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Yes / The purpose of this paper is to study the effect of the implementation of Lean bundles on hospital performance in private hospitals in Jordan and evaluate how much the size of organization can affect the relationship between Lean bundles implementation and hospital performance. Design/methodology/approach The research is considered as quantitative method (descriptive and hypothesis testing). Three statistical techniques were adopted to analyse the data. Structural equation modeling techniques and multi-group analysis were used to examine the research’s hypothesis, and to perform the required statistical analysis of the data from the survey. Reliability analysis and confirmatory factor analysis were used to test the construct validity, reliability and measurement loadings that were performed. Findings Lean bundles have been identified as an effective approach that can dramatically improve the organizational performance of private hospitals in Jordan. Main Lean bundles – just in time, human resource management, and total quality management are applicable to large, small and medium hospitals without significant differences in advantages that depend on size. Originality/value According to the researchers’ best knowledge, this is the first research that studies the impact of Lean bundles implementation in healthcare sector in Jordan. This research also makes a significant contribution for decision makers in healthcare to increase their awareness of Lean bundles.

Submitted by NATÁLIA GROSSI VISONÁ null (natty_visona@hotmail.com) on 2018-04-04T01:15:21Z No. of bitstreams: 1 Dissetação Natália Grossi Visona Baruffi - repositorio.pdf: 882820 bytes, checksum: f8d4a34d565ca478f7d76d96ea3b1826 (MD5) / Approved for entry into archive by ROSANGELA APARECIDA LOBO null (rosangelalobo@btu.unesp.br) on 2018-04-06T12:01:58Z (GMT) No. of bitstreams: 1 baruffi_ngv_me_bot.pdf: 882820 bytes, checksum: f8d4a34d565ca478f7d76d96ea3b1826 (MD5) / Made available in DSpace on 2018-04-06T12:01:59Z (GMT). No. of bitstreams: 1 baruffi_ngv_me_bot.pdf: 882820 bytes, checksum: f8d4a34d565ca478f7d76d96ea3b1826 (MD5) Previous issue date: 2018-02-19 / Estudo retrospectivo e documental cujo objetivo foi analisar a efetividade do protocolo bundles como ferramenta para prevenção de Infecções Relacionadas à Assistência a Saúde (IRAS) de indivíduos internados em Unidade de Terapia Intensiva de Queimaduras (UTIQ) de um hospital terciário do interior paulista. Inicialmente, efetuou-se o levantamento de dados dos prontuários de todos os indivíduos que apresentaram IRAS internados na UTIQ de janeiro de 2008 a dezembro de 2016 e coletadas informações referentes aos que apresentaram infecções abordadas no protocolo bundles, compreendidos como as pneumonias associadas à ventilação mecânica (PAV), Infecção de corrente sanguínea (ICS) por uso de cateter venoso central e infecção do trato urinário (ITU) por uso de sonda vesical de demora, dividida em dois momentos: M1 (2008 a 2010) e M2 (2011 a 2016) pré e pós implantação do protocolo respectivamente. Dos 612 indivíduos admitidos na UTIQ nos dois momentos, 58,4% são do sexo masculino, a média de idade da população do estudo foi de 44,1 ± 15,3 anos. Em relação à área queimada, a média calculada em porcentagem foi de 33 +/- 18,5%, e o grau de queimadura predominante foram os de 2º e 3º graus (61,1%), tendo o fogo como agente causal com maior ocorrência (76,5%). O microrganismo com maior percentual de notificações 91 (36,7%) foi o Acinetobacter baumanii, também relacionados com os casos de PAV e ICS, enquanto que a Candida albicans (8,5%) aparece como o microrganismo mais frequente nos casos de ITU, 267 indivíduos (43,6%) apresentaram IRAS, sendo 49 (55,8%) resultantes de infecções por dispositivos invasivos de longa permanência, 179 (29,2%) evoluíram a óbito, sendo 74 dos óbitos (41,3%) relacionados/causados por infecções. Comparando os dois momentos, não foi observada associação significativa entre os indivíduos que apresentaram infecção hospitalar, o número total de infecções por dispositivos invasivos e os óbitos relacionados/causados por infecções. A incidência de IRAS, não diminuiu após o uso do protocolo, entretanto ao analisar separadamente os tipos de infecção, evidenciou-se que o uso dos bundles mostrou-se efetivo para prevenção de PAV e ICS em queimados. / A retrospective and documentary study aimed at analyzing the effectiveness of the Bundles protocol as a tool for the prevention of Health Care Related Infections (IRAS) of individuals hospitalized in an Intensive Care Unit of Burns (UTIQ) of a tertiary hospital in the countryside of São Paulo State. Initially, data were collected from the medical records of all individuals who presented IRAS hospitalized at the ICUQ from January 2008 to December 2016 and it has been collected the information referring to those who presented Bundle-related infections, known as pneumonias associated with mechanical ventilation (PAV), bloodstream infection (ICS) by the use of the central venous catheter and urinary tract infection (UTI) by use of the bladder catheter, divided into two moments: M1 (2008 to 2010) and M2 (2011 to 2016), before and after the implantation of the protocol, respectively. From the 612 individuals admitted in the ICUQ at both moments, 58.4% were males, the mean age of the study population was 44.1 ± 15.3 years old. In relation to the burned area, the mean calculated in percentage was 33 +/- 18.5% and the predominant degree of burn was those of 2º and 3º degrees (61.1%), with fire being the causal agent with the highest occurrence (76.5%). The microorganism with the highest percentage of reports 91 (36,7%) was Acinetobacter baumanii, it also related to cases of PAV and ICS, while Candida albicans (8.5%) appears as the most frequent microorganism in cases of UTI. 267 individuals (43.6%) presented IRAS, of which 49 (55.8%) resulted from invasive device infections. Regarding deaths during the same period, 179 individuals (29.2%) of the total hospitalizations died, of which 74 death (41.3%), was related/caused by infections. Comparing the two moments, no significant association was observed among the individuals who presented hospital infection, the total number of infections by invasive devices and deaths related/caused by infections, that is, the incidence of IRAS, did not decrease after the use of the protocol, but when analyzing the types of infection separately, it was evidenced that the use of Bundles was effective for the prevention of PAV and ICS in burns.

Orientador: Silvia Maria Caldeira / Resumo: Estudo retrospectivo e documental cujo objetivo foi analisar a efetividade do protocolo bundles como ferramenta para prevenção de Infecções Relacionadas à Assistência a Saúde (IRAS) de indivíduos internados em Unidade de Terapia Intensiva de Queimaduras (UTIQ) de um hospital terciário do interior paulista. Inicialmente, efetuou-se o levantamento de dados dos prontuários de todos os indivíduos que apresentaram IRAS internados na UTIQ de janeiro de 2008 a dezembro de 2016 e coletadas informações referentes aos que apresentaram infecções abordadas no protocolo bundles, compreendidos como as pneumonias associadas à ventilação mecânica (PAV), Infecção de corrente sanguínea (ICS) por uso de cateter venoso central e infecção do trato urinário (ITU) por uso de sonda vesical de demora, dividida em dois momentos: M1 (2008 a 2010) e M2 (2011 a 2016) pré e pós implantação do protocolo respectivamente. Dos 612 indivíduos admitidos na UTIQ nos dois momentos, 58,4% são do sexo masculino, a média de idade da população do estudo foi de 44,1 ± 15,3 anos. Em relação à área queimada, a média calculada em porcentagem foi de 33 +/- 18,5%, e o grau de queimadura predominante foram os de 2º e 3º graus (61,1%), tendo o fogo como agente causal com maior ocorrência (76,5%). O microrganismo com maior percentual de notificações 91 (36,7%) foi o Acinetobacter baumanii, também relacionados com os casos de PAV e ICS, enquanto que a Candida albicans (8,5%) aparece como o microrganismo mais frequente nos caso... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: A retrospective and documentary study aimed at analyzing the effectiveness of the Bundles protocol as a tool for the prevention of Health Care Related Infections (IRAS) of individuals hospitalized in an Intensive Care Unit of Burns (UTIQ) of a tertiary hospital in the countryside of São Paulo State. Initially, data were collected from the medical records of all individuals who presented IRAS hospitalized at the ICUQ from January 2008 to December 2016 and it has been collected the information referring to those who presented Bundle-related infections, known as pneumonias associated with mechanical ventilation (PAV), bloodstream infection (ICS) by the use of the central venous catheter and urinary tract infection (UTI) by use of the bladder catheter, divided into two moments: M1 (2008 to 2010) and M2 (2011 to 2016), before and after the implantation of the protocol, respectively. From the 612 individuals admitted in the ICUQ at both moments, 58.4% were males, the mean age of the study population was 44.1 ± 15.3 years old. In relation to the burned area, the mean calculated in percentage was 33 +/- 18.5% and the predominant degree of burn was those of 2º and 3º degrees (61.1%), with fire being the causal agent with the highest occurrence (76.5%). The microorganism with the highest percentage of reports 91 (36,7%) was Acinetobacter baumanii, it also related to cases of PAV and ICS, while Candida albicans (8.5%) appears as the most frequent microorganism in cases of UTI. 267 indiv... (Complete abstract click electronic access below) / Mestre

The problem of embedding a manifold in Euclidean space is considered. Manifolds are introduced in Chapter I along with other basic definitions and examples. Chapter II contains a proof of the Regular Value Theorem along with the "Easy" Whitney Embedding Theorem. In Chapter III, vector bundles are introduced and some of their properties are discussed. Chapter IV introduces the Stiefel-Whitney classes and the four properties that characterize them. Finally, in Chapter V, the Stiefel-Whitney classes are used to produce a lower bound on the dimension of Euclidean space that is needed to embed real projective space.

We develop a new geometric method of understanding principal G-Higgs bundles through their spectral data, for G a real form of a complex Lie group. In particular, we consider the case of G a split real form, as well as G = SL(2,R), U(p,p), SU(p,p), and Sp(2p,2p). Further, we give some applications of our results, and discuss open questions.

This thesis is concerned with the study of the geometry and derived categories associated to the moduli problems of local systems and Higgs bundles in positive characteristic. As a cornerstone of our investigation, we establish a local system analogue of the BNR correspondence for Higgs bundles. This result (Proposition 4.3.1) relates flat connections to certain modules of an Azumaya algebra on the family of spectral curves. We prove properness over the semistable locus of the Hitchin map for local systems introduced by Laszlo–Pauly (Theorem 4.4.1). Moreover, we show that with respect to this Hitchin map, the moduli stack of local systems is étale locally equivalent to the moduli stack of Higgs bundles (Theorem 4.6.3) (with or without stability conditions). Subsequently, we study two-dimensional examples of moduli spaces of parabolic Higgs bundles and local systems (Theorem 5.2.1), given by equivariant Hilbert schemes of cotangent bundles of elliptic curves. Furthermore, the Hilbert schemes of points of these surfaces are equivalent to moduli spaces of parabolic Higgs bundles, respectively local systems (Theorem 5.3.1). The proof for local systems in positive characteristic relies on the properness results for the Hitchin fibration established earlier. The Autoduality Conjecture of Donagi–Pantev follows from Bridgeland–King–Reid’s McKay equivalence in these examples. The last chapter of this thesis is concerned with the con- struction of derived equivalences, resembling a Geometric Langlands Correspondence in positive characteristic, generalizing work of Bezrukavnikov–Braverman. Away from finitely many primes, we show that over the locus of integral spectral curves, the derived category of coherent sheaves on the stack of local systems is equivalent to a derived category of coherent D-modules on the stack of vector bundles. We conclude by establishing the Hecke eigenproperty of Arinkin’s autoduality and thereby of the Geometric Langlands equivalence in positive characteristic.

Tsoi, Hung Ming. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 88-90). / Abstracts in English and Chinese. / Preface --- p.7 / Chapter 1 --- Kahler Manifold --- p.10 / Chapter 1.1 --- Hermitian Manifold --- p.12 / Chapter 1.2 --- Kahler Manifold --- p.13 / Chapter 1.2.1 --- "Positive (l,l)-form" --- p.15 / Chapter 2 --- Vector Bundle --- p.16 / Chapter 2.1 --- Holomorphic Vector Bundle and Connection --- p.17 / Chapter 2.2 --- Hermitian Connection and Chern Connection --- p.18 / Chapter 2.2.1 --- Existence of Chern connection on a holomorphic vector bundle --- p.19 / Chapter 2.3 --- Curvature --- p.21 / Chapter 2.4 --- Positivity of Vector Bundles --- p.23 / Chapter 2.5 --- Chern Classes and Holomorphic Line Bundle --- p.24 / Chapter 2.5.1 --- Chern class in axiomatic approach --- p.25 / Chapter 2.5.2 --- Chern class in algebraic topology --- p.26 / Chapter 2.5.3 --- Chern class in terms of curvature --- p.27 / Chapter 2.5.4 --- In the case of hermitian line bundle --- p.28 / Chapter 3 --- Analytic Technique on Kahler Manifold --- p.30 / Chapter 3.1 --- Dolbeault Cohomology --- p.30 / Chapter 3.2 --- Commutator Relations on Kahler Manifold --- p.31 / Chapter 3.2.1 --- Commutator relation on a line bundle --- p.32 / Chapter 3.3 --- Hodge Theory --- p.33 / Chapter 3.4 --- Bochner Technique --- p.35 / Chapter 3.4.1 --- Bochner-Kodaira-Nakano identity --- p.36 / Chapter 4 --- Kodaira Vanishing Theorem and L2 estimate of d --- p.38 / Chapter 4.1 --- Kodaira Vanishing Theorem --- p.39 / Chapter 4.2 --- Extension of Kodaira Vanishing Theorem by L2 Method --- p.44 / Chapter 4.2.1 --- Plurisubharmonic functions and weakly pseudoconvex Kahler manifold --- p.47 / Chapter 5 --- Multiplier Ideal Sheaf --- p.55 / Chapter 5.1 --- Algebraic Properties of Multiplier Ideal Sheaf --- p.56 / Chapter 5.2 --- Some Calculations of Multiplier Ideal Sheaf --- p.59 / Chapter 6 --- Nadel Vanishing Theorem --- p.62 / Chapter 6.1 --- Nadel Vanishing Theorem by L2 Estimate of d --- p.62 / Chapter 6.2 --- The Original Setting of Nadel --- p.64 / Chapter 6.2.1 --- S-bounded and S-null sequence --- p.65 / Chapter 6.2.2 --- Multiplier ideal sheaf by Nadel --- p.67 / Chapter 6.3 --- Nadel Vanishing Theorem by Computation of Cech Cohomology --- p.69 / Chapter 6.3.1 --- L2 estimate of d --- p.69 / Chapter 6.3.2 --- Koszul cochain --- p.70 / Chapter 6.3.3 --- The cohomology vanishing theorem --- p.73 / Chapter 7 --- Kawamata-Viehweg Vanishing Theorem --- p.77 / Chapter 7.1 --- Numerically Effective Line Bundle --- p.77 / Chapter 7.2 --- Kawamata-Viehweg Vanishing Theorem --- p.85 / Bibliography --- p.88

Due to increasing incidence and noncompliance with sepsis at a local hospital, an educational deficit was identified on the sepsis bundle in the medical intensive care unit. The purpose of this project was to develop and validate a sepsis bundle education program for all frontline staff in the MICU at a local University Hospital. The goal was for the educational tool to be validated by a multidisciplinary team to increase awareness, education, and ultimately, compliance with the severe sepsis and septic shock guidelines. The diffusion of innovation theory was utilized to support the process of change by encouraging the use of screening tools and best practice guidelines. The research question asked whether the education program meets critical care expert panel standards to educate frontline MICU staff on the sepsis bundle. The research design included a 5-member panel of experts in critical care, utilizing the Likert scale to review the proposed educational project on the sepsis bundle. Results are averaged from each reviewer. Results from the review included a unanimous '5' rating on every issue identified, equating to strongly agree on the Likert scale. This rating supported the validity of the educational project, the use of evidence-based practice and that the educational material was clear and easy to follow. Utilizing this validated tool will guide the education of sepsis, severe sepsis, and septic shock and promote social change by increasing education, awareness, recognition and early deployment of the sepsis bundle to improve patient outcomes.

Engineering and Physical Science Research Council (EPSRC) / This thesis describes the development of the two-frequency Planar Doppler Velocimetry (2n-PDV) flow measurement technique. This is modification of the Planar Doppler Velocimetry (PDV) technique that allows the measurement of up to three components of the flow velocity across a plane defined by a laser light sheet. The 2n-PDV technique reduces the number of components required to a single CCD camera and iodine cell from the two CCDs in conventional PDV. This removes the error sources associated with the misalignment of the two camera images and polarisation effects due to the beam splitters used in conventional PDV. The construction of a single velocity component 2n-PDV system is described and measurements made on the velocity field of a rotating disc and an axisymmetric air jet. The system was then modified to make 3D velocity measurements using coherent imaging fibre bundles to port multiple views to a single detector head. A method of approximately doubling the sensitivity of the technique was demonstrated using the measurements made on the velocity field of the rotating disc and was shown to reduce the error level in the final orthogonal velocity components by ~40 to 50%. Error levels of between 1.5ms-1 and 3.1ms-1 depending upon observation direction are demonstrated for a velocity field of ±34ms-1. The factors that will influence the selection of a viewing configuration when making 3D PDV measurements are then investigated with the aid of a computer model. The influence of the observation direction, the magnitude of the flow velocity, and the transformation to orthogonal velocity components are discussed. A new method using additional data in this transformation is presented and experimental results calculated using four-measured velocity components are compared to those found conventionally, using only three components. The inclusion of additional data is shown to reduce the final error levels by up to 25%.