Made available in DSpace on 2014-10-09T12:52:27Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:01:19Z (GMT). No. of bitstreams: 0 / Dissertação (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

Made available in DSpace on 2014-10-09T12:42:17Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:03:00Z (GMT). No. of bitstreams: 0 / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Os ensaios de proficiência têm sido utilizados, por laboratórios de ensaio e calibração acreditados sob a norma ISO/IEC 17025 (General requirements for the competence of testing and calibration laboratories), como principal mecanismo para garantia da qualidade de seus resultados. Além de atender a um requisito normativo, a participação satisfatória neste tipo de atividade é utilizada, por organismos acreditadores, como condição à obtenção e manutenção da acreditação. Entretanto, existe uma carência por provedores de ensaios de proficiência acreditados de acordo com a norma ISO/IEC 17043 (Conformity assessment — General requirements for proficiency testing), o que causa dificuldades aos laboratórios. Esta dissertação teve como objetivo analisar a viabilidade de que laboratórios acreditados à ISO/IEC 17025 atuem, simultaneamente, como provedores de ensaios de proficiência, acreditados à ISO/IEC 17043. Para isso, foram estabelecidas as relações entre os itens das normas, identificadas e analisadas as exigências adicionais e adaptações necessárias no sistema de gestão, identificados os potenciais conflitos de interesses e estabelecidas propostas de atendimento para cada item normativo afetado. Os artigos que constituem esta pesquisa foram validados por um grupo de especialistas na área da metrologia, sendo as suas opiniões consideradas nos estudos realizados. Conclui-se, ao final, que a atuação simultânea proposta é viável, exigindo adaptações no sistema de gestão e procedimentos complementares referentes à confidencialidade e à imparcialidade. Como resultado prático, espera-se minimizar a carência por este serviço, sem comprometer sua confiabilidade. / Proficiency tests have been used by testing and calibration laboratories accredited to the ISO/IEC 17025 standard (General requirements for the competence of testing and calibration laboratories) as the main mechanism for assuring the quality of their results. Besides attending to a normative requirement, the satisfactory participation in this kind of activity is used by accreditation bodies as a condition to obtaining and maintaining the accreditation. However, there is a lack of proficiency testing providers accredited according to the ISO/IEC 17043 standard (Conformity assessment — General requirements for proficiency testing), which causes laboratories to have difficulties. This thesis had as its goal to analyze the viability of laboratories accredited to the ISO/IEC 17025 acting simultaneously as proficiency testing providers, accredited to the ISO/IEC 17043. For that, relations between the items of both standards have been established, additional requirements and necessary adaptations in the management system have been identified and analyzed, potential conflicts of interest have been identified and solutions have been proposed for each normative item. A group of experts in the field of metrology validated the articles that constitute this research and their opinions have been considered in the studies. At the end, the conclusion was that the proposed simultaneous acting is viable, requiring adaptations in the management system and complementary procedures referring to confidentiality and impartiality. As a practical result, it is hoped to minimize the shortage for this kind of service, without compromising its reliability.

Made available in DSpace on 2014-10-09T12:52:27Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:01:19Z (GMT). No. of bitstreams: 0 / Tendo em vista a importância da calibração de instrumentos medidores de radiação e do conhecimento das principais características destes instrumentos, diversos tipos de câmaras de ionização foram intercomparados em termos de seus coeficientes de calibração e dependência energética, em feixes padrões de raios X, níveis radioterapia, radiodiagnóstico e radioproteção. Foi realizada uma intercomparação de activímetros utilizados em medicina nuclear, com três radionuclídeos: 67Ga, 201Tl e 99mTc. Todos os activímetros que participaram da intercomparação apresentaram resultados dentro dos limites recomendados pela norma CNEN-NE-3.05. Para completar o conjunto de qualidades de radiação do Laboratório de Calibração de Instrumentos do IPEN, foram estabelecidos feixes de radiação-X, nível radioproteção e radioterapia de energias baixas, seguindo recomendações internacionais. Três metodologias para a obtenção de coeficientes de calibração de câmaras de ionização não seladas em feixes de radiação-X foram estudadas e comparadas. Um conjunto de câmaras de ionização Victoreen, especialmente projetado para uso em intercomparações laboratoriais, foi submetido a testes de caracterização. O desempenho destas câmaras mostrou que elas podem ser utilizadas em feixes de radiação-X nível radioproteção de maneira segura, visto que nestes feixes estas câmaras apresentaram resultados em conformidade com recomendações internacionais. No entanto, seu uso em feixes de radioterapia e de radiodiagnóstico deve ser feito com algumas considerações, pois especialmente nos testes de dependência energética e de tempo de estabilização, estas câmaras não atenderam às respectivas recomendações internacionais. Este trabalho apresenta dados sobre o desempenho de diversos modelos de câmaras de ionização em diferentes feixes de radiação-X, fornecendo uma ferramenta para a escolha do instrumento mais adequado para a realização de medições em feixes de radiação ionizante / Dissertação (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

Made available in DSpace on 2014-10-09T12:42:17Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:03:00Z (GMT). No. of bitstreams: 0 / Com a intenção de estabelecer métodos físico-químicos como uma alternativa ao bioensaio in vivo para determinação de atividade biológica, o conteúdo de hFSH, hTSH e hLH de diferentes preparações, nativas e recombinantes, foi determinado por cromatografia líquida de alta eficiência em fase reversa (RP-HPLC) e comparado ao dado obtido pelo clássico bioensaio in vivo em camundongos ou ratos (BA). Para estes hormônios foi encontrada uma relação linear entre os dois métodos: hFSH BAUI = 0,9925 RP-HPLCUI - 1,3165, r = 0,9371, p < 0,001, n = 24; hTSH BA&mu;g = 0,9790 RP-HPLC&mu;g - 0,052, r = 0,8725 , p < 0,001, n = 14; hLH BAUI = 0,8771 RP-HPLCUI + 12,41; r = 0,9786, p < 0,01, n = 5. Para outras nove preparações de hFSH e onze preparações de hTSH foi determinada a diferença média (d) entre a bioatividade predita pela RP-HPLC através destas equações e da média das bioatividades obtidas com os dois métodos. Para o hLH não foi possível determinar esta diferença em virtude das poucas amostras disponíveis. No caso do hFSH, d ± DP = -2,11 ± 3,49 % sendo a precisão de 1,16% e no caso do hTSH, d ± DP = -2,01 ± 5,56 % com precisão de 1,68%. Amostras parcialmente alteradas apresentaram diferentes graus de atividade de hFSH, hTSH e hLH que puderam ser preditas por RP-HPLC com uma aceitável concordância com os bioensaios in vivo. Estes resultados demonstraram que o emprego de um ensaio físico-químico sem o uso de animais, tal como a RP-HPLC, é uma alternativa viável ao uso do bioensaio in vivo para a determinação da potência de hFSH e hTSH, reduzindo assim o número de animais em geral utilizados para assegurar a qualidade e eficácia de um produto farmacêutico. / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

The aim of the thesis is to evaluate the performance of the company AGRALL Ltd., which sells agricultural equipment. This thesis is split into two parts. The first part describes the theoretical assumptions and used methods. The second part applies theoretical knowledge to the data of the selected company. At first, the performance is evaluated by traditional indicators of profitability and then by using the economic value added which is calculated according to the methodology of the Ministry of Industry and Trade of Czech Republic. The company data are compared with values of indicators for the sector and with the data of the selected competition to ensure better explanatory capability. At the end of thesis the findings are evaluated and improvements are recommended.

The thesis deals about methods widely used for life insurance products evaluation from the clients perspective. These methods of evaluation are important mainly for comparisons of several insurance products. One of goals of the thesis is to analyze existing methods used for evaluation of insurance products and discuss their suitability for comparing life insurance products. These methods are based mainly on cost analyses because they were originally developed especially for investments projects comparisons. The main goal of the thesis is to create new indices for comparing life insurance products. These new indices are supposed to resolve imperfections of regularly used evaluation methods. They are also designed to cover all functions of life insurance therefore they are supposed to provide with more coherent information for comparisons. The indices are based on knowledge of life insurance products, probability, demography, financial and insurance calculus.

Fertilitetsenheten på Karolinska Universitetssjukhuset använder sig idag av databasen LinnéFiler för att hantera behandlingsprotokoll för par som behandlas för ofrivillig barnlöshet. Fertilitetsenheten kan inte enbart använda sig av Stockholms Läns Landstings journalsystem TakeCare då tillverkade embryon tillhör både mannen och kvinnan i paret och det behövs därför en sammankoppling mellan deras journaler.   Till Linnéfiler finns behov av en automatisk inmatning av provsvar tagna på provtagningsenheter runt om i Stockholmstrakten. Samtliga prov analyseras på Karolinska Universitetslaboratoriet varpå provsvaren matas in i TakeCare via SLL IT samt skickas till Fertilitetsenheten via post.   Idag matas provsvaren in i Linnéfiler manuellt. Detta är oerhört tidskrävande och innebär stora risker för misstag. LinnéFiler är förberett för en automatisk mottagning av provsvar via en modul som heter Labmessage. Både Linnéfiler och Labmessage är en del av programmet ivfServices.  Labmessage ställer dock vissa krav på formatet hos provsvaren som ska importeras från provtagningsenheterna.   Vi har undersökt 3 möjliga flöden som skulle innebära att Fertilitetsenheten får Labmessage i bruk och därmed skulle få sina provsvar inmatade per automatik. De tre alternativ vi har undersökt är: 1)      Provsvaren skickas på ett separat flöde från Karolinska Universitetssjukhuset till Labmessage 2)      Stockholms läns landstings (SLL) IT; EDI, plockar ut de aktuella provsvaren och levererar dessa elektroniskt till Labmessage 3)      Möjligheten att journalsystemet TakeCare (till vilket provsvaren skickas nu) tar kopior på provsvaren och levererar dessa till Labmessage elektroniskt   Det är mycket svårt att garantera säker dataöverföring och ansvariga på Fertilitetsenheten tycker inte att risken är värt nyttan med alternativ 1. Detta gäller även för alternativ 2. Alternativ 3 framstår som det säkraste och bästa alternativet. Dock saknas resurser på TakeCare-förvaltningen för att tillfredsställa små enheter med särskilda önskemål. Det rimliga alternativ som kvarstår är att förbättra säkerheten i dagens manuella inmatning av provsvar. Linnéfiler skulle kunna modifieras så att signering smidigare kan ske av de anställda på Fertilitetsenheten.   Det finns många idéer för hur man i framtiden kan ha en smidigare och säkrare dataöverföring. Till exempel så finns inom Nationella Vävnadsrådet planer på att eventuellt byta ut de patientdatabaser som används av fertilitetsenheter i Sverige mot en gemensam nationell patientdatabas. Detta skulle förhoppningsvis innebära en gemensam lösning på automatisk inmatning av provsvar för dessa enheter.   Det har framkommit att det finns många problem med dagens hantering av data inom offentlig sjukvård. Det ska garanteras att dataöverföringen är säker, patienternas integritet måste skyddas och juridiska aspekter måste tas hänsyn till. Bristande resurser är ett stort problem i alla avseenden samt att samtliga parter naturligtvis drar sig för att ta på sig ansvaret för säker dataöverföring. / The Fertility department at Karolinska University Hospital uses a database called LinnéFiler to handletreatment protocols for couples treated for infertility. The Fertility department are not able to only use the database TakeCare developed by Stockholm’s läns landsting because the embryo produced belongs to both the man and the woman in the couple, and they therefor need a link between their respective medical charts.   There is a need to import laboratory test resultstaken at clinical laboratory services around the Stockholm area to LinnéFiler.  All test results are analysed at Karolinska University Laboratory, from where they are sent to SLL IT where the test results are put into TakeCare and also sent to the Fertility department by post.   Today, test results are entered into the LinnéFiler system manually. This is very time consuming and there is also a huge risk for making mistakes.LinnéFiler is prepared to receive test results via a module called Labmessage. Both LinnéFiler and Labmessage are part of a program called IvfServices. Labmessage can only receive test results from the clinical laboratories in specific data formats.   An examination of three possible flows of data has been made which would lead to that Labmessage would be implemented at the Fertility unit. Making one of these flows work would achieve an automated input of data results. The three alternatives we have examined are: 1)      Sending the test results on a separate flow from Karolinska University Laboratory to Labmessage 2)      SLL IT; EDI picks out the intended test results and sends them to Labmessage 3)      TakeCare (to which the test results are sent today) makes copies of the test results and sends them to Labmessage   It is very difficult to guarantee complete safety regarding data transfer and responsible employees at the Fertility unit are today not willing to take the risks associated with alternative 1. This was also the case with alternative 2. Alternative 3 seems to be the safest and best way to send data to Labmessage. However, the issue here is the lack of resources at the TakeCare-unit to make specialized solutions for the interest of small units. The only reasonable alternative left was to improve today´s safety regarding the manual input of the test results. LinnéFiler could perhaps be modified to favour an easier way for the employees at the Fertility unit to sign in TakeCare.   There are many ideas regarding how to improve the safety within today´s data transfer. The Swedish Board of Tissue Banking has plans to replace the databases used today by Fertility units in Sweden to a unified national database. That would probably imply a common solution regarding automated input of test results to all Fertility units.   We have during this work experienced many problems associated with handling of data in public health care. The data transfer must be safe, the patients’ integrity has to be protected and there has to be a legal certainty. There is a lack of resources and all partners wants to avoid the legal responsibility.

Purpose. The use of antiplatelet agents in patients hospitalized with ischemic stroke was studied. Methods. Patients with a primary or secondary diagnosis of noncardiogenic, thrombotic ischemic stroke from January 2002 through December 2004 were included in the analysis. Patients were then subdivided into four treatment groups and one no-treatment group based on whether they were charged for any of four antiplatelet regimens (low-dose aspirin [≤325 mg daily], extended-release dipyridamole 200 mg with aspirin 25 mg, clopidogrel 75 mg, and clopidogrel 75 mg [as the bisulfate] plus low-dose aspirin) at any time during hospitalization. Patients who did not receive any of these medications during hospitalization were defined as the no-treatment group. A patient's illness severity was measured and compared with other patients in the data set. Results. A total of 44,108 patients were assigned to the treatment group, and 14,255 patients were assigned to the no-treatment group. In general, longer lengths of stay and higher institutional costs were associated with the no-treatment group. Patients in the no-treatment group consistently displayed more comorbid conditions than did patients in the treatment group. The no-treatment group exhibited higher usage rates of both fibrinolytic agents and vitamin K. More patients in the treatment group were discharged to home or rehabilitation, while more patients in the no-treatment group were either discharged to another nursing facility or died before discharge. Conclusion. A retrospective analysis of a large national hospital database revealed that one quarter of patients who suffered an acute stroke did not receive antiplatelet drugs during their patient stay. Outcomes for such patients were poorer than for patients who had received antiplatelet therapy.

Runstenar dokumenteras idag både för att skapa en visuell avbildning och medsyftet att användas vid forskning. Om avbildningen ska användas vid forskningfinns krav på en låg mätosäkerhet. Vid de studier som funnits har terresterlaserskanning (TLS) varit den valda dokumentationsmetoden. Fotobaseradskanning vilken är en billigare dokumentationsmetod har utvecklats mycketunder senare tid i och med utvecklingen av högupplösta kameror ochanvändarvänliga mjukvaror för bildbehandling.Denna studie syftar till att finna svar på om fotobaserad skanning är en lämpligmetod vid avbildandet av runor och ornament då en 3D-modell med lågmätosäkerhet ska skapas. För att avgöra detta jämförs tre fotogrammetriskapunktmoln och modeller mot punktmoln och modeller från en TLS av märketHexagon Romer Absolute Arm. Punktmolnen och modellerna från HexagonRomer Absolute Armen bildar i denna studie referensmodellen. Endigitalkamera och en smartphonekamera används i studien. Fotografier tasmed båda kamerorna på ett avstånd av 40 cm från runorna. Medsmartphonekameran tas även fotografier på 10–20 cm för att utvärderaavståndets betydelse för resultatet.Jämförelser mellan de sammanlagda RMS-värdena för fotogrammetriskamodellernas och referensmodellens ytor visar på den lägsta avvikelsen fördigitalkamerans modell. Detta då RMS-värdet för avvikelsen motreferensmodellen endast är 0,30 mm för digitalkameran. RMS-värdena föravvikelserna för smartphonekamerans modell är 0,63 mm då fotograferingenutfördes på 10–20 cm och 2,59 mm om avståndet var 40 cm. Alla modellerhar avvikelser på mm-nivå vilket jämfört med tidigare studier får anses somsmå skillnader. Resultatet visar även på avståndets betydelse för punkttäthetenoch den skapade modellens mätosäkerhet. De punktmoln som skapades avsmartphonekamerans fotografier uppvisar en ungefärlig dubblering avpunkttätheten i det täta punktmolnet då avståndet minskas från 40 cm till 10–20 cm mellan kamera och objekt. Till viss del kan kortare avstånd med andraord kompensera för en kamera med sämre upplösning. Detta gör att även ensmartphonekamera kan vara ett alternativ vid dokumentation av runskrift omingen bättre kamera finns att tillgå. Studien antyder att en högupplöstdigitalkamera kan vara ett fullgott alternativ till TLS vid dokumentation avrunskrift med låg mätosäkerhet. Detta skulle underlätta för forskare vidinsamlandet av material vid studier av runskrift.