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Successively Issued by: U.S. Naval School of Aviation Medicine, Pensacola, Fla; Naval Aerospace Medical Institute

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.

Sustainable rural micro-enterprises through co- and tri-generation:review of concepts

Biomass production, conversion and utilization can be done locally with value addition to small farmers. However, new technical inputs are needed for profitable exploitation of biomass within the constraints related to land, water and skill availability and to provide higher quality of energy needed for rural industries. Trigeneration, which is generating energy simultaneously in three forms (electric power, heat for processing and refrigeration), helps in fully utilizing the stored energy in biomass and would be most appropriate for micro enterprises. This paper presents concepts in terms of trigeneration systems feasible for rural areas.

Technical and economic simulation of biomass pyrolysis processes for fuels and electricity

There is considerable concern over the increased effect of fossil fuel usage on the environment and this concern has resulted in an effort to find alternative, environmentally friendly energy sources. Biomass is an available alternative resource which may be converted by flash pyrolysis to produce a crude liquid product that can be used directly to substitute for conventional fossil fuels or upgraded to a higher quality fuel. Both the crude and upgraded products may be utilised for power generation. A computer program, BLUNT, has been developed to model the flash pyrolysis of biomass with subsequent upgrading, refining or power production. The program assesses and compares the economic and technical opportunities for biomass thermochemical conversion on the same basis. BLUNT works by building up a selected processing route from a number of process steps through which the material passes sequentially. Each process step has a step model that calculates the mass and energy balances, the utilities usage and the capital cost for that step of the process. The results of the step models are combined to determine the performance of the whole conversion route. Sample results from the modelling are presented in this thesis. Due to the large number of possible combinations of feeds, conversion processes, products and sensitivity analyses a complete set of results is impractical to present in a single publication. Variation of the production costs for the available products have been illustrated based on the cost of a wood feedstock. The effect of selected macroeconomic factors on the production costs of bio-diesel and gasoline are also given.

Energy efficient architectures and techniques for green radio access networks

Energy consumption in wireless networks, and in particular in cellular mobile networks, is now of major concern in respect of their potential adverse impact upon the environment and their escalating operating energy costs. The recent phenomenal growth of data services in cellular mobile networks has exacerbated the energy consumption issue and is forcing researchers to address how to design future wireless networks that take into account energy consumption constraints. One fundamental approach to reduce energy consumption of wireless networks is to adopt new radio access architectures and radio techniques. The Mobile VCE (MVCE) Green Radio project, established in 2009, is considering such new architectural and technical approaches. This paper reports highlights the key research issues pursued in the MVCE Green Radio project.

Retrospective reports of child feeding practices, current eating behaviors, and BMI in college students

Research concerning child feeding practices has focused on children and adolescents, and little is known about how feeding practices used in childhood relate to eating behaviors and weight status in early adulthood. We assessed college students' and their parents' retrospective reports of child feeding practices used when the students were in middle childhood. We also assessed the college students' current reports of their eating behaviors using the Dutch Eating Behavior Questionnaire (DEBQ) and the Intuitive Eating Scale (IES), and measured their current BMI. Results showed that college students' and their parents' reports about previous parental use of child feeding practices were not correlated. Parent reports of their own use of child feeding practices were more related to students' eating behaviors and BMI than were students' recollections about feeding practices used by their parents. An analysis of gender effects showed that there were positive correlations between parental child feeding practices, BMI, and emotional eating for female students. These relationships did not exist for male students. The results suggest that child feeding practices recollected by parents are linked to the development of emotional eating and weight status of women in early adulthood.

Digital Preservation and Access to Cultural and Scientific Heritage: Presentation of the KT-DigiCult-BG Project

The fast development and wide application of digital methods, combined with broadened access to the Internet and falling computing costs, have created intense interest in electronic presentation and access to cultural and scientific heritage resources. Information technologies have offered cultural institutions new opportunities for the presentation of their holdings, which are now made accessible not only to the specialists, but also to the citizens and interested parties worldwide. The paper presents an overview of the Bulgarian experience in the field of digital preservation and access and on-going work on the project “Knowledge Transfer for the Digitisation of Scientific and Cultural Heritage to Bulgaria” (MTKD-CT-2004-509754) supported by the Marie Curie programme of the FP6 of the EC.

Marl Prairie/Slough Gradients; Patterns and Trends in Shark Slough and Adjacent Marl Prairies (CERP monitoring activity 3.1.3.5), First Annual Report (2005)

The work on CERP monitoring item 3.1.3.5 (Marl prairie/slough gradients) is being conducted by Florida International University (Dr Michael Ross, Project Leader), with Everglades National Park (Dr. Craig Smith) providing administrative support and technical consultation. As of January 2006 the funds transferred by ACOE to ENP, and subsequently to FIU, have been entirely expended or encumbered in salaries or wages. The project work for 2005 started rather late in the fiscal year, but ultimately accomplished the Year 1 goals of securing a permit to conduct the research in Everglades National Park, finalizing a detailed scope of work, and sampling marsh sites which are most easily accessed during the wet season. 46 plots were sampled in detail, and a preliminary vegetation classification distinguished three groups among these sites (Sawgrass marsh, sawgrass and other, and slough) which may be arranged roughly along a hydrologic gradient from least to most persistently inundated . We also made coarser observations of vegetation type at 5-m intervals along 2 transects totaling ~ 5 km. When these data were compared with similar observations made in 1998-99, it appeared that vegetation in the western portion of Northeast Shark Slough (immediately east of the L-67 extension) had shifted toward a more hydric type during the last 6 years, while vegetation further east was unchanged in this respect. Because this classification and trend analysis is based on a small fraction of the data set that will be available after the first cycle of sampling (3 years from now), the results should not be interpreted too expansively. However, they do demonstrate the potential for gaining a more comprehensive view of marsh vegetation structure and dynamics in the Everglades, and will provide a sound basis for adaptive management.

A key role for PTP1B in dendritic cell maturation, migration and T cell activation

Acknowledgements We thank the Iain Fraser Flow Cytometry Centre and the Medical Research Facility of the University of Aberdeen. We are grateful to Drs West, Zaru, and Davidson (University of Dundee) for the scientific discussion and technical assistance. Wethank Derek Mitchell (University of Dundee) for aiding with the quantification of focal contacts. Funding This work was supported by Saving Sight in Grampian and the Development Trust of the UoA (both to J.V.F.). Work on this project was partly funded by project grants from British Heart Foundation and European Foundation for the Study of Diabetes/Lilly diabetes programme grant (to M.D.).

A key role for PTP1B in dendritic cell maturation, migration and T cell activation

Acknowledgements We thank the Iain Fraser Flow Cytometry Centre and the Medical Research Facility of the University of Aberdeen. We are grateful to Drs West, Zaru, and Davidson (University of Dundee) for the scientific discussion and technical assistance. Wethank Derek Mitchell (University of Dundee) for aiding with the quantification of focal contacts. Funding This work was supported by Saving Sight in Grampian and the Development Trust of the UoA (both to J.V.F.). Work on this project was partly funded by project grants from British Heart Foundation and European Foundation for the Study of Diabetes/Lilly diabetes programme grant (to M.D.).

Comparative genomic analysis of novel Acinetobacter symbionts : A combined systems biology and genomics approach

Acknowledgements This work was supported by University of Delhi, Department of Science and Technology- Promotion of University Research and Scientific Excellence (DST-PURSE). V.G., S.H. and U.S. gratefully acknowledge the Council for Scientific and Industrial Research (CSIR), University Grant Commission (UGC) and Department of Biotechnology (DBT) for providing research fellowship.

Digital anthropology and educational eGames: learning through behavioural patterns in digital, game-based contexts

The selected publications are focused on the relations between users, eGames and the educational context, and how they interact together, so that both learning and user performance are improved through feedback provision. A key part of this analysis is the identification of behavioural, anthropological patterns, so that users can be clustered based on their actions, and the steps taken in the system (e.g. social network, online community, or virtual campus). In doing so, we can analyse large data sets of information made by a broad user sample,which will provide more accurate statistical reports and readings. Furthermore, this research is focused on how users can be clustered based on individual and group behaviour, so that a personalized support through feedback is provided, and the personal learning process is improved as well as the group interaction. We take inputs from every person and from the group they belong to, cluster the contributions, find behavioural patterns and provide personalized feedback to the individual and the group, based on personal and group findings. And we do all this in the context of educational games integrated in learning communities and learning management systems. To carry out this research we design a set of research questions along the 10-year published work presented in this thesis. We ask if the users can be clustered together based on the inputs provided by them and their groups; if and how these data are useful to improve the learner performance and the group interaction; if and how feedback becomes a useful tool for such pedagogical goal; if and how eGames become a powerful context to deploy the pedagogical methodology and the various research methods and activities that make use of that feedback to encourage learning and interaction; if and how a game design and a learning design must be defined and implemented to achieve these objectives, and to facilitate the productive authoring and integration of eGames in pedagogical contexts and frameworks. We conclude that educational games are a resourceful tool to provide a user experience towards a better personalized learning performance and an enhance group interaction along the way. To do so, eGames, while integrated in an educational context, must follow a specific set of user and technical requirements, so that the playful context supports the pedagogical model underneath. We also conclude that, while playing, users can be clustered based on their personal behaviour and interaction with others, thanks to the pattern identification. Based on this information, a set of recommendations are provided Digital Anthropology and educational eGames 6 /216 to the user and the group in the form of personalized feedback, timely managed for an optimum impact on learning performance and group interaction level. In this research, Digital Anthropology is introduced as a concept at a late stage to provide a backbone across various academic fields including: Social Science, Cognitive Science, Behavioural Science, Educational games and, of course, Technology-enhance learning. Although just recently described as an evolution of traditional anthropology, this approach to digital behaviour and social structure facilitates the understanding amongst fields and a comprehensive view towards a combined approach. This research takes forward the already existing work and published research onusers and eGames for learning, and turns the focus onto the next step — the clustering of users based on their behaviour and offering proper, personalized feedback to the user based on that clustering, rather than just on isolated inputs from every user. Indeed, this pattern recognition in the described context of eGames in educational contexts, and towards the presented aim of personalized counselling to the user and the group through feedback, is something that has not been accomplished before.