In this thesis, methods for using computer-based models as support tools for assessing Transport Telematic Services (TTSs) are studied. Such assessments provide one way to understand how TTSs can address problems caused by transportation, such as accidents, emissions, and energy consumption. TTSs are services based on telematic systems which are Intelligent Transport Systems (ITS) involving the integrated use of information and communication technologies in transport. The focus is on TTSs that are relevant for road freight transport, even though the suggested methods can easily be adapted for TTSs in other areas. We characterize TTSs, e.g., in terms of their functionalities, and apply computer-based modeling for pre-deployment assessment of various TTSs (from an ex-ante perspective). By analyzing information provided by the suggested computer-based models, it is possible to make an informed decision whether to (or not to) deploy a given TTS. A review of previous studies reveals information about relevant TTSs for freight transport in areas such as driver support, administration, safety, traffic management, parking, and goods handling. A hierarchical clustering algorithm and a k-minimum spanning tree algorithm were employed to analyze synergies of TTSs. Synergies can enable identification of sets of TTSs that can lead to cost savings if deployed on a common platform (cf. Multi-Service Architectures). An analytical model inspired by the net present value concept is used to estimate quantified societal benefits of TTSs. An optimization model is formulated and solved using a branch and bound method to determine an optimal combination of TTSs taking into consideration societal benefits, costs, dependencies, and synergies. The optimization model also addresses possible system architectures for achieving multiple TTSs. Dominance rough set approach is used to assess and compare benefit areas for TTSs specific to truck parking. The benefit areas are suggested with the help of conceptual modeling, which describes functional models of a system in terms of states, transitions among states, and actions performed in states. The main scientific contributions of the thesis are in suggesting new quantitative models, extending and applying existing models in the assessments of TTSs, and obtaining results that can help decision-makers select TTSs for medium-to long-term investments. Researchers can employ and build on the proposed methods when addressing different scenarios (geographic or organizational) involving similar TTSs. By studying a range of TTSs and possible Multi-Service Architecture concepts for such TTSs, the thesis contributes to achieving convergence of TTSs in a Multi-Service Architecture environment that will improve cost efficiency, minimize redundancies, and encourage the establishment of standards in the deployment of TTSs in road freight transport. TTSs implemented in such an environment can contribute to optimizing available capacity, accuracy, speed, and efficiency of road freight transport systems.

The main goal of this thesis is to create management flight simulator for inventory management in selected company. The proposed management simulator is developed in the context of the taxonomy of decision support systems. It is a model-oriented system based on the models proposed by me and created a user interface. In this particular situation the application is realized on company Dynavix, that is a manufacturer of navigations. After opening theoretic information about models, computer technologies for systems modeling and individual phases of simulation process, there follows a case study. It is trying to find and recommend appropriate solutions of fluctuations in the need for planning the purchase of navigation Dynavix by using a system dynamics approach (developed model and its testing). The recommended solution is verified by testing hypotheses according to a predefined test scenarios.

Bakgrund: Telefonrådgivning inom hälso- och sjukvård förekommer runt om i världen och är ett enkelt sätt för patienten att komma i kontakt med vården. Bedömningsprocessen i telefonrådgivning försvåras på grund av att sjuksköterskan inte ser patienten vilket ställer krav på en bred kunskap. Beslutsstöden ger då möjlighet för sjuksköterskorna att kunna ge den vård som behövs. Syfte: är att beskriva sjuksköterskans upplevelser av att arbeta med telefonrådgivning. Metod: En litteraturöversikt baserad på 10 artiklar med kvalitativ ansats. Resultat: Två huvud kategorier framkom ur analysen; Användandet av beslutsstöd och rådgivning som beslutsprocess. Kategorierna understödjs av sammanlagt fyra underkategorier. Diskussion: Sjuksköterskan upplever arbetet med beslutsstöd inom telefonrådgivning som svårt vilket kan påverka den vårdande relationen med patienten. Sjuksköterskorna anser att det finns en fördel för att underlätta telefonrådgivningen. Sjuksköterskorna anser att beslutsstödet kan brista i vården till patienten för att innehållet är otillräckligt. Beslutstöden kan även hjälpa till att stödja sjuksköterskornas egna medicinska kunskap. Slutsats: Sjuksköterskorna anser att det finns fördelar med beslutsstöd men att uppdatering av beslutsstödet samt utbildning om hur det ska användas krävs. / Background: Telephone counseling in health and medical care occurs around the world and is an easy way for the patient to come into contact with health- care. The assessment process in telephone counseling is made difficult by the fact that the nurse does not see the patient, which demands a broad knowledge. Decision support then provides the opportunity for the nurses to be able to provide the necessary care. Purpose: The aim is to describe the nurse's experiences of working with telephone counseling. Method: A literature review based on 10 articles with qualitative approach. Result: Two main categories emerged from the analysis; The use of decision support and the consulting as a decision-making process. The categories are supported by a total of four subcategories. Discussion: The nurse experiences the work with decision support in telephone counseling as difficult, which can affect the caring relationship with the patient. The nurses believe that there is an advantage in facilitating telephone counseling. The nurses believe that the decision support can be burst in the care of the patient because the content is insufficient. Decision support can also help to support nurses own medical knowledge. Conclusion: The nurses believe that there are benefits of using decision support, but that updating the decision support and training on how to use it is required.

Alguns dos problemas enfrentados pelas cidades que ainda sofrem com um crescimento rápido são, não raro, conseqüência da falta de políticas públicas que possam orientar o crescimento espacial de forma sustentável e com qualidade de vida. Há uma clara necessidade de instrumentos efetivos de controle e monitoramento da mobilidade urbana, bem como de políticas mais sustentáveis destinadas a orientar o crescimento e ordenamento espacial. Neste contexto, a elaboração de um sistema de suporte à decisão através de uma interface on-line pode proporcionar novas perspectivas para um planejamento da mobilidade mais participativo e sustentável. Assim, um dos objetivos desta pesquisa foi desenvolver uma ferramenta computacional destinada a promover um processo integrado e sustentável para elaboração e monitoramento de planos diretores de mobilidade urbana. A proposta focou no processo de tomada de decisão participativo envolvendo múltiplos segmentos da sociedade, sobretudo em cidades pequenas e médias. Outro objetivo foi verificar se, através da utilização do sistema proposto, os avaliadores (especialistas ou não-especialistas), modificariam significativamente seu nível de percepção com relação à mobilidade urbana. Para atingir a estes objetivos, a pesquisa foi dividida em duas fases. Inicialmente foi desenvolvido o sistema de suporte à decisão para internet, denominado PLANUTS - PLANejamento Urbano e de Transportes integrado e Sustentável. Este sistema é composto por quatro módulos de avaliação da mobilidade urbana e um módulo administrativo. O funcionamento da ferramenta proposta foi demonstrado, na prática, através de sua aplicação junto a um grupo de especialistas e não-especialistas em Bauru, cidade média localizada no estado de São Paulo, Brasil. Com a aplicação foi possível simular etapas do desenvolvimento de um plano diretor de transporte e mobilidade participativo, com a definição de indicadores de mobilidade. A aplicação também foi útil para demonstrar a contribuição do sistema na mudança de percepção dos usuários com relação a questões que envolvem aspectos da mobilidade. Os resultados obtidos conduziram às seguintes conclusões: i) o sistema PLANUTS pode contribuir para a participação de diferentes segmentos da sociedade no processo de avaliação da mobilidade urbana; ii) a utilização do sistema possibilita uma ampliação no conhecimento e definição dos temas que envolvem a mobilidade urbana; e iii) é possível definir um conjunto de indicadores representativos dos problemas mais importantes de mobilidade com vistas a um sistema de indicadores de mobilidade no município. / Some of the problems faced by fast growing cities are often a consequence of the lack of public policies able to drive the spatial growth towards sustainable development and a better quality of life. There is a clear need of more effective tools for urban mobility monitoring and control, as well as sustainable policies for guiding urban growth and spatial distribution. In such a context, the construction of a web-based decision support system can produce new perspectives for mobility planning in a more participative and sustainable way. Therefore, one of the objectives of this research was to develop a computational tool for promoting an integrated and sustainable process of construction and management of mobility master plans. The focus of the proposal was on a participative decision-making process involving multiple segments of the society, mainly of small and medium-sized cities. Another objective of the research was to test if the use of the proposed system could significantly change the perception level of the participants (experts or non-experts) regarding urban mobility. In order to reach the stated objectives, the research was conducted in two phases. The first step was the development of the internet-based decision support system named PLANUTS (which stands for PLANnig Urban and Transportation integrated and Sustainable systems). It comprises four modules for the evaluation of urban mobility and one administrative module. The use of the proposed tool was shown, in practice, through an application with a group of experts and another one of non-experts in Bauru, which is a medium-sized city located in the state of São Paulo, Brazil. The application made possible to simulate some steps of the development of a participative mobility master plan, with the definition of mobility indicators. It was also useful for showing the contribution of the system in changing the users\' perception regarding mobility issues. The results obtained led to the following conclusions: i) PLANUTS can be used to allow the participation of distinct segments of the society in the evaluation of urban mobility; ii) the use of the system brings an improvement in the definition of the Themes and to the overall knowledge of urban mobility; and iii) it is possible to define a set of indicators associated to the most important mobility problems in order to build a system of urban mobility indicators to the municipality.

A importância de um bom sistema de medição de desempenho (SMD) para o sucesso de uma empresa é uma questão bastante estudada e discutida, tanto no meio científico quanto no próprio meio empresarial. No entanto, grande parte das empresas não possui um sistema de medição de desempenho que possa lhes trazer uma vantagem competitiva, sendo ele muitas vezes pontual e desligado da estratégia. Por isso, este trabalho é mais uma tentativa de aproximar a teoria e a prática dentro das empresas no que se refere à medição de desempenho organizacional. O objetivo da pesquisa é desenvolver um sistema informatizado para a gestão do desempenho e apresentar um método para sua implantação. Para a definição das características deste método e dos requisitos do sistema, empreendeu-se uma revisão bibliográfica e um estudo de caso em uma empresa de grande porte que já possui um SMD formalizado. O método foi aplicado em duas empresas de Sertãozinho para identificar seus objetivos estratégicos e indicadores de desempenho, o que resultou em uma primeira versão de um SMD formal para elas. Uma aplicação piloto do software foi feita em uma destas empresas para verificar seu funcionamento na prática. Após estes estudos, pôde-se concluir que o método e o sistema são úteis para implantar e acompanhar indicadores de desempenho nas empresas pesquisadas. No entanto, a implantação encontrou alguns obstáculos como a falta de tempo das empresas para se dedicarem à medição de desempenho e a resistência de alguns funcionários em usar o software. / The importance of a well-developed performance measurement system (PMS) for the success of a company is a subject which is widely studied and discussed either in the academic and business enviroments. However, many companies still do not have a performance measurement system able to bring them competitive advantage, because they are all too often ad-hoc solutions not concerned about the strategy. Hence, this work is yet another attempt to bring theory closer to practice inside the companies in the regard of business performance measurement. This research\'s objective is to develop an information system for performance measurement and present a method for its deployment. In order to define the characteristics of both the method and the information system, a literature review and a case study in a company which had a formal PMS were done. The method was then applied to two companies from Sertãozinho aiming to identify their strategic objectives and performance indicators, which resulted in a first version of their formal PMS. A pilot deployment of the software was made in one of these companies to verify how it would work in practice. After these studies, it was possible to conclude that the method and the information system were useful for deploying and keeping track of performance indicators in the researched companies. However, some dificulties were found during the deployment, such as the lack of time available for performance management and the resistance of some employees to the use of the software.

A carência, absoluta ou relativa, de água direcionou diversas ações no sentido de amenizar esse problema. A política nacional de recursos hídricos (Lei 9.433/97), com seus cinco instrumentos de gestão e planejamento, pode ser considerada o principal marco. Entre esses instrumentos, encontra-se o sistema de informações, que tem por finalidade coletar, armazenar e disponibilizar dados para uma gestão racional. É nesse âmbito e no sentido de contribuir para a evolução desses sistemas, que se apresenta essa tese de doutoramento. O tema principal trata da implementação de um sistema de suporte a decisões – SSD com base nos conceitos da programação orientada a objetos – POO, forma esta de programação que procura representar os sistemas por meio de classes de maneira a buscar a semelhança à realidade. Esse SSD, denominado de ARENA (análise de recursos naturais), é composto de um sistema de informações geográficas – SIG, dois simuladores (simulação do fluxo de águas subterrâneas e do ciclo hidrológico superficial), uma base de dados georeferenciada e módulos de acesso aos dados. A forma como os simuladores foram implementados, baseado em conceitos da POO e suas integrações às entidades geométricas do SIG, é apresentada como contribuição. No ARENA, o SIG não é apenas utilizado nas fases de pré e pós-processamento de dados para modelos, e sim no processo de simulação. Aplicações do ARENA a uma bacia hidrográfica (escoamento superficial) e a dois sistemas hipotéticos (escoamento subterrâneo) são apresentados ao final do trabalho. A maneira como esse SSD foi implementado induz ao desenvolvimento de simuladores adicionais sem realizar modificações nos pacotes já implementados neste trabalho, sendo facilitada a utilização dos pacotes que compõem esse SSD / The relative or complete lack of water has been directing various actions in order to solve this problem. The national water resources politic (Law 9.433/97) with its five instruments for water resources planning and management can be considered the main action. Among these instruments, it is found the information system that has as purpose to collect, store and turn it into available data to the rational management. In this scope and in order to give some contributions to the improvement of these systems, this Ph.D. thesis is presented. The main topic deals with the decision support system (DSS) implementation based on oriented object – OO, a kind of programming which tries to represent systems through classes very closely to the reality. This DSS, called ARENA (análise de recursos naturais, in Portuguese), is made up of a geographic information system (GIS), two models (a groundwater model and a distributed rainfall-runoff model), a georeferenced database and graphic user interfaces (GUI). The way the models were built, based on OO concepts and its integration to GIS geographic data, is presented as contribution. In the ARENA, the GIS is not only used in the pre and post processing steps, but also in the simulation. The ARENA applications were carried out for two examples, a watershed (surface water simulation) and a hypothetic system (groundwater simulation), both presented in the end of this study. The way this DSS was built induces to the development of other models without modifications in the existing packages, so that the development of new applications becomes easy because the use of existing packages that made this DSS up

O problema de escassez da água para o abastecimento humano vem se agravando a cada ano que passa. As demandas vem crescendo e precisam ser supridas da melhor maneira possível sob pena de limitar o processo de desenvolvimento regional. Para tanto, deve-se recorrer ao planejamento e gerenciamento dos recursos hídricos como forma de se promover ao seu uso racional. Descreve-se neste trabalho a implantação de um sistema de apoio ao planejamento e gerenciamento de recursos hídricos, dando uma maior ênfase ao modelo hidrológico distribuído utilizado para gerar as vazões na bacia hidrográfica. Avalia-se sua calibração e validação realizada com dados fluviométricos e de níveis de açudes. Apresentam-se os resultados de estudo de potencialidade da bacia hidrográfica, e por último as disponibilidades dos principais açudes. Todas estas etapas formam realizadas tendo sempre a visão especializada e integrada da bacia hidrográfica do rio do Peixe. / The problem of scarcity of water for human supply has increased each year. The needs have increased and must be fullfilled as satisfactory as possible. If not the development process ofthe region could be limited. In this way, we must use the planning and management of water resources to promote a rational use. This dissertation describes the implantation of a support system to the planning and management of water resources, focusing the hydrologic distributed model used to generate the inflows in the basin. The calibration and validation processes with sets of data formed by gauge stream go stations and reservoir levels are analyzed. The results of a study of the potentiality of the basin, and finally the availability of the mains reservoirs are presented. All this steps were made with a specialized and integrated view of the Peixe river basin.

Introdução: O Sistema Manchester de Classificação de Risco (SMCR) estabelece um tempo para o atendimento médico conforme o grau de urgência dos pacientes, a partir de um processo de tomada de decisão por registro eletrônico ou manual. Objetivo: Avaliar o grau de confiabilidade, a acurácia e o tempo despendido para a realização do SMCR em registros eletrônico e manual. Método: Estudo exploratório-descritivo de abordagem quantitativa, realizado com todos 43 (100%) enfermeiros do Hospital Universitário da Universidade de São Paulo (HU-USP) que foram aprovados no curso de classificador do SMCR pelo Grupo Brasileiro de Classificação de Risco (GBCR). A casuística do estudo correspondeu ao número total de casos clínicos simulados (37) validados e fornecidos pelo GBCR e ao número de casos aplicados para cada participante da pesquisa (4). A amostra foi estimada, para que se obtivesse um coeficiente kappa de Cohen maior ou igual a 0,5, confiança de 95% e poder de teste de 80%, considerando o número de pacientes classificados em cada nível de prioridade clínica no HU-USP em 2016. A amostra foi composta por 10 participantes. A coleta de dados foi realizada, em duas fases, utilizando 20 casos clínicos simulados, os quais passaram por processo de avaliação junto a especialistas do GBCR. Na fase 1, foram entregues 4 casos para uso no registro manual e na fase 2, após aproximadamente, 4 semanas, os mesmos casos foram entregues para realização do SMCR por meio do registro eletrônico. A confiabilidade inter-avaliadores foi calculada pelo coeficiente kappa de Cohen e, em relação ao padrão ouro (acurácia), pela porcentagem de concordância. O tempo despendido foi analisado com o teste Wilcoxon-Mann-Whitney, considerando intervalo de confiança de 95% e valor de p menor que 0,05. Resultados: O grau de confiabilidade foi igual para a escolha dos fluxogramas e dos discriminadores com o uso de ambos os registros e apresentou diferenças na determinação da prioridade e dos sinais vitais. A acurácia apresentou diferença estatisticamente significante, apenas, em relação aos sinais vitais. O tempo despendido para o registro do SMCR foi menor com o uso eletrônico. Conclusão: O uso do registro eletrônico apresenta vantagens referentes à confiabilidade, acurácia e tempo despendido para a realização da classificação de risco, indicando a importância da adoção de tecnologias no processo de trabalho gerencial e assistencial nos serviços de saúde. / Introduction: The Manchester Triage System (MTS) defines clinical priority by determining the maximum allowed waiting time for medical care for the different levels of urgency based on decision support process by electronic or manual registration. Objective: Evaluate the degree of reliability, accuracy and time spent of the use of MTS with an electronic or manual registration. Method: This is an exploratory-descriptive study applied for all (43) nurses of the University Hospital of the University of São Paulo (HU-USP) approved in the MTS classifier course by Brazilian Group of Risk Classification. The casuistry of the study corresponded to the total number of simulated clinical cases (37) and the number of cases applied to each participant (4). The sample were calculated to obtain a Cohen kappa coefficient equal to 0.5 or greater than it, 95% confidence and 80% test power, considering the number of patients classified in each clinical priority level at the HU-USP in 2016. The sample had 10 participants. Data were collected from the triage of 20 clinical cases. This clinical cases were evaluated by Brazilian Group experts. In phase 1, 4 cases were given for use in the manual registration. In phase 2, after approximately 4 weeks, the same cases were given for use in the electronic registration. The inter-rater reliability was calculated by the Cohen kappa coefficient. The accuracy (the comparison with the golden standard) was calculated by the concordance percentage. The efficiency was calculated by the Wilcoxon-Mann-Whitney test, with a 95% confidence interval and p-value less than 0.05. Results: The degree of reliability was the same for the choice of flowcharts and discriminators with the use of electronic and manual registration. There were differences in reliability for determination of priority and the recording of vital signs. The accuracy presented a statistically significant difference only in relation to vital signs. The time spent with use the MTS was shorter with electronic registration. Conclusion: The use of the electronic registration had advantages related to the reliability, accuracy and time spent to use the MTS, showing how important it is to adopt technologies in the manage and assistencial care working process of the health services.

La planification des déplacements urbains au travers de la prédominance des réseaux et des déplacements de l'automobile interroge l'influence de la hiérarchisation du réseau sur le risque routier. Cette question a été peu traitée dans la littérature. Elle s'intègre dans une problématique plus vaste, qui vise à intégrer la sécurité routière dans l'action locale. Le risque routier dépend des caractéristiques d'individus qui se déplacent avec différents modes sur des réseaux plus ou moins dangereux gérés par les pouvoirs publics. L'analyse du risque d'avoir un accident pour les populations habitant des niveaux hiérarchiques différents est au cœur de ce travail de thèse. Elle peut être abordée au travers des dimensions spatiales et socio-économiques que la hiérarchisation du réseau engendre. La différenciation spatiale et socio-économique des habitants des niveaux hiérarchiques différents peut induire une inégalité du niveau du risque routier encouru par ces habitants. La recherche menée dans le cadre de cette thèse porte sur la mise en œuvre d'une approche méthodologique, dont l'analyse épidémiologique, statistique et spatiale constituent les principales composantes. Les investigations sur l'influence de la hiérarchisation du réseau sur le risque routier ont permis de trouver le lien qui peut exister entre les dimensions spatiales et socio-économiques et le risque routier. Elles permettent aussi de cibler les populations ayant un fort risque afin de mobiliser la responsabilité morale des élus pour protéger leurs concitoyens. Cette mobilisation vise à sensibiliser les acteurs locaux au risque d'implication dans un accident de la circulation des habitants plus qu'à se focaliser sur l'accidentologie des voies qu'ils gèrent. D'autre part, elles permettent d'éclairer les décisions publiques sur la question de la hiérarchisation du réseau en associant le risque routier afin d'intégrer l'objectif de la sécurité routière plus en amont dans les processus de la décision des projets de l'aménagement urbain / Planning urban mobility dominated by networks and car travel brings up the question of the effects of network hierarchy on accident risk. This issue has not been addressed very much in the literature. It can be linked to a broader problem which aims to integrate road safety into local action. Road risks depend on the characteristics of individuals who travel in different modes using networks (with more or less risk) that are managed by public authorities. Risk analysis of accident involvement for residents of different hierarchical levels is at the heart of this thesis. It can be approached through spatial and socioeconomic dimensions generated by network hierarchy. Spatial and socioeconomic differentiation of these residents can lead to risk inequalities. The studies carried out as part of this thesis suggest a methodological approach whose main components are epidemiological, statistics and spatial analysis. Investigating the influence of network hierarchy on traffic accident risk made it possible to find the potential link between the spatial and socioeconomic dimensions and traffic risk. It also allowed to target populations that are at high risk in order to motivate elected officials to act in favour of the residents' safety while making them aware of the risk residents are exposed to rather than the accidents of roads they manage. On the other hand, it highlights the policies related to network hierarchy while considering accident risk in order to address the objective of road safety at the earliest possible stage of the decision making process in urban planning projects

Cardiac auscultation, an important part of the physical examination, is difficult for many primary care providers. As a result, diagnoses are missed or auscultatory signs misinterpreted. A reliable, automated means of interpreting cardiac auscultation should be of benefit to both the primary care provider and to patients. This paper explores a novel approach to this problem and develops an algorithm that can be expanded to include all the necessary electronics and programming to develop such a device. The algorithm is explained and its shortcomings exposed. The potential for further development is also expounded. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection