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Adams, Michael Roy. "Development of a User Cost Estimation Procedure for Work Zones." Diss., CLICK HERE for online access, 2005. http://contentdm.lib.byu.edu/ETD/image/etd860.pdf.
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Martin, Stephen E. "Modifications to the systematic layout planning procedure to allow departmental division and irregularly shaped subdepartments." Ohio : Ohio University, 2004. http://www.ohiolink.edu/etd/view.cgi?ohiou1103141249.
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De, la Harpe Charles William Henry. "The development of a seismic risk reduction procedure for the prioritization of low cost, load bearing masonry buildings." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97014.
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Thesis (MEng)--Stellenbosch University, 2015.<br>ENGLISH ABSTRACT: The Western Cape is one of the most seismically active regions in South Africa. It features
geological properties which can develop earthquakes as large as 6.87 on the Richter scale.
This poses a serious threat to all of the buildings that are currently located within this
region.
A recent study has found that typical three-storey Unreinforced Masonry (URM) buildings
in the Cape Town area shows a high probability of failure or damage if subjected to such
a large earthquake. Many of these buildings can be found in an area of Cape Town called
the Cape Flats, housing approximately 11 000 individuals. The structural integrity of these
buildings are of concern to engineers since it houses a number of individuals.
The purpose of the study was to develop a risk assessment procedure that could be used to
assess low-rise multi-storey (2, 3 and 4 storeys) URM buildings in order to determine where
the risk of earthquake related damage would be the highest. The risk assessment procedure
compared various characteristics regarding the buildings, residents, seismic attributes of the
region and the recovery capability of the residents.
The result, in the form of a risk rating, enabled the buildings to be prioritized according to
their seismic risk. The aim was to develop a comparative model which could be applied to
a range of buildings, indicating where the impact of an earthquake would be greatest. This
result could then be used for further remedial action (such as retrofitting) where it is needed
the most.
The risk assessment procedure used an Earthquake Risk Assessment Model (ERAM) which
was specifically developed to assess the earthquake risk of each building with the use of 26
factors. These factors would each be individually scored and through the ERAM model
would produce a risk rating. The buildings' can then be ranked (prioritized) according to
it's risk rating to determine where remedial actions or procedures are needed first.<br>AFRIKAANSE OPSOMMING: Die Wes-Kaap is een van die mees seismiese aktiewe streke in Suid-Afrika. Dit bevat geologiese
eienskappe wat aardbewings met groottes van 6,87 op die Richterskaal kan laat
ontwikkel (1 in 475 jaar herhaal periode). Dit hou 'n bedreiging vir baie die geboue wat tans
in hierdie streek geleë is.
'n Onlangse studie het bevind dat tipiese drie-verdieping lasdraende steengeboue in die
omgewing van Kaapstad 'n hoë waarskynlikheid van faling of skade toon as dit blootgestel
word aan 'n groot aardbewing. Baie van hierdie geboue kan gevind word in 'n gebied van
Kaapstad genaamd die Kaapse Vlakte, wat vir ongeveer 11 000 individue behuising bied.
Die strukturele integriteit van hierdie geboue is van belang aangesien dit 'n groot aantal
individue huisves.
Die doel van die studie was om 'n risiko-evaluerings proses te ontwikkel wat gebruik kan word
om multi-verdieping (2, 3 en 4 verdiepings) lasdraende steengeboue te evalueer ten opsigte
van aardbewing verwante skade. Die risiko-evaluering proses vergelyk verskeie kenmerke van
die geboue, die inwoners, seismiese eienskappe van die streek en die vermoë van die inwoners
om terug te keer na hul alledaagse leefstyl.
Die resultaat is in die vorm van 'n risiko-gradering, wat die gebruiker in staat stel om die
geboue te prioritiseer volgens hul aardbewings risiko. Die doel was om 'n vergelykende model
te ontwikkel wat toegepas kan word om 'n verskeidenheid van geboue te evalueer, en aan
te dui waar die impak van 'n aardbewing die grootste sal wees. Hierdie resultaat kan dan
gebruik word vir verdere remediërende optrede of prosedures soos versterkings.
Die risiko-evaluerings proses gebruik 'n "Earthquake Risk Assessment Model" (ERAM) wat
spesifiek ontwikkel is om die aardbewings-risiko van elke gebou te evalueer met die gebruik
van 26 faktore. Hierdie faktore word elkeen individueel beoordeel en 'n risiko-gradering word
verkry met behulp van die ERAM model. Die geboue kan dan geprioritiseer word volgens
elkeen se risiko-gradering om te bepaal waar daar remediërende optrede nodig is.
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DAGRAMODJOPOULOS, TIFFANY. "A CASE STUDY OF THE PROCEDURE OF DEVELOPMENT OF A LARGE REAL ESTATE PROJECT IN SÃO PAULO, B RAZIL." Thesis, KTH, Bygg- och fastighetsekonomi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-77490.
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This thesis report presents the process which has been followed to develop a large real estate project in São Paulo, Brazil where the buildings remaining on the site are landmarks. The report includes an extensive case study the Matarazzo Project about which I performed the analysis of the procedure of development during my internship at SCPM – a French Project Management company. The ultimate goal of the thesis is to provide investors with brief recommendations to develop similar project in Brazil with respect of the cultural values. A French Investor intends to develop the Matarazzo Project – a large and complex real estate project in São Paulo, Brazil – on a site defined as a national and municipal landmark by public authorities, respectively CONDEPHAAT and CONPRESP, due to the remaining buildings erected from 1904 which are witnesses of the well-organized institutions of Italian immigrants. The protection of the existing buildings involved a particular procedure to apply for permits. Indeed, it implies the presentation of the project to several organs such as IPHAN, CONDEPHAAT , CONPRESP, SEHAB, SMT, DEPAVE, etc. with a list of required documents – TAC , Projeto de Restauro, Relatorió de Impacto de Vicinhenza, plans, layout, renderings, etc. Thus, to apply for building permits such a situation implies a selected numbers of particular consultants as a Legal Authorization Specialist, Retrofit Specialist, DEPAVE Specialist, Cultural Centre Specialist , lawyers, added to the stakeholders normally present during the development of a real estate project – architects, engineers, land surveyor, quantity surveyor , insurance companies, etc. The case study involved, at this stage, more than 23 entities (2 from the Direction, 3 from the Supervision, and 18 from the Executive Stakeholders) The combination of actors was such because I realized my internship at an early stage of the project – maybe the earliest. Indeed, when I started, the Master Plan had not been defined yet and the Work Cost Estimate had not been performed, even though the Project Manager already had an idea about the overall schedule and was hiring the appropriate stakeholders. By now, the Master Plan has been fixed and shares both green and brown field areas. The existing buildings will host a Retail Centre (18.000m²) surrounded by glazed roof, a Palace Hotel (10.000m²), the Chapel remains a religious place, the Paediatric will be replaced by a Village Hall (500m²). Underground constructions will be located all above the site with a Cultural Centre (18.500m²) and a Parking Lot (55.000m²). Plus, depending on the Right-to- Built, a Tower (21.000m²) will be erected near the Ponta. Consequently, in terms of time, the Project Manager forecasts the whole project to last no less than five years – including legal documents approvals and works execution. In terms of budget, a Work Cost Estimate – more or less accurate depending on the level of completion of the plans of each specific area – has been done so that the Client can start to set up the Business Plan and develop the strategy to finance the project – finding financers, operators, tenants, etc. Having work more than five months on the Matarazzo Project enables to make an analysis of what the situation had been and what it should be. It is crystal clear that mentalities and ways of proceeding between France and Brazil are different. Nothing is said but that is the role of the consultants to establish what strategy to choose, or to state things such as what is allowed to build, how to build, etc. Nothing is written either, indeed there is no code of construction, barely a Código de Obras e Edificações which define for which permit to apply depending on the work to perform. So, the spirit is ‘ do as best as you can and let’s see if will be accepted by legal authorities’. And conflict is avoided – problems are not pointed directly, they last and they became bigger putting the whole project on hold. The solution to all this has been to hire a Project Manager Assistant to work directly from there, increasing communication between France and Brazil, making researches about similar projects, and trying to keep everyone on the right track cause – due to the size of the project – minor points are often forgotten and became major points. For the future, the Project Manager starts to forecast the whole organization of the project, in particular for the detailed conception and execution phases. Regarding the work breakdown structure, to simplify communication proceeding having one representative for the architectural team and one general contractor is the favourite option despite the disadvantages it implies (information retention, increased fees for management of sub-contractor, etc.). The analysis of the procedure of development of a large real estate project in São Paulo, Brazil has resulted in future recommendations on what attention should be focused on. In short, the recommendations include the following: Being aware of local culture and local way of proceeding (steps of development, local institutions, subsequent required documents); Having a good intern organization (being aware of what is due and by who); For more details on the future recommendations, cf. chapter 6.
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Valpas, A. (Antti). "Evaluation of laparoscopic colposuspension and the tension-free vaginal tape procedure in the surgical treatment of female stress urinary incontinence." Doctoral thesis, University of Oulu, 2005. http://urn.fi/urn:isbn:9514278275.
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Though not a life threatening condition, involuntary loss of urine is a miserable situation. It has a multidimensional effect on the afflicted individuals, both men and women – and for the society. The purpose of this study was to evaluate two modern, minimally invasive surgical techniques for the treatment of female stress urinary incontinence (SUI). The techniques evaluated were laparoscopic colposuspension with mesh and staples (LCM) and the tension-free vaginal tape procedure (TVT).
The study consisted of four parts. The first part (Study I) was an observational retrospective follow-up study. Data on the first forty patients operated on with LCM at Oulu University Hospital were collected. Patients had SUI or mixed urinary incontinence (MUI) with predominantly stress incontinence. The Studies II–IV were parts of a randomized, multicenter clinical trial, where LCM was compared with TVT. According to the predefined inclusion criteria 128 SUI women were randomly allocated into two treatment groups: 70 patients received TVT treatment as allocated and 51 LCM. There were seven drop-outs after randomization.
After one year of follow-up the cure and improvement rate of the patients operated with LCM were ~ 90%. Also a significant improvement was found in Urinary Incontinence Severity Scores (UISS). At base line the score was 12.1 and after one year follow-up 2.7 (p < 0.001). The bladder perforation rate was 15%. In Study II immediate cure rates and complications of LCM and TVT were studied. After six weeks of follow-up there was no difference in cure rates (~ 90%) between the procedures. There was no difference in complication rates. A significant difference was found in the use of anti-inflammatory / opioid drugs in the immediate post-operative period to relief the pain in favour for TVT. Hospital care was also significantly shorter after TVT than LCM. After one year of follow-up (Study III) TVT was found to give better result both objectively and subjectively. Negative stress test result was recorded in 85.7% in the TVT group and 56.9% in the LCM group. A significant difference was also found, when Visual Analoque Scale (VAS), King's College Health Questionnaire (KHQ) and UISS were used as outcome measures, in the favour of TVT. When 48-hour pad test was used as outcome measure there was no statistically significant difference between the groups. The cost-effectiveness (Study IV) of TVT was found to be better than that of LCM after one year of follow-up.
In conclusion, the results of this study suggest, that TVT procedure is on the whole a cost-effective alternative for LCM in the treatment of female SUI.
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Li, Ye. "Development of a procedure for power generated from a tidal current turbine farm." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/2690.
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A tidal current turbine is a device functioning in a manner similar to wind turbine for harnessing energy from tidal currents, a group of which is called a farm. The existing approaches used to predict power from tidal current turbine farms oversimplify the hydrodynamic interactions between turbines, which significantly affects the results. The major focus of this dissertation is to study the relationship between turbine distribution (the relative position of the turbines) and the hydrodynamic interactions between turbines, and its impact on the power from a farm.
A new formulation of the discrete vortex method (DVM-UBC) is proposed to describe the behavior of turbines and unsteady flow mathematically, and a numerical model is developed to predict the performance, the unsteady wake and acoustic emission of a stand-alone turbine using DVM-UBC. Good agreement is obtained between the results obtained with DVM-UBC and published numerical and experimental results. Then, another numerical model is developed to predict the performance, wake and acoustic emission of a two-turbine system using DVM-UBC. The results show that the power of a two-turbine system with optimal relative position is about 25% more than two times that of a stand-alone turbine under the same conditions. The torque such a system may fluctuate 50% less than that of a stand-alone turbine. The acoustic emission of such a system may be 35% less than that of a stand-alone turbine. As an extension, a numerical procedure is developed to estimate the efficiency of an N-turbine system by using a linear theory together with the two-turbine system model.
By integrating above hydrodynamic models for predicting power and a newly-developed Operation and Maintenance (O&M) model for predicting the cost, a system model is framed to estimate the energy cost using a scenario-based cost-effectiveness analysis. This model can estimate the energy cost more accurately than the previous models because it breaks down turbine’s components and O&M strategies in much greater detail when studying the hydrodynamics and reliability of the turbine.
This dissertation provides a design tool for farm planners, and shed light on other disciplines such as environmental sciences and oceanography.
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Egbuna, C. Chukwudi. "An electric actuator selection aid for low cost automation." Thesis, Stellenbosch : University of Stellenbosch, 2008. http://hdl.handle.net/10019.1/1912.
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Thesis (MScEng (Mechanical and Mechatronic Engineering))--University of Stellenbosch, 2008.<br>Low Cost Automation (LCA) is of immense importance to industry, and even more so
for small scale industries. In implementing LCA determining cost effective and
efficient actuator alternatives present challenges for design engineers. Most often
decisions are experiential or entirely based on manufacturer recommendations.
Experience based decisions are most often biased with respect to the engineers’
knowledge. Similarly, manufacturer recommendations are restricted to their own
products and are as such also biased. Either way, sub-optimum drive alternatives may
sometimes be chosen. This demonstrates the need for making better informed decisions
based on more than experience and what is available for use.
This thesis reports the development of an electric actuator selection procedure and aid
for use in the early layout design phase. It provides readily accessible information on
technically viable actuator options. Experiential knowledge of experts in the field,
commercial information, as well as data obtained from experimentation was used in its
development. Being orientated towards LCA, the procedure has been targeted at the
application of electric motors and their associated control technologies but can be
extended to hydraulic, pneumatic and other actuators. In achieving a wider applicability
of the selection aid, a generic set of actuator properties descriptive of most actuators
was formulated.
An AC drives control evaluation was conducted for developing the selection procedure
and aid. It provided a means to validate some selection aid rules associated with
actuator controllability. Quantitative data on speed and positioning accuracies of
common AC three phase motors and their associated inverter technologies were the
targeted results of the experimentation.
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Puhto, T. (Teija). "The burden of healthcare-associated infections in primary and tertiary healthcare wards and the cost of procedure-related prosthetic joint infections." Doctoral thesis, Oulun yliopisto, 2018. http://urn.fi/urn:isbn:9789526219851.
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Abstract Healthcare-associated infections (HAI) are infections acquired during treatment in a healthcare facility. The most common infections are pneumonias, surgical site infections (SSIs) and urinary tract infections (UTIs). HAIs burden the healthcare system by increasing patient days, the use of antibiotics, examinations, and thus the costs of care. The occurrence of HAIs can be used to evaluate the quality of care and to make comparisons between institutions. The purpose of this dissertation was to evaluate the burden of HAIs in the primary and tertiary healthcare wards and the costs of procedure-related prosthetic joint infections (PJIs). The first part of this dissertation evaluated the prevalence of HAIs in the wards of primary healthcare in the Oulu University Hospital (OUH) district with two point prevalence studies (one-day sampling) conducted in 2006 and in 2017. In 2006, the study comprised 27 healthcare centres with 44 wards and 1,294 patients. HAIs were found in 9.3% of the patients. The most common infections were UTIs, skin and soft tissue infections and lower respiratory tract infections (LRTIs). In 2017, there were 20 healthcare centres with 34 wards and 764 patients; 9.4% of the patients had a HAI. The most common HAIs were pneumonias, SSIs and LRTIs. In the second part, we evaluated the incidence of HAIs in the OUH with a computer-based electronic infection surveillance program. The study covered 15 adult wards with a total of 353 beds. The overall incidence of HAIs during the six-year study period was 4.5% of discharged patients. The most common infections were SSIs, pneumonias and UTIs. The surveillance carried out in this way required a total of one person's workload per year. The third part evaluated hospital costs of procedure-related PJIs. The study population consisted of all total knee and hip arthroplasties performed in the OUH from 2013 to 2015: 1,768 patients with 42 PJIs. A PJI tripled the cost of a procedure compared to an arthroplasty without an infection (€25,100 vs. €7,200). Two-stage revision caused three times more costs than debridement, antibiotics and implant retention treatment (DAIR) (€53,400 vs. €18,500). HAIs are common in the wards of primary and tertiary healthcare in the OUH district. Electronic HAI monitoring is feasible but requires relatively large employer resources. Postoperative PJI triples the cost of the procedure<br>Tiivistelmä Sairaalainfektio (SI) on infektio, jonka potilas saa ollessaan hoidossa laitoksessa. Yleisimpiä SI:ita ovat leikkausalueen infektio, keuhkokuume ja virtsatieinfektio (VTI). SI:t kuormittavat terveydenhoitoa lisäämällä hoitopäiviä, antibioottien käyttöä, tutkimuksia ja näin myös hoidon kustannuksia. SI:iden määrää voidaan käyttää hoidon laadun mittarina sekä sairaaloiden väliseen vertailuun. Tämän väitöskirjan tarkoituksena oli arvioida SI:iden määrää Pohjois-Pohjanmaan sairaanhoitopiirin (PPSHP) terveyskeskusten ja Oulun yliopistosairaalan (OYS) vuodeosastoilla sekä selvittää tekonivelleikkauksen jälkeisen tekonivelinfektion (TI) aiheuttamia sairaalakustannuksia. Väitöskirjan ensimmäisessä osatyössä selvitettiin SI:iden esiintyvyyttä PPSHP:n terveyskeskusten vuodeosastoilla pisteprevalenssilla eli yhden päivän otannalla vuosina 2006 ja 2017. Vuoden 2006 tutkimuksessa oli 27 terveyskeskusta, joissa oli 44 vuodeosastoa ja yhteensä 1 294 potilasta. SI todettiin 9,3 %:lla potilaista. Yleisimpiä olivat VTI:t, pehmytkudosinfektiot ja alahengitystieinfektiot. Vuonna 2017 tutkimuksessa oli 20 terveyskeskusta, 34 vuodeosastoa ja 764 potilasta. Tällöin SI todettiin 9,4 %:lla. Yleisimmät infektiot olivat keuhkokuume, leikkausalueen infektio ja alahengitystieinfektio. Toisessa osatyössä selvitettiin OYS:n SI:iden ilmaantuvuutta kuuden vuoden ajan jatkuvan infektioseurannan mahdollistavan tietokoneohjelman avulla. Tutkimuksessa seurattiin 15:ttä aikuisvuodeosastoa, joissa oli yhteensä 353 potilaspaikkaa. SI todettiin 4,5 %:ssa hoitojaksoista. Seuranta vaati yhteenlaskettuna noin yhden hoitajan työpanoksen vuodessa. Väitöskirjan kolmannessa osatyössä selvitettiin vuosina 2013–2015 OYS:ssa tehtyjen tekonivelleikkausten jälkeisten TI:iden sairaalakustannuksia. Tutkimuksessa oli 1 768 tekonivelleikkausta, joista 42 infektoitui. Infektoitumattoman tekonivelleikkauksen sairaalakustannukset olivat keskimäärin 7 200 € ja TI:iden 25 100 €. Hoitomenetelmänä kaksivaiheisen revision eli tekonivelen vaihtohoidon hinta oli kolminkertainen tekonivelen säilyttävään hoitoon verrattuna (53 400 € vs. 18 500 €). SI:t ovat yleisiä PPSHP:n alueella sekä terveyskeskusten että OYS:n vuodeosastoilla. SI:iden seurantaohjelma soveltuu infektioseurantaan, mutta se vaatii kohtalaisesti henkilökuntaresurssia. Leikkauksen jälkeinen TI kolminkertaistaa tekonivelleikkauksen sairaalakustannukset
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Boddu, Arathi. "A procedure to evaluate the costs and benefits of managing staffing levels in an order picking operation." Ohio : Ohio University, 2006. http://www.ohiolink.edu/etd/view.cgi?ohiou1155309515.
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Dudinská, Lenka. "Preprava elektrických spotrebičov z Turecka do Českej republiky." Master's thesis, Vysoká škola ekonomická v Praze, 2013. http://www.nusl.cz/ntk/nusl-192977.
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This thesis deals with problems of transportation of goods from Turkey to the Czech Republic. The goal of this thesis is to provide a comprehensive overview of geo-political, legal and economic knowledge, which could serve as a guide for small transportation companies. The overview is divided into three parts. The first part deals with multilateral agreements governing international road transport with emphasis on the CMR Convention. The second part is devoted to customs issues, in particular transit procedure. The third part deals with transport from the economic point of view. In this part, two transportation routes are proposed, which are then analysed considering time, safety and cost.
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Zandecki, Erin Marie. "The Effects of Informational Prompts and Performance Feedback on Recyclign Behavior." Scholar Commons, 2012. http://scholarcommons.usf.edu/etd/4265.
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Recycling behavior was examined by the implementation of Informational Prompts and Performance Feedback. Prompts containing facts on recycling and waste along with group performance feedback were studied at The Florida Mental Health Institute at The University of South Florida (Tampa campus). Informational Prompts were introduced by placing informational facts about recycling and waste by 26 bins throughout the building. Performance feedback signs were placed by the same bins and included the frequency of recycled material and trash discarded in the recycling bins on a daily basis when the campus was open. The results showed that both interventions increased recycling. Informational Prompts showed an increase in recycling and a decrease in trash placed in the recycling bin. Performance Feedback showed a stronger increase in recycling when compared to Informational Prompts. The combination of the two produced a significant increase in the amount of recyclable material placed in the recycling bins and a decrease in the waste placed in the recycling containers.
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Ronchini, Michele. "A comparative analysis of seismic design strategies for R.C. frame structures." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2015. http://amslaurea.unibo.it/8549/.
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Negli ultimi anni sono state sviluppate varie soluzioni tecniche per la progettazione sismica di strutture. Questa ricerca sviluppa un metodo di confronto basato sull'analisi di costi di costruzione e danni causati dal sisma. Il metodo viene applicato al caso di studio della scuola di Bisignano (CO, Italia). L'edificio è stato progettato conformemente alle NTC 2008 con approccio tradizionale e combinando il contributo di dissipatori viscosi e dissipazione isteretica. Le strutture vengono poi analizzate sotto diverse condizioni sismiche al fine di calcolare i costi di riparazione attesi e comprendere quale soluzione tecnica risulti più economicamente vantaggiosa a parità di azione sismica di progetto.
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Lundberg, Sofia. "Going once, going twice, SOLD! : the economics of past and present public procurement in Sweden." Doctoral thesis, Umeå universitet, Institutionen för nationalekonomi, 2001. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-73622.
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This thesis is about the economic aspects of public procurement of services through auctionsin Sweden. It focuses on two different institutions, auctions used to find foste r-parents forboarded out children in the 19th century, and auctions of cleaning service contracts in the 20 thcentury. I n both cases, the contracting entity is the municipality or its representative, thelowest bidder wins the auction, and is paid in accordance with his/her bid.In the child auctions, c hildren were allotted to foster-parents by means of an open biddingprocess, the descending English auction, where the bids were given continuously to theauctioneer. In modern public procurement sealed bids ar e used in accordance with the firstprice,sealed bid auction. The first part of this thesis is about price formation in the childauctions and a study is made of the children who were auctioned several times, indicatingasymmetric information among bidders or adverse selection in this market. These subjects arestudied using field data on 601 child auctions held in Northern Sweden during the period 1863to 1889. The empirical findings in the first paper suggest that the foster-parents had a cleareconomic motive in these auctions. The child characteristics significantly affect the amount ofcompensation paid to the foster-parent. There is also evidence that farmers preferred older,more productive children. The second paper studies whether a re-auctioned child commandeda higher or lower price than a child that was not re-auctioned. The results indicate some formof asymmetric information because foster-parents demanded a higher level of compensationfor a re-auctioned child. The results also suggest that the probability that a child was reauctionedincreased if he/she was not healthy.The third paper in the thesis discusses a kind of "paradox". Although there is a competitiveeffect on the bids in the auction of cleaning service contracts, the contracting entity has anoption, given by law, to restrict the number of bidders. In th is paper, an implementation costis introduced fo r the contracting entity to justify such a restriction. The results, based onSwedish municipality data, indicate that contract and municipality characteristics, assumed toaffect the implementation cost, affect the volume of the procurement, and the number ofbidders, but not necessarily the choice of allocation mechanism. The final paper studiesregional differences in bids, costs, and competition in municipal procurement using the samedata as in paper [3]. The results show higher estimated costs for completing the contract, butlower estimated mean bids in the major city area of Stockholm compared with the res t of thecountry. This is explained by lower profit margins and higher operational costs in the majorcity area. An analysis is also carried out of why the lowest bidder is not always the contractedbidder.<br><p>Härtill 4 delar.</p><br>digitalisering@umu
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Olsson, Helen, and Linda Nääs. "Hur skiljer sig avstyckning i Sverige och Norge? : En jämförelse avseende process, tidsåtgång, kostnader, nyttjande av teknik och digitalisering." Thesis, Högskolan i Gävle, Samhällsbyggnad, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-33189.
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Avstyckning är en fastighetsbildningsåtgärd där en fastighet nybildas. Det innebär att en bit mark avskiljs från en fastighet och på så sätt bildar en ny egen fastighet. Fastigheten som avstyckningen sker från heter stamfastighet, och den som nybildas heter styckningslott (Julstad, 2018). Syftet med detta arbete är att se om fastighetsbildningsprocessen för avstyckning kan göras effektivare genom att jämföra den med Norges process för avstyckning. Aspekterna som jämförs är processens genomförande, tidsåtgång och kostnader samt nyttande av teknik och digitalisering. Kvalitativa metoder har använts genom litteraturstudier, intervjustudier och fallstudie. Semistrukturerade intervjuer utförs med förrättningslantmätare och en som jobbar med utvecklingsfrågor inom fastighetsbildning på Lantmäteriet. Från Norge har fyra personer intervjuats från olika kommuner som jobbar med matrikkelföring och oppmåling. Fallstudien utförs genom att granska förrättningsakter, en från Östersund, Sverige och en från Bodø, Norge. Jämförelsen visar mer skillnader än likheter. De största skillnaderna är att i Sverige är staten myndighetsutövare, men i Norge är det kommunen. Tillvägagångssätten för en avstyckning ser olika ut på grund av de privaträttsliga förhållandena som fortfarande styr mycket av den norska fastighetsbildningen. En iakttagelse är att juridiken är en faktor som gör att fastighetsbildningsprocessen går långsamt eftersom ärendet ska gå igenom flera rättsled. Juridiken har också en påverkan i utvecklingen av digitalisering. En annan stor skillnad är att Norge inte har någon lämplighetsprövning, vilket gör att processen går snabbare. Utifrån jämförelsen har idéer uppstått om hur avstyckningsprocessen i Sverige skulle kunna effektiviseras. Några av idéerna är kortare överklagandetid, bättre kommunikation mellan parter och utveckling av digitalisering.<br>Subdivide is a property formation measure where a new property unit is created. A bit of land separates from the main property unit and a new property is created. The main property who the new unit is subdivided from is called residual property unit, and the new property is called a lot (Julstad, 2018). The main purpose of the paper is too having a look if Sweden’s cadastral procedure can in one way or another become more efficient in the area of subdividing by compare it with Norway’s subdividing process. The goal is to see what the similarities and differences are, and from that view somehow benefit and use it to streamline the time of the process. The main focus of the study’s is to go deeper in the areas of the process, expenditure of time, procedure costs, the use of technique and digitalization. Qualitative methods have been used by literature reviews, an interview study and a case study. Semi-structured interviews have been made, one interview with a cadastral surveyor and one with a person who is working with development issues about property formation at the executory authorly. Four people from Norway have been interviewed from different counties who is working with property formation. The case study was executed by reviewing two cadastral dossiers, one from Östersund, Sweden and one from Bodø, Norway. From the comparison of the subdividing process a few main things are clear. One conclusion of the comparison is that there’re more differences than similarities between the two countries. In Sweden it is the state who is performing the exercise of authority, in Norway it is the municipality. The course of action for a subdividing looks different because of the private legal matter that is conducted in Norway’s property formation. A factor that slows down the subdividing process in Sweden is the legal matter. When subdividing a property, the case must follow the laws who governs. This process can in some cases take time. The development of digitizing is also affected of the legal matter, it must go hand in hand. In Norway they don’t perform the adjudicate of suitability, and that reduces the subdividing process a lot. Ideas on how to effectivity Sweden’s subdividing process have arisen from the comparison of the two countries. Some of the ideas that have been brought up are shorter appeal time, better communication between the persons involved and the development of digitalization.
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Hermansson, Hélène. "Ethical aspects of risk management." Licentiate thesis, KTH, Philosophy and History of Technology, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-3948.
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<p>The subject of this thesis is ethical aspects of risk management. It is argued that a model for risk management needs to be developed that acknowledges several ethical aspects and most crucial among these, the individual’s right not to be unfairly exposed to risks.</p><p><i>Article </i>I takes as its starting point the demand frequently expressed in the risk literature for a consistent risk management. Such consistency is often assumed to be in accordance with some kind of cost-benefit analysis. It is maintained that such a model, here called the Standard Model, does not respect the rights of the individual. Two alternative models are outlined in order to better deal with this ethical weakness, the Model of Inviolable Rights and the Model of Procedural Justice. The arguments in the alternative models evolve around the separateness of individuals, rights and fair risk taking. It is claimed that the latter model, which focuses on a fair procedure, seems most fruitful to develop.</p><p><i>Article II</i> is a discussion of the NIMBY (Not In My Backyard) conflict, which is well known from situations of siting potentially risky facilities. Of special concern is to investigate what the ethical premises are behind the negative characterization of the NIMBY concept. It is argued that, contrary to the assumption that the total benefit should outweigh the individual’s cost, individuals in siting scenarios have rights not to be unfairly exposed to risks.</p><p><i>Article III</i>, which is co-authored with Professor Sven Ove Hansson, presents a three party model as a tool for ethical risk analysis. It is argued that ethical dimensions need to be acknowledged in the analysis of risks and that this is best done through a discussion of three parties that are involved in risk decisions – the risk-exposed, the beneficiary, and the decisionmaker. Seven crucial ethical questions are recognized and discussed regarding the relation between these parties. By using examples from the railway sector it is shown how the questions can be used to identify salient ethical features of risk management problems.</p>
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Onukogu, Dr Claret. "Streamlining Hospital Administrative Procedures to Reduce Costs." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4810.
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Americans spent nearly $2.6 trillion, or $8,000 per person for medical and administrative costs in 2010. By 2015, healthcare spending in the United States increased to 5.8% reaching $3.2 trillion or $9,990 per individual. By tackling healthcare administrative costs, it is estimated that healthcare providers could reduce these costs by $20 billion yearly. This case study explored strategies for streamlining hospital administrative procedures to reduce costs. The business process reengineering model formed the conceptual framework for this study. Data were gathered through semistructured face-to-face interviews guided by open-ended questions with a purposeful sample of 4 hospital managers in Atlanta, Georgia. This study identifies important themes regarding cost reduction and hospital administration based on participant interviews. Themes included participants' unfavorable perspectives of the Spell out PPACA (PPACA) legislation, employment of physicians, PPACA reimbursement method, follow-up services, hospital administrative governance, and lack of business education. The themes comprised steps hospital managers could take to streamline administrative procedures to reduce costs. The implications for positive social change included the potential to provide strategies for streamlined processes that could lead to savings passed on to patients from low socio-economic backgrounds through accessibility to affordable healthcare services.
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Garg, Amit. "Three Essays in Parallel Machine Scheduling." Case Western Reserve University School of Graduate Studies / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=case1196441940.
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SaÌnchez, Manuel. "Optimisation of tolerances and manufacturing procedures for aircraft surface features." Thesis, Queen's University Belfast, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.343087.
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Buzaianu, Elena Mihaela. "Selection procedures for binomial populations." Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2006. http://proquest.umi.com/login?COPT=REJTPTU0NWQmSU5UPTAmVkVSPTI=&clientId=3739.
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Rojas, Paico Danny Hubert. "A new procedure for history matching naturally fractured reservoirs /." May be available electronically:, 2008. http://proquest.umi.com/login?COPT=REJTPTU1MTUmSU5UPTAmVkVSPTI=&clientId=12498.
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Murphy, Douglas M. "Nonparametric cost evaluation of the Department of Defense's small parcel shipping procedures." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1995. http://handle.dtic.mil/100.2/ADA304335.
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Wildermuth, Jessica Leigh. "The application of Federal and Texas state sentence ranges in a consider-the-opposite paradigm can the magnitude of bias in sentencing decisions be reduced? /." To access this resource online via ProQuest Dissertations and Theses @ UTEP, 2008. http://0-proquest.umi.com.lib.utep.edu/login?COPT=REJTPTU0YmImSU5UPTAmVkVSPTI=&clientId=2515.
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Ganesh, Vijay. "Decision procedures for bit-vectors, arrays and integers /." May be available electronically:, 2007. http://proquest.umi.com/login?COPT=REJTPTU1MTUmSU5UPTAmVkVSPTI=&clientId=12498.
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Tiano, Jennifer D. "Managing classroom behavior of Head Start children using response cost and token economy procedures." Morgantown, W. Va. : [West Virginia University Libraries], 2004. https://etd.wvu.edu/etd/controller.jsp?moduleName=documentdata&jsp%5FetdId=3651.
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Thesis (M.A.)--West Virginia University, 2004.<br>Title from document title page. Document formatted into pages; contains iv, 106 p. : ill. Includes abstract. Includes bibliographical references (p. 53-61).
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Rubinfeld, Rachel Emily. "Instituting trade : procedures, rules and negotiations under the GATT /." May be available electronically:, 2009. http://proquest.umi.com/login?COPT=REJTPTU1MTUmSU5UPTAmVkVSPTI=&clientId=12498.
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Posada, Jarred L., and David E. Caballero. "Item unique identification capability expansion: established process analysis, cost benefit analysis, and optimal marking procedures." Thesis, Monterey, California: Naval Postgraduate School, 2014. http://hdl.handle.net/10945/44647.
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Approved for public release; distribution is unlimited<br>The purpose of this Master of Business Administration project is to identify possible expansion capabilities, by researching the most cost-effective two-dimensional barcode technology known as an item unique identification that will allow for tracking Department of the Navy assets from cradle to grave. While the Navy is not 100 percent complete, the Office of the Under Secretary of Defense for Acquisition, Technology, and Logistics mandated that all new tangible and legacy items over $5,000 and/or serially managed, mission critical, or controlled by inventory, must be serialized and registered by 2010. There are two methods that the Navy can use to mark such items: intrusive and nonintrusive. For legacy items, the best method to mark an item would be nonintrusive, due to the criticality of maintaining the integrity of the item for safety reasons. Thus, it was determined that the best marking procedure for legacy items would be metal foil tags, generated by a contracting company, since they are the most cost-effective, nonintrusive marking method.
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QUINTELLA, FERNANDO FERREIRA. "CASE STUDY: COST-EFFECTIVENESS OF ENOXAPARIN FOR PROPHYLAXIS IN CANCER PATIENTS SUBMITTED TO SURGICAL PROCEDURES." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2009. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=15764@1.
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PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO<br>Este estudo de caso tem o objetivo de avaliar a introdução de uma
tecnologia em saúde, a enoxaparina 40 mg, na profilaxia de eventos
tromboembólicos em pacientes com câncer elegíveis para cirurgia. Antes de
realizar o estudo de caso, devido à falta de um modelo brasileiro sobre avaliação
de tecnologia em saúde, realizou-se uma revisão na literatura sobre este tema,
fundamentando-se a estrutura utilizada no estudo de caso.Para a realização do
estudo de caso, desenvolveu-se uma simulação baseado em dois modelos de
Markov, o primeiro simulando o avanço dos pacientes que realizam a profilaxia e
o segundo o grupo de controle, ambos durante um período de dois anos. Os dados
de eficácia foram obtidos de uma revisão da literatura, e os custos de tratamento
foram modelados e obtidos através de profissionais do Instituto Nacional do
Câncer (INCA). O resultado do estudo demonstra que o uso da enoxaparina 40
mg, quando comparado com a ausência de profilaxia, é um tratamento dominante,
pois oferece maior benefício de saúde com menor custo.<br>The aim of this case study was to evaluate the introduction of a health
technology, the enoxaparin 40 mg, for prolonged thrombosis prophylaxis in
cancer patients submitted to surgical procedures in Brazilian socioeconomic
policies. Before the case study, due to lack of a Brazilian model of evaluation of
health technologies. A review was made in this subject to create the frame used in
the case study. The study create two Markov models to simulate the evolution of
the patients using enoxaparin 40 mg for prophylaxis versus the control group,
during a period of 2 years. The benefits inputs were obtained with a literature
review, the treatment cost were developed with the help of professionals of the
Brazilian National institute of Cancer (INCA). The study result show that the use
of enoxaparin 40 mg when compared with no prophylaxis is a dominant treatment
as it offers greater health benefits at lower cost.
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Rivey, Darren. "A practical method for incorporating Real Options analysis into US federal benefit-cost analysis procedures." Thesis, Massachusetts Institute of Technology, 2007. http://hdl.handle.net/1721.1/43102.
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Thesis (S.M.)--Massachusetts Institute of Technology, System Design and Management Program, 2007.<br>Includes bibliographical references (p. 77-83).<br>This research identifies how Real Options (RO) thinking might acceptably and effectively complement the current mandates for Benefit-Cost Analysis (BCA) defined by the Office of Management and Budget (OMB) in Circular A-94. The research examines opportunities for improving economic analysis using mandated rules for a large complex system, highlights where improvements can be made with RO thinking, and proposes a framework that can be optionally and generically applied to mandated decisionmaking guidelines. The framework relies on a simple spreadsheet analysis that is augmented with Monte-Carlo simulation. The proposed approach complements existing practices and should be easy to integrate with current tools, procedures, staff, and resources.This approach builds upon a careful analysis of Federal mandates for benefit-cost analyses, the implementing directions of the OMB, and the way these guidelines are followed by practitioners who have to deal with the particularities that exist in the field. The current practice was determined by examining several case studies of work for the Federal Aviation Administration (FAA) and through discussions with FAA officials knowledgeable about the BCA methods in practice. The proposed approach with FAA Airport Benefit-Cost Analysis Guidelines was applied to a Hypothetical Project for illustrative purposes.<br>by Darren Rivey.<br>S.M.
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DeCaro, Daniel Anthony. "The Cost of Coercion: Decision Utility as a Function of both Decision Procedures and Outcomes." Miami University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=miami1281026603.
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Olesnevich, Craig. "Evaluation of the United States Coast Guard's remote network access procedures." Menomonie, WI : University of Wisconsin--Stout, 2005. http://www.uwstout.edu/lib/thesis/2005/2005olesnevichc.pdf.
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Borghi, Corrado <1979>. "Procedura di progettazione di protesi a basso costo per l'arto inferiore." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2009. http://amsdottorato.unibo.it/1828/.
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L'attività di ricerca descritta in questa tesi fornisce linee guida per la progettazione di arti protesici inferiori, con particolare riferimento alla progettazione di protesi a basso costo. La necessità di efficienti protesi a basso costo risulta infatti sentita nei Paesi in via di sviluppo ma anche dalle fasce meno abbienti dei paesi occidentali.
Al fine di comprendere le strategie adottate dall'apparato locomotorio per muoversi con le protesi sono analizzati il cammino fisiologico, le protesi presenti sul mercato ed infine le modalità con cui le loro prestazioni sono valutate.
Con il presente lavoro, dopo aver osservato la presenza di una scarsa strutturazione della metodologia di progettazione che riguarda specialmente il settore del basso costo, si propone una metodologia il più possibile oggettiva e ripetibile tesa ad individuare quali sono gli aspetti essenziali di una protesi per garantire al paziente una buona qualità di vita. Solo questi aspetti dovranno essere selezionati al fine di ottenere la massima semplificazione della protesi e ridurre il più possibile i costi.
Per la simulazione delle attività di locomozione, in particolare del cammino, è stato elaborato un apposito modello spaziale del cammino. Il modello proposto ha 7 membri rigidi (corrispondenti a piedi, tibie, femori e bacino) e 24 gradi di libertà. Le articolazioni e l'appoggio dei piedi al suolo sono modellati con giunti sferici. La pianta del piede consente tre possibili punti di appoggio.
I criteri di realizzazione delle simulazioni possono comprendere aspetti energetici, cinematici e dinamici considerati come obiettivo dall'apparato locomotorio.
In questa tesi vengono trattati in particolare gli aspetti cinematici ed è mostrata un'applicazione della procedura nella quale vengono dapprima identificati i riferimenti fisiologici del cammino e quindi simulato il cammino in presenza di una menomazione al ginocchio (eliminazione della flessione in fase di appoggio).
Viene quindi lasciato a sviluppi futuri il completamento della procedura e la sua implementazione in un codice di calcolo.<br>Inexpensive and efficient prostheses are needed both for developing and Western countries. The research activity described in this thesis aims at providing guidelines for the development of lower limb prostheses, referring in particular to the design of low cost prostheses.
Physiological gait, commercial prostheses and prostheses evaluation methods are analyzed in order to understand the strategies adopted by the human locomotion system to walk with such artificial devices.
This work outlines a lack of systematic approaches for the design prostheses, in particular for the low cost ones. This lack is overcome by suggesting a metodology, which is as much objective and repeatable as possible, oriented to the definition of the essential aspects that provide the patient with a good quality of life. Only these aspects should be selected to design the low cost prostheses, i.e. in order to obtain the maximum simplification and thus the maximum cost reduction.
A model for the simulation of gait has been implemented. The spatial model presented is made up of 7 rigid members (correspondent to feet, shanks, thighs and pelvis) and has 24 degrees of freedom. The articular joints and the contact of the foot with ground are modeled as spherical joints. The foot sole allows three different supporting points. The simulations are executed utilizing criteria that consider the energetic, kinematic and dynamic issues as addressed by the locomotion system.
An application of the procedure is shown. The identification of the kinematic physiological parameters and the simulation of a maimed gait (without stance knee flexion) are presented.
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Charpin, Ariane. "Essays on decision theory and economic efficiency." Thesis, Paris 1, 2019. http://www.theses.fr/2019PA01E009/document.
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Cette thèse de doctorat s’intéresse à deux thèmes distincts : la prise de décision en situation de risque et l’efficacité économique. Ces deux questions sont traitées dans un cadre empirique en utilisant des bases de données uniques. Le premier chapitre teste les modèles théoriques de décision en situation de risque sur des données réelles de paris hippiques pour identifier la théorie qui permet la meilleure description des choix des individus. Ce chapitre montre que les théories comportementales de la décision en situation de risque (théorie des perspectives cumulées et modèle de l’utilité dépendante du rang) sont mieux adaptées pour expliquer le comportement des parieurs observé dans les données que la théorie de l’utilité espérée. Le second chapitre estime l’effet d’une concentration entre deux grandes entreprises du secteur des transports urbains en France sur leurs coûts. Les résultats obtenus mettent en évidence que la fusion n’a pas entraîné de gains d’efficacité pour les parties à la fusion. Ce résultat s’explique notamment par le contexte dans lequel la fusion a été menée, en particulier les raisons du choix de la cible, la perception des clients et des employés de la fusion, les différences de culture entre les entreprises et la préparation opérationnelle de l’opération. Le troisième chapitre examine l’impact d’une plus grande discrétion dans les procédures d’appels d’offres sur la sélection des opérateurs, en particulier leur productivité. Le résultat principal est que la procédure qui accroît potentiellement le pouvoir discrétionnaire des acheteurs publics conduit à la sélection d’entreprises moins efficaces qu’une procédure n’impliquant pas ou peu de discrétion. Nos analyses complémentaires suggèrent que le résultat s’explique par l’effet d’une plus grande discrétion à l’étape de sélection des entreprises<br>This doctoral thesis focuses on two distinct themes: decision-making in situations of risk and economic efficiency. These two questions are treated in an empirical framework using unique databases. The first chapter tests the theoretical models of decision under risk on bets on horseraces to identify the theory that allows the best description of individuals’ choices. This chapter shows that behavioral theories of decision under risk (cumulative prospect theory and rank-dependent utility) are better suited to explain the behavior of bettors observed in the data than the expected utility theory. The second chapter estimates the effect of a merger between two large companies in the urban transport sector in France on their costs. The results show that the merger did not result in efficiency gains for the merging parties. This result can be understood in light of the context in which the merger was conducted, in particular the reasons for the choice of the target, the perception of customers and employees of the merger, the differences in culture between the companies and the operational preparation of the merger. The third chapter examines the impact of greater discretion in tendering procedures on the selection of operators, particularly their productivity. The main result is that the procedure that potentially increases the discretion of public purchasers leads to the selection of less efficient companies than a procedure involving little or no discretion. Further analyzes suggest that the result is due to the effect of greater discretion at the screening stage
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Cardoso, Marco Antônio. "Development and application of reduced-order modeling procedures for reservoir simulation /." May be available electronically:, 2009. http://proquest.umi.com/login?COPT=REJTPTU1MTUmSU5UPTAmVkVSPTI=&clientId=12498.
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Barwell, Lauriston. "Integrity assessment procedure for buffer dune systems on the Cape South Coast, South Africa." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/6524.
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Thesis (MScEng (Civil Engineering))--University of Stellenbosch, 2011.<br>ENGLISH ABSTRACT: The hypothesis postulated in this research, namely that the effectiveness of natural and
constructed buffer dune systems can be assessed by a set of indicators that defines the
integrity of the dune system and triggers informed management decisions, was evaluated
and proved to be essentially true.
Two key objectives, namely (1) the identification of key indicators that define the buffer
dune integrity; and (2) the development of a scientifically defendable and practical
checklist-based method of gathering qualitative information on the identified key indicators
so as to guide decision-making at municipal level formed the core of the study.
The six dune integrity indicators that collectively define the risk profile of a particular site
along the Southern Cape coastline are (1) the degree of protection from prevailing wave
energy, (2) the characteristics of the dominant winds and sand supply during the dry
season, (3) the relative height of the foredune, (4) the degree of pressure on the buffer
dune due to humans, (5) the vulnerability of the type of coastline to erosion, and (6) the
coastline stability considering the prevailing coastal processes.
The first two indicators relate to the natural (permanent) characteristics of the site and can
be defined by experts and presented in the form of a risk and vulnerability atlas layer for
direct use by non-experts. The third and fourth indicators relate directly to the
implementation of proactive assessment and appropriate management actions to ensure a
high level of buffer dune integrity. The last two indicators allow for management
intervention to reduce the vulnerability but may entail costly engineering solutions and
require expert input.
A conceptual risk profile assessment procedure and a decision support guideline
incorporating these indicators were developed and evaluated for relevance and practicality
through a series of workshops with municipal officials along the south coast of South Africa.
It was seen that although some initial basic training may be required, carrying out rapid
assessments of the environmental status of key components of an identified human–nature
system, such as a buffer dune, is practical and achievable by non-experts.<br>AFRIKAANSE OPSOMMING: Die hipotese wat in hierdie navorsing gepostuleer is, naamlik dat die doeltreffendheid van
natuurlike en geboude bufferduinstelsels geassesseer kan word deur ’n stel aanwysers wat
die integriteit van die duinstelsel bepaal en ingeligte bestuursbesluite tot gevolg het, is
getoets en bewys hoofsaaklik waar te wees.
Twee sleuteldoelwitte, naamlik (1) die identifisering van sleutelaanwysers wat die
bufferduinintegriteit bepaal; en (2) die ontwikkeling van ’n praktiese kontrolelys-gebaseerde
metode wat wetenskaplik verdedigbaar is om kwalitatiewe inligting oor die geïdentifiseerde
sleutelaanwysers in te samel ten einde besluitneming op munisipale vlak te bevorder, vorm
die kern van die studie.
Die ses duin-integriteitsaanwysers wat gesamentlik die risikoprofiel van ’n bepaalde terrein
langs die kuslyn bepaal, is (1) die graad van beskerming teen die heersende golfenergie,
(2) die kenmerke van die dominante winde en sandbron gedurende die droë seisoen, (3)
die relatiewe hoogte van die voorduin, (4) die graad van druk op die bufferduin as gevolg
van mense, (5) die eroderingskwesbaarheid van die soort kuslyn, en (6) die kuslynstabiliteit
met inagname van die kusprosesse.
Die eerste twee aanwysers het betrekking op die natuurlike (permanente) eienskappe van
die terrein en kan deur kundiges bepaal word en in die vorm van ’n kaart in ’n risiko-enkwesbaarheidsatlas
aangebied word vir direkte gebruik deur niedeskundiges. Aanwysers 3
en 4 hou direk verband met die implementering van tydige en deurlopende proaktiewe
assessering en gepaste bestuursaksies om ’n hoë vlak van bufferduinintegriteit te verseker.
Aanwysers 5 en 6 bevorder bestuursaksies om kwesbaarheid te verminder, maar kan
moontlik duur ingenieursoplossings inhou en kundige insette benodig.
’n Konseptuele risikoprofielassesseringsprosedure en ’n besluitondersteuningsriglyn wat die
aanwysers insluit, is ontwikkel en geëvalueer vir toepaslikheid en uitvoerbaarheid deur ’n
reeks werkswinkels met munisipale amptenare aan die suidkus van Suid-Afrika. Hoewel
aanvanklike basiese opleiding nodig kan wees, bly dit dat vinnige assessering van die
omgewingstatus van sleutelkomponente van ’n geïdentifiseerde mens–natuurstelsel, soos ‘n
bufferduin, prakties en haalbaar deur niedeskundiges is.
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Giblin, Melissa S. "Implementation of Differential Reinforcement of Other Behavior and Response Cost Procedures in Children with Down Syndrome." Scholar Commons, 2019. https://scholarcommons.usf.edu/etd/7795.
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There is some discrepancy on how differential reinforcement of other behavior (DRO) and response cost (RC) affect responding within the context of token economies. We evaluated DRO and two variations of response cost with and without verbal feedback to decrease response errors in the context of academic skills for three children diagnosed with Down syndrome. The results suggest that a token economy intervention alone, with or without verbal feedback, was not effective for 2 of 3 participants. Gestural prompting was required to reduce response errors for those 2 participants and is possibly responsible for reducing response errors for the third participant.
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McIntyre, Diane. "A cost-effectiveness analysis of the tuberculosis control procedures applied in the Cape Divisional Council area." Master's thesis, University of Cape Town, 1987. http://hdl.handle.net/11427/14384.
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Bibliography: leaves 215-226.<br>This study evaluates the costs and effectiveness of preventive and curative procedures currently available for Tuberculosis (TB) control purposes. The procedures examined are as follows : i) BCG vaccinations; ii) Secondary chemoprophylaxis; iii) Health education; iv) Mass screening campaigns; v) Investigation of contacts of infectious TB cases and symptomatic persons, i.e. suspects; and vi) Treatment regimens for notified TB patients. The analysis is largely based on data from the records of 300 randomly selected TB patients, treated at clinics in the Cape Divisional Council area in 1983. The major finding of this study is that resources available for TB control should be reallocated in the direction of secondary chemoprophylaxis, BCG vaccination administration in the Black and Coloured populations, investigation of contacts and suspects, and ambulatory treatment of notified TB patients. Conversely, vaccinating the White population, mass screening campaigns and hospitalisation of TB patients should be given relatively less emphasis in the overall TB control programme. In addition, the proportion of patients confirmed as TB cases by means of bacteriological examinations should be increased to reduce misdiagnosis.
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Duchesne, Léa. "Prise en charge de l'hépatite C dans les pays à ressources limitées en santé : quels outils et quelles stratégies diagnostiques ? HCV Ag quantification as a one-step procedure in diagnosing chronic hepatitis C infection in Cameroon : the ANRS 12336 study Model-based cost-effectiveness estimates of testing strategies for diagnosing hepatitis C virus infection in people who use injecting drugs in Senegal." Thesis, Sorbonne université, 2019. http://www.theses.fr/2019SORUS198.
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L’arrivée sur le marché en 2011 de nouveaux traitements de l’hépatite C – les antiviraux à action directe (AAD) – bien plus efficaces et mieux tolérés que leurs prédécesseurs ont rendu l’élimination de cette dernière envisageable. Le prix élevé des AAD ainsi que le faible taux de diagnostic de l’hépatite C dans le monde ont cependant limité le nombre de personnes ayant pu en bénéficier jusqu’à présent. Dans les pays à revenu faible et intermédiaire (PRFI) où vivent 72% des personnes atteintes d’hépatite C chronique dans le monde, seules 6% d’entre elles auraient été diagnostiquées. L’Organisation Mondiale de la Santé (OMS) a appelé à diagnostiquer 30% et 90% des cas d’hépatite C chronique dans le monde respectivement d’ici à 2020 et 2030. Les méthodes de référence pour le diagnostic de l’hépatite C sont la détection d’anticorps anti-VHC et la quantification de l’ARN du VHC. Ces méthodes sont onéreuses et requièrent un personnel hautement qualifié ainsi que de lourdes infrastructures. Étant donné que les PRFI disposent de ressources financières et matérielles restreintes, ces méthodes y sont peu disponibles. Atteindre les objectifs de l’OMS dans ces pays implique donc de simplifier, de décentraliser et de rendre abordable le diagnostic de l’hépatite C dans les PRFI. Cette thèse a eu pour objectif d’identifier des outils pouvant permettre de répondre à ces enjeux. Pour cela, trois axes d’étude ont été développés. Une première étude menée sur un grand nombre d’échantillons sanguins camerounais nous a permis de valider les performances diagnostiques de la quantification de l’antigène de capside du VHC (AgC), une technique de confirmation virémique alternative à la détection de l’ARN du VHC, avec une sensibilité de 95,7%, une spécificité de 99,7% et une aire sous la courbe de 0,99. À la suite de ce premier travail, plusieurs études évaluant les performances de divers outils diagnostiques autres que la quantification de l’AgC ont été publiées. À partir des données de ces dernières, nous avons mené deux études médico-économiques dans le but d’identifier parmi ces outils ceux qui offriraient le meilleur rapport coût-efficacité pour renforcer le diagnostic de l’hépatite C. Ces deux études portaient sur deux contextes différents : d’une part la population d’usagers de drogues injectables de Dakar au Sénégal et, d’autre part, les populations générales de trois pays d’Afrique sub-Saharienne. Dans les deux cas étudiés, combiner la détection des anticorps anti-VHC par un test portatif appelé « point-of-care » (POC) et la détection de l’ARN du VHC – grâce soit à un test POC, soit à un test de laboratoire effectué sur un échantillon de sang prélevé sur papier buvard (un type d’échantillons pouvant être transportés à température ambiante) ‒, était plus coût-efficace que les autres stratégies proposées. Notre critère d’efficacité ne permettant pas de se référer à un seuil de coût-efficacité de référence, il n’a cependant pas été possible de définir laquelle de ces deux stratégies il serait préférable de mettre en place dans chaque contexte. Par ailleurs, dans le cas de la population générale, nos estimations de budget pour atteindre les objectifs de l’OMS dans les trois pays étudiés indiquent qu’il est peu vraisemblable qu’ils soient atteints aux dates visées sans une baisse des prix des tests diagnostiques ou une augmentation des ressources financières disponibles. Bien que représentant un véritable progrès vers la décentralisation du diagnostic, les tests POC actuels comportent certaines limites techniques pouvant restreindre leur potentiel. Une revue de la littérature sur les innovations diagnostiques a montré qu’une grande variété de solutions techniques pouvant permettre de dépasser ces limites étaient en cours de développement, pour certaines à un stade avancé. Plusieurs barrières empêchent cependant leur diffusion commerciale<br>The advent in 2011 of new hepatitis C treatments, direct-acting antivirals (DAAs), much more effective and better tolerated than their predecessors, made the elimination of hepatitis C conceivable. However, the high cost of DAAs combined to the low diagnosis rate of hepatitis C worldwide have limited the number of people who have been able to benefit from it so far. In low- and middle-income countries (LMICs) where 72% of people with chronic hepatitis C live worldwide, only 6% of them have been diagnosed. The World Health Organization (WHO) has called for the diagnosis of 30% and 90% of chronic hepatitis C cases worldwide by 2020 and 2030, respectively. The reference methods for the diagnosis of hepatitis C are the detection of anti-HCV antibodies and the quantification of HCV RNA. These methods are expensive and require highly qualified personnel as well as heavy infrastructure. Given the limited financial and material resources of LMICs, these methods are not readily available in these countries. Thus, achieving the WHO objectives in these countries implies simplifying, decentralizing and making hepatitis C diagnosis in LMICs affordable. The aim of this thesis was to identify tools that could be used to address these issues. For this purpose, three areas of study have been developed. A first study, conducted on a large number of Cameroonian blood samples, enabled us to validate the diagnostic performance of the HCV core antigen quantification, an alternative viraemic confirmation technique to the detection of HCV RNA, with a sensitivity of 95.7%, a specificity of 99.7%, and an area below the curve of 0.99. Concurrently with this first work, studies assessing the performance of several other diagnostic tools were published. Based on their data, we conducted two health economic studies in order to identify which of these tools would be the most cost-effective for scaling-up the diagnosis of hepatitis C in two different contexts: the population of injecting drug users in Dakar, Senegal, and the general population in three sub-Saharan countries. In both cases, combining the detection of anti-HCV antibodies by a point-of-care (POC) test and the detection of HCV RNA, either by a POC test or by a laboratory test performed on dried blood spots (a type of sample that can be transported at room temperature), was more cost-effective than the other proposed strategies. However, given that the efficiency outcome we chose prevented us from using a reference cost-effectiveness threshold, we were not able to evaluate which of these two strategies was the most feasible. However, in the case of general population diagnosis, it appears that, given the budget required to achieve the WHO’s objectives with each of these strategies, it is unlikely that the latter can be achieved on the said dates without a decrease in the prices of diagnostic tests or an increase in the available financial resources. Although representing a real progress towards the decentralization of diagnosis, the current POC tests have some technical limitations that may limit their potential. A literature review on diagnostic innovations has shown that a wide variety of technical solutions that could overcome these limits are being developed, some at an advanced stage. However, there are several barriers to their commercial distribution. An exploratory work on the concept of frugal innovation and the implementation of health innovations in LMICs concluded that these barriers could probably be removed. Future studies to accurately identify the conditions required for successfully implement these innovations in LMICs are needed. This work shows that improving access to hepatitis C diagnostic tools is no longer a technical issue but an organizational, economic and political one
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Damle, Rachelle N. "Clinical and Financial Impact of Hospital Readmissions Following Colorectal Resection: Predictors, Outcomes, and Costs: A Thesis." eScholarship@UMMS, 2014. http://escholarship.umassmed.edu/gsbs_diss/739.
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Background: Following passage of the Affordable Care Act in 2010, 30-day hospital readmissions have come under greater scrutiny. Excess readmissions for certain medical conditions and procedures now result in penalizations on all Medicare reimbursements. We examined the risk factors, outcomes, and costs of 30-day readmissions after colorectal surgery (CRS).
Methods: The University HealthSystem Consortium database was queried for adults (≥ 18 years) who underwent colorectal resection for cancer, diverticular disease, inflammatory bowel disease, or benign tumors between January 2008 and December 2011. Our outcomes of interest were readmission within 30-days of the patient’s index discharge, hospital readmission outcomes, and total direct hospital costs.
Results: A total of 70,484 patients survived the index hospitalization after CRS during the years under study, 13.7% (9,632) of which were readmitted within 30 days of discharge. The strongest independent predictors of readmission were: LOS ≥4 days (OR 1.44; 95% CI 1.32-1.57), stoma (OR 1.53; 95% CI 1.45-1.61), and discharge to skilled nursing (OR 1.63; 95% CI 1.49-1.76) or rehabilitation facility (OR 2.93; 95% CI 2.54-3.40). Of those readmitted, half occurred within 7 days of the index admission, 13% required ICU care, 6% had a reoperation, and 2% died during the readmission stay. The median combined total direct hospital cost was over twice as high ($26,917 v. $13,817) for readmitted than for nonreadmitted patients.
Conclusions: Readmissions following colorectal resection occur frequently and incur a significant financial burden on the healthcare system. Future studies aimed at targeted interventions for high-risk patients may reduce readmissions and curb escalating healthcare costs.
Categorization: Outcomes research; Cost analysis; Colon and Rectal Surgery
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Conn, Michael David. "An examination of the cost reimbursement policies and procedures followed by DoD when providing services to private organizations." Thesis, Monterey, California. Naval Postgraduate School, 1991. http://hdl.handle.net/10945/28194.
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Johnston, Susan Joy. "The development of an operational management procedure for the South African west coast rock lobster fishery." Doctoral thesis, University of Cape Town, 1998. http://hdl.handle.net/11427/22567.
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This thesis considers the development of an operational management procedure (OMP) to provide scientific recommendations for commercial TAC for the South African west coast rock lobster (Jasus lalandii) fishery. This fishery has been under considerable stress in recent years as a result of overfishing and low somatic growth rates. Present catch levels, less than 2000 MT, are substantially smaller than levels recorded in the past. The present biomass (above 75mm carapace length) is estimated to be only six percent of the pristine level. At the start of this research, no long-term management strategy for the resource existed. Neither was there any robust, tested, scientific method available for setting the annual TAC for the fishery, which resulted in a time-consuming and unsatisfactory scientific debate each year in developing a series of ad hoc TAC recommendations. The work presented in this thesis is thus aimed at answering two important questions. i) Can an adequate mathematical model be developed as a basis to simulate the resource and its associated fishery? ii) Can a self-correcting robust OMP be developed for the resource? The first phase of this thesis is the development of a size-structured population model of the resource and the associated fishery. A size-structured model is necessary as lobsters are difficult to age and hence most of the data collected are on a size basis. Furthermore, important management issues, such as the legal minimum size which has changed over time, require a model able to take size-structure into account. This model is fitted to a wide range of data from the fishery, including CPUE (catch-per-unit-effort) and catch-at-size information, by maximising a likelihood function. The model is shown to fit reasonably well to all data, and to provide biologically plausible estimates for its six estimable parameters.
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Baníková, Denisa. "Studie procesu zásobování v obchodní společnosti." Master's thesis, Vysoké učení technické v Brně. Fakulta podnikatelská, 2018. http://www.nusl.cz/ntk/nusl-377444.
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The diploma thesis deals with the study of the supply process in the chosen company, which mainly deals with the purchase and sale of cleaning machines and equipment. The thesis presents a proposal to improve the Supply Chain, with an emphasis on streamlining traffic, while at the same time making it possible to streamline customer service by designing a website. The work is divided into three main parts. The first part includes all the theoretical starting points, from which the analytical part starts. This part is mainly consists of analyzing the state of the company by using appropriate methods. On the basis of the shortcomings identified, the third part discusses suggestions for improving the processes that will contribute to their improvement, increasing the competitiveness of the company and increasing the value for the customer.
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Napoli, Joseph A. "Analysis of processing procedures for requisitions submitted by West Coast units for DLA managed material." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1994. http://handle.dtic.mil/100.2/ADA282897.
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Palmer, Angela C. "An investigative study of value engineering in the United States of America and its relationship to United Kingdom cost control procedures." Thesis, Loughborough University, 1992. https://dspace.lboro.ac.uk/2134/7204.
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The aim of this thesis is to make an investigative study of value engineering (VE) in the United States. The purpose is to establish if current United Kingdom cost control procedures could benefit from value engineering. The study examined the system of value engineering that exists in the US, along with the design procedures within which it prevails. The examination was based on a survey, analysis of fifty-five completed VE studies and attendance at four VE workshops. A comparison of VE practice in the US was made with UK procedures to establish whether VE is supplementary to UK cost control. Any supplementary components were analysed for effective integration into UK systems. This analysis was based on examination of existing UK cost control, coupled with the opinions, obtained by interview, of twenty British professionals with VE experience either in the UK or USA. The study produced the following conclusions, 1) Value engineering originally developed in manufacturing as a broad philosophy based on the technique of function analysis. Adapting value engineering for the construction industry in the USA distorted the technique of function analysis from its original principles. 2) Despite this, value engineering in the United States is effective in reducing construction cost by approximately 10%. However, this saving cannot be attributed to function analysis and is the result of other, broader, factors. 3) The practice of value engineering in the US offers only two components which do not exist in the UK cost planning system. First, VE is an autonomous approach and second it is carried out by an external team. 4) This autonomous approach by an external team is fraught with difficulties in the US. It is likely that these difficulties would also occur in the UK. In addition, British design procedures are not conducive to the application of US value engineering practice. Possibly as a result of this the majority of UK companies involved in VE have developed alternative systems. These systems appear to be based on an adaptation of American practice. 5) Function analysis could possibly be of benefit in the UK. The technique of function analysis however is largely a design orientated process that has no direct relationship to cost. The technique is not independent and it's successful implementation is influenced by other factors.
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Bellander, Henrik. "Rättegångskostnader : Om kostnadsbördan i dispositiva tvistemål." Doctoral thesis, Uppsala universitet, Juridiska institutionen, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-312475.
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Rättegångskostnader – Costs in Civil Procedure The rules on costs in Chapter 18 of the Swedish Code of Legal Procedure (Sw: Rättegångsbalken) have an impact on several procedural questions but have rarely been thoroughly discussed in legal practice or theory since their adoption in 1942. On the other hand, since the Code was adopted civil procecedure scholars have considerably focused on the development and changes in society and how they affect civil procedure. This thesis aims at examining both these lines of development. The impact of the theoretical discussions during the 20th century is critically addressed, with special attention to cost-related questions, and the application of rules on costs in some current and actual situations are examined and evaluated from a pragmatic perspective. The inquiry shows that costs have been of indirect relevance for the theoretical discussion in procedural law and that this theoretical development in turn has had effects on cost rules. Changing views on civil procedure have led to altered framings of cost problems and to shifts in how the rules have been comprehended and applied. The inquiry covers questions on cost assessment and cost shifting between the parties, as well as problems connected to possibilities to spread costs and risk on legal representatives, funders and others. It is argued that a more compromising and pluralistic application of the rules combined with more explicit communication in cost issues between the parties and the court during early stages of the proceedings may facilitate and lead to more nuanced cost decisions without burdening the final stages of the proceedings with extensive legal argumentation.
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Tollefson, Eric Sander. "Optimal randomized and non-randomized procedures for multinomial selection problems." Diss., Georgia Institute of Technology, 2012. http://hdl.handle.net/1853/43629.
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Multinomial selection problem procedures are ranking and selection techniques that aim to select the best (most probable) alternative based upon a sequence of multinomial observations. The classical formulation of the procedure design problem is to find a decision rule for terminating sampling. The decision rule should minimize the expected number of observations taken while achieving a specified indifference zone requirement on the prior probability of making a correct selection when the alternative configurations are in a particular subset of the probability space called the preference zone. We study the constrained version of the design problem in which there is a given maximum number of allowed observations.
Numerous procedures have been proposed over the past 50 years, all of them suboptimal. In this thesis, we find via linear programming the optimal selection procedure for any given probability configuration. The optimal procedure turns out to be necessarily randomized in many cases. We also find via mixed integer programming the optimal non-randomized procedure. We demonstrate the performance of the methodology on a number of examples.
We then reformulate the mathematical programs to make them more efficient to implement, thereby significantly expanding the range of computationally feasible problems. We prove that there exists an optimal policy which has at most one randomized decision point and we develop a procedure for finding such a policy. We also extend our formulation to replicate existing procedures.
Next, we show that there is very little difference between the relative performances of the optimal randomized and non-randomized procedures. Additionally, we compare existing procedures using the optimal procedure as a benchmark, and produce updated tables for a number of those procedures.
Then, we develop a methodology that guarantees the optimal randomized and non-randomized procedures for a broad class of variable observation cost functions -- the first of its kind. We examine procedure performance under a variety of cost functions, demonstrating that incorrect assumptions regarding marginal observation costs may lead to increased total costs.
Finally, we investigate and challenge key assumptions concerning the indifference zone parameter and the conditional probability of correct selection, revealing some interesting implications.
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DiGennaro, Florence Donna. "Examining the relationship between treatment integrity and student outcomes a comparison of performance feedback, goal setting and negative reinforcement procedures with teachers /." Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2006. http://proquest.umi.com/login?COPT=REJTPTU0NWQmSU5UPTAmVkVSPTI=&clientId=3739.
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Freitas, Gisele Palo Corrêa de. "Contribuição para o estudo do custo unitário das análises laboratoriais e sua comparação com a tabela de procedimentos da Associação Médica Brasileira - AMB 92, em um laboratório de pequeno porte." Universidade de São Paulo, 2005. http://www.teses.usp.br/teses/disponiveis/9/9136/tde-09112015-150841/.
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O Laboratório de Análises Clínicas (LAC) vem buscando, no decorrer dos anos, alternativas quanto à sua capacidade em gerar receita. A busca por melhores resultados incrementou a parceria com as organizações chamadas de \"convênios médicos\" ou \"medicina de grupo\" que, em geral, remuneram as análises laboratoriais com base em tabelas de procedimentos criadas pela Associação Médica Brasileira AMB. Destas, a mais utilizada é a Tabela AMB 92, devido a utilizar valores de Coeficiente de Honorários (CH), que convertidos em reais, são mais interessantes para os LAC. Este estudo teve como base o método recomendado pelo \"National Committee for Clinical Laboratory Standards\" - NCCLS, que normatiza a apuração do custo baseado na atividade desempenhada durante a sua realização. O objetivo deste trabalho foi estabelecer o custo das análises laboratoriais e verificar se, em comparação à tabela AMB 92, a opção pelos contratos com os \"convênios médicos\" realmente gera lucro a um laboratório de pequeno porte. Para tanto foram selecionadas as análises mais solicitadas no mês de agosto de 2004 em um laboratório de pequeno porte, que presta atendimento a pacientes conveniados a planos de saúde e particulares. O ressarcimento aos laboratórios prestadores de serviço é efetuado com base no valor do CH, que pode variar de acordo com o contrato firmado com os convênios médicos. Os resultados mostraram que na comparação dos custos unitários das 69 análises apuradas com a Tabela AMB-92 houve lucro em 52% das análises quando o valor de CH foi de R$ 0,2610 e quando atribuído um valor de CH de R$ 0,1800, houve lucro em apenas 28% das análises.<br>The Clinical Laboratory (CL) has been seeking, throughout these years, alternative forms of increasing budget. The search for better results has flourished partnerships with organizations named \"prepaid group practice\" or \"group medicine\" which usually reward the clinical analysis based on tables of procedures established by the Brazilian Medicai Association - BMA. Among them, the most employed is the BMA 92 Table, due to the use of payment coefficient values (PC) which, expressed in Brazilian currency (reais), are in CLs interests. This study was carried out based on the method recommended by the National Committee for Clinical Laboratory Standards - NCCLS, who draws up the regulation of the cost estimate of a procedure while it is carried out. The objective of this study was to establish the cost of clinical analysis and to verify if, comparing to the BMA 92 Table, the contracts with prepaid group practices are actually profitable for a small size laboratory. In order to achieve it, most requested analysis during August 2004 in a small size laboratory which offers services to patients affiliated with prepaid health plans and private health plans. The payment to the laboratories which offer services is made regarding the PC values, which may change according to the contract with the health plans. The results demonstrated that in comparison to the cost of each one of 69 analysis verified according to the BMA 92 Table, 52% of the analysis were profitable when the PC value was R$ 0.2610 and for the PC value of R$ 0.1800 only 28% of the analysis were profitable.
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Hernández, Romero Luis Alfredo. "Selection of tropical forages development and implementation of a participatory procedure and main results from Honduras, Nicaragua and Costa Rica." Weikersheim Margraf, 2007. http://d-nb.info/986803529/04.
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Wheeler, Anthony J. "Procedural Rates, Economic Costs, and Geographic Variation of Primary and Revision Lumbar Total Disc Replacement." DigitalCommons@USU, 2013. https://digitalcommons.usu.edu/etd/1764.
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Lumbar degenerative disc disease is a remarkably common condition among patients presenting with chronic low back pain and physical disability. When a surgical treatment option is warranted, patients now have the option of undergoing lumbar total disc replacement (TDR), a relatively new procedure that is designed to replace lumbar fusion, the traditional surgical intervention for degenerative disc disease. The lumbar TDR procedure has demonstrated clinical efficacy equivalent to that of lumbar fusion, although concern remains about the longevity, safety, and costs related to the procedure. These issues were addressed in three separate observational studies using administrative claims data. The first study estimated the revision burden and economic revision burden of lumbar TDR. The second study examined the lumbar TDR hybrid procedure, where both a lumbar TDR and lumbar fusion are performed simultaneously. No observational data have been reported on the frequency, cost, and diagnostic indications related to the TDR hybrid procedure. The third study mapped the geographic variation of procedural rates of lumbar TDR. Previous research has found substantial geographic variation in lumbar spine surgery rates and a similar analysis of lumbar TDR variation has yet to be reported. The present series of studies found the revision burden and economic revision burden of lumbar TDR to be similar to data reported for this procedure from the mid-2000s, though the overall occurrence of the procedure appears to have declined. The economic revision burden made this a lower-cost procedure than lumbar fusion, with a tradeoff in terms of revision burden being higher for lumbar TDR. The lumbar TDR hybrid procedure was found to make up approximately 16% of the total number of TDR procedures, involving much higher costs than a single-level TDR procedure. Finally, geographic variation of the procedural rate of lumbar TDR varied dramatically across the U.S., surpassing the variation observed in lumbar fusion surgery. Limitations of the observational data used in these studies are described. Recommendations for future observational research are offered as well. Finally, implications for these studies on practice guidelines and reimbursement policies are provided.
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SUZUKI, FABIO F. "Estudo de niveis genericos de intervencao para protecao do publico em um acidente nuclear ou emergencia radiologica." reponame:Repositório Institucional do IPEN, 2003. http://repositorio.ipen.br:8080/xmlui/handle/123456789/11137.
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