mobile robot navigation, many of the most difficult problems in mobile robot navigation can be simplified or avoided. Using the real- Time position information from the laser tracker, a very simple navigation algorithm, and a low cost robot, 5mm repeatability was achieved over a volume of 30m radius. A surface digitization scan of a wind turbine blade section was also demonstrated, illustrating possible applications of the method for manufacturing processes. © Springer-Verlag Berlin Heidelberg 2010.

Large volume metrology instrument selection and measurability analysis

Metrology processes used in the manufacture of large products include tool setting, product verification and flexible metrology enabled automation. The range of applications and instruments available makes the selection of the appropriate instrument for a given task highly complex. Since metrology is a key manufacturing process it should be considered in the early stages of design. This paper provides an overview of the important selection criteria for typical measurement processes and presents some novel selection strategies. Metrics which can be used to assess measurability are also discussed. A prototype instrument selection and measurability analysis application is presented with discussion of how this can be used as the basis for development of a more sophisticated measurement planning tool. © Springer-Verlag Berlin Heidelberg 2010.

Simplified Predictive Instrument to Rule Out Acute Coronary Syndromes in a High-Risk Population.

BACKGROUND: It is unclear whether diagnostic protocols based on cardiac markers to identify low-risk chest pain patients suitable for early release from the emergency department can be applied to patients older than 65 years or with traditional cardiac risk factors. METHODS AND RESULTS: In a single-center retrospective study of 231 consecutive patients with high-risk factor burden in which a first cardiac troponin (cTn) level was measured in the emergency department and a second cTn sample was drawn 4 to 14 hours later, we compared the performance of a modified 2-Hour Accelerated Diagnostic Protocol to Assess Patients with Chest Pain Using Contemporary Troponins as the Only Biomarker (ADAPT) rule to a new risk classification scheme that identifies patients as low risk if they have no known coronary artery disease, a nonischemic electrocardiogram, and 2 cTn levels below the assay's limit of detection. Demographic and outcome data were abstracted through chart review. The median age of our population was 64 years, and 75% had Thrombosis In Myocardial Infarction risk score ≥2. Using our risk classification rule, 53 (23%) patients were low risk with a negative predictive value for 30-day cardiac events of 98%. Applying a modified ADAPT rule to our cohort, 18 (8%) patients were identified as low risk with a negative predictive value of 100%. In a sensitivity analysis, the negative predictive value of our risk algorithm did not change when we relied only on undetectable baseline cTn and eliminated the second cTn assessment. CONCLUSIONS: If confirmed in prospective studies, this less-restrictive risk classification strategy could be used to safely identify chest pain patients with more traditional cardiac risk factors for early emergency department release.

Élaboration et validation d'un instrument préliminaire mesurant les connaissances, les attitudes, les croyances, les normes subjectives et les intentions d'agir des professionnels de la santé sur le don d'organes

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

The development and validity of a functional assessment instrument for persons with major mental disorders

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Testing a gravity-based accessibility instrument to engage stakeholders into integrated LUT planning

The paper starts from the concern that while there is a large body of literature focusing on the theoretical definitions and measurements of accessibility, the extent to which such measures are used in planning practice is less clear. Previous reviews of accessibility instruments have in fact identified a gap between the clear theoretical assumptions and the infrequent applications of accessibility instruments in spatial and transport planning. In this paper we present the results of a structured-workshop involving private and public stakeholders to test usability of gravity-based accessibility measures (GraBaM) to assess integrated land-use and transport policies. The research is part of the COST Action TU1002 “Accessibility Instruments for Planning Practice” during which different accessibility instruments where tested for different case studies. Here we report on the empirical case study of Rome.

New Observations of Balmer Continuum Flux in Solar Flares:Instrument Description and First Results

Increase in the Balmer continuum radiation during solar flares was predicted by various authors, but has never been firmly confirmed observationally using ground-based slit spectrographs. Here we describe a new post-focal instrument, the image selector, with which the Balmer continuum flux can be measured from the whole flare area, in analogy to successful detections of flaring dMe stars. The system was developed and put into operation at the horizontal solar telescope HSFA2 of the Ondřejov Observatory. We measure the total flux by a fast spectrometer from a limited but well-defined region on the solar disk. Using a system of diaphragms, the disturbing contribution of a bright solar disk can be eliminated as much as possible. Light curves of the measured flux in the spectral range 350 – 440 nm are processed, together with the Hα images of the flaring area delimited by the appropriate diaphragm. The spectral flux data are flat-fielded, calibrated, and processed to be compared with model predictions. Our analysis of the data proves that the described device is sufficiently sensitive to detect variations in the Balmer continuum during solar flares. Assuming that the Balmer-continuum kernels have at least a similar size as those visible in Hα, we find the flux increase in the Balmer continuum to reach 230 – 550 % of the quiet continuum during the observed X-class flare. We also found temporal changes in the Balmer continuum flux starting well before the onset of the flare in Hα.

Towards a Virtual-Acoustic String Instrument

In acoustic instruments, the controller and the sound producing system often are one and the same object. If virtualacoustic instruments are to be designed to not only simulate the vibrational behaviour of a real-world counterpart but also to inherit much of its interface dynamics, it would make sense that the physical form of the controller is similar to that of the emulated instrument. The specific physical model configuration discussed here reconnects a (silent) string controller with a modal synthesis string resonator across the real and virtual domains by direct routing of excitation signals and model parameters. The excitation signals are estimated in their original force-like form via careful calibration of the sensor, making use of adaptive filtering techniques to design an appropriate inverse filter. In addition, the excitation position is estimated from sensors mounted under the legs of the bridges on either end of the prototype string controller. The proposed methodology is explained and exemplified with preliminary results obtained with a number of off-line experiments.

Uppföljning och utvärdering av det balanserade styrkortet : Är balanserat styrkort ett värdeskapande och strategiskt instrument inom den kommunala verksamheten?

The need to steer economic development has always been great and as management model has the balanced scorecard has been popular since the mid- 1990s, mainly in the private sector but also in the municipal sector. The introduction of the balanced scorecard has been primarily to organizations to see more than economic dimensions. The Balanced Scorecard was originally a measurement system, and today it works more as a strategic instrument. In our study is a case study to evaluate a municipality and how they make use of the balanced scorecard as a tool for strategic and value-adding work in municipal activities. In the local business is it important that the organization adapts the balanced scorecard, so it fits on the basis that it is a politically driven organization, with mandates, committees and administrations. In our study, we used a qualitative method with a deductive approach. In the study, we have gathered information through a case study where we interviewed 7 people in leading positions. In our analysis and results section, we came to the conclusion that the municipality does not use the balanced scorecard correctly. We also found that the balanced scorecard as a tool for value creation and strategic planning does not work in a favorable way. In our study, we see difficulties with the implementation of the balanced scorecard. If the municipality has invested in implementing the balanced scorecard at all levels of the business so the municipality would be able to use it on one of the activities more adequately. When the municipality is a politically driven organization, it is important that vision alive and changing based on the conditions that reflect the outside world and the municipality in general. Looking at a vivid vision, goals and business ideas, it's balanced scorecard in line with how a balanced scorecard should look like. The municipality has a strategic plan in terms of staff and employees at large. In the study, we have seen that the strategic plan is not followed up in a good way and for the business favorably, the municipality chooses the easy way out for evaluation. Employee participation to changes and ongoing human resources management feels nonexistent. However, as has been the vision of creating empowered and motivated employees. In our conclusion, we describe how we in our study look at the use of the balanced scorecard in municipal operations. We can also discern that a balanced scorecard as a tool for value creation and strategic work is good if it is used properly. In the study, we have concluded that the municipality we have chosen to study should not use the balanced scorecard when you have not created the tools and platforms required for employees, civil servants and politicians to evaluate, monitor and create a living scorecard change over time. The study reveals major shortcomings in the implementation, evaluation and follow-up possibilities, and the consequence of this is that the balanced scorecard is not - 4 - preferable in municipal operations as a strategic instrument for value creation and long-term planning.

Validação do Youth Quality of Life Instrument para a população portuguesa: YQOL-R

É incontornável o estatuto que o conceito de qualidade de vida assume hoje na prática e políticas de saúde pública. Na infância e adolescência é ainda escassa a investigação, tornando-se crucial o desenvolvimento de instrumentos de qualidade vida relacionada com a saúde validados para esta população. O presente trabalho tem como objetivo fundamental analisar as qualidades psicométricas e validar a versão portuguesa do Youth Quality of Life (YQOL-R) (Patrick, et al., 2002). A amostra é constituída por 507 adolescentes, com idades compreendidas entre os 12 e os 19 anos, a frequentar o 3º ciclo do ensino básio e ensino secundário de escolas públicas do ensino regular. Para além do citado instrumento a validar, os jovens preencheram também, para a análise da validade convergente e divergente, o Kidscreen-27 (Gaspar & Matos, 2008) e a Escala da Depressão, Ansiedade e Stresse (EADS-21) (Pais-Ribeiro, Honrado & Leal, 2004). Os resultados mostram que o YQOL-R apresenta uma estrutura fatorial de quatro fatores, semelhantes à versão original americana (individual, relações sociais, ambiente e qualidade de vida em geral). Possui uma boa consistência interna e uma adequada estabilidade temporal. Mostrou correlações significativas e no sentido esperado com as variáveis em estudo. Foram igualmente encontradas diferenças de género em relação à qualidade de vida, sendo os rapazes a reportarem em média níveis mais elevados de perceção da qualidade de vida, comparativamente às raparigas. Futuros estudos devem ser realizados em amostras clínicas para confirmação dos dados. Não obstante esta limitação, o presente estudo contribuiu para a disponibilização de um novo instrumento para avaliação da qualidade de vida em crianças e adolescentes, o qual evidenciou boas propriedade psicométricas, apoiando, assim empiricamente, a sua utilização nas práticas de saúde e investigação em amostras da comunidade. / Nowadays, it´s unavoidable the status that, the concept of quality of life assumes in practices and politics of public health. In childhood and adolescence it´s weak the investigation but it´s crucial the development of instruments of quality of life related to health validated to this population. The present work has an important aim, it´s analyze the psychometric qualities and validate the Portuguese version of Youth Quality of Life (YQOL-R) (Patrick, et al., 2002). The sample consists of 507 adolescents, aged between 12 and 19 years old and they attend the 3 rd cycle of basic education and secondary education schools in villages of regular education. Apart from that instrument, teenagers fill in, also, to the analysis convergent and divergent, the Kidscreen-27 (Gaspar & Matos, 2008) and the Depression, Anxiety and Stress Scale (EADS-21) (Pais-Ribeiro, Honrado & Leal, 2004). The results show that the YQOL-R presents a factorial structure with four factors similar to original American version (individual, social relations, environment and general quality of life), presenting a good internal consistence and an adequate temporal stability. Substantial correlations showed and in the expected way with the variables in study. Have been found differences of gender related to quality of life, boys reported on average higher levels of quality of life perception, comparatively to the girls. Future studies must be performed in clinical samples to confirm the findings. In spite of this restriction, the actual study contributes to providing a new instrument to evaluate the quality of life in children and adolescents, this evidenced good psychometric properties, supported empirically its application in heath practices and investigation in community samples.