Yes / Objectives: To compare the performance of a validated automatic computer-aided risk of mortality (CARM) score versus medical judgement in predicting the risk of in-hospital mortality for patients following emergency medical admission. Design: A prospective study. Setting: Consecutive emergency medical admissions in York hospital. Participants: Elderly medical admissions in one ward were assigned a risk of death at the first post-take ward round by consultant staff over a 2-week period. The consultant medical staff used the same variables to assign a risk of death to the patient as the CARM (age, sex, National Early Warning Score and blood test results) but also had access to the clinical history, examination findings and any immediately available investigations such as ECGs. The performance of the CARM versus consultant medical judgement was compared using the c-statistic and the positive predictive value (PPV). Results: The in-hospital mortality was 31.8% (130/409). For patients with complete blood test results, the c-statistic for CARM was 0.75 (95% CI: 0.69 to 0.81) versus 0.72 (95% CI: 0.66 to 0.78) for medical judgements (p=0.28). For patients with at least one missing blood test result, the c-statistics were similar (medical judgements 0.70 (95% CI: 0.60 to 0.81) vs CARM 0.70 (95% CI: 0.59 to 0.80)). At a 10% mortality risk, the PPV for CARM was higher than medical judgements in patients with complete blood test results, 62.0% (95% CI: 51.2 to 71.9) versus 49.2% (95% CI: 39.8 to 58.5) but not when blood test results were missing, 50.0% (95% CI: 24.7 to 75.3) versus 53.3% (95% CI: 34.3 to 71.7). Conclusions: CARM is comparable with medical judgements in discriminating in-hospital mortality following emergency admission to an elderly care ward. CARM may have a promising role in supporting medical judgements in determining the patient's risk of death in hospital. Further evaluation of CARM in routine practice is required. / Supported by the Health Foundation, National Institute for Health Research (NIHR) Yorkshire and Humberside Patient Safety Translational Research Centre (NIHR YHPSTRC).

Syftet med studien är att undersöka huruvida det är möjligt att generera högre avkastning genom fundamental analys med fokus på värdeinvestering och Joseph Piotroskis modell (2000) Fundamental Signal Score (F-SCORE). Modellen testas på den svenska aktiemarknaden under perioden 2007-2015. Genom att skapa 27 fiktiva portföljer, beräkna årlig avkastning och jämföra dem mot marknadsindexet SIXRX utvärderas modellens möjligheter att skapa marknadsjusterad avkastning på den svenska aktiemarknaden. Vidare undersöks modellens statistiska samband med avkastning samt kvoten mellan bokfört värde och marknadsvärde (B/M). Studien visar att H_F-portföljen bestående av företag med höga F-SCORES (7-9) gav upphov till bättre marknadsjusterad avkastning än både HBM-portföljen, bestående av företag med höga B/M-tal samt L_F-portföljen med F-SCORES mellan 0-3. Resultatet indikerar att det är möjligt att hitta undervärderade tillgångar och slå marknaden fem av nio gånger genom tillämpning av F-SCORE på den svenska aktiemarknaden. Detta innebär att den effektiva marknadshypotesen (EMH) inte är lika effektiv som teorin antyder. / The aim of this paper is to examine whether it is possible to generate higher returns through the use of fundamental analysis with focus on value investing and Joseph Piotroski’s (2000) model called Fundamental Signal Score (F-SCORE). The model is tested on the Swedish Stock Market during the period 2007-2015. By forming 27 fictive portfolios, calculating yearly returns and comparing them to the SIXRX benchmark, the model’s possibility to generate market-adjusted returns on the Swedish Stock Market is evaluated. Furthermore, the model’s correlation with the returns and book-to-market ratio (B/M) are tested statistically. The study shows that the H_F-portfolio consisting of companies with high F-SCORES (7-9) gave rise to better market-adjusted returns than both the HBM-portfolio, consisting of companies with high book-to-market ratios, and the L_F-portfolio with F-SCORES between 0-3. The results indicate that it is possible to find undervalued assets and beat the market five out of nine times by using the F-SCORE on the Swedish Stock Market. Therefore, the efficient market hypothesis (EMH) is not as efficient as the theory applies.

Um dos principais desafios da agricultura, e mais especificamente da produção de cana-de-açúcar no Brasil, visando garantir o abastecimento do mercado doméstico e a competitividade nos mercados internacionais, é manter níveis elevados de produtividade. Embora tenha ocorrido um avanço significativo nas técnicas de produção nas últimas décadas, a produtividade desta lavoura se encontra, conforme alguns estudos disponíveis na literatura, aquém do seu nível potencial. Uma das alternativas para contribuir com o aumento da produtividade é a utilização de novas técnicas, como o Manejo Integrado de Pragas, por exemplo. Os trabalhos que avaliaram recentemente a produtividade do setor sugerem que há ganhos para os adotantes dessa técnica. Para o estado de São Paulo, porém, existem poucos estudos empíricos de avaliação de impacto no setor sucroalcooleiro. Portanto, o objetivo deste trabalho foi avaliar como a adoção de tecnologia, no caso o manejo integrado de pragas, pode impactar na produtividade da cana-de-açúcar nas Unidades de Produção Agropecuária (UPA) do estado de São Paulo, que constam no Levantamento Censitário de Unidades de Produção Agropecuárias (Projeto LUPA), do Instituto de Economia Agrícola (IEA). Para isto, utilizou-se o método de Propensity Score Matching (PSM) para medir o impacto da adoção tecnológica na produtividade. As estimativas mostraram efeitos positivos e significativos, indicando que o manejo integrado de pragas pode aumentar de 2,9 ton/ha a 4,4 ton/ha, aproximadamente, a produtividade da cana de açúcar. Os resultados indicam, também, que há maiores chances de adotar o manejo integrado de pragas osprodutores que apresentaram maiores níveis de instrução, os adeptos de técnicas de análise de solo, de adubação, mudas fiscalizadas entre outros. / One of the main challenges of agriculture, and more specifically of the production of sugarcane in Brazil, in order to guarantee domestic supply and competitiveness on the international markets, is to maintain high levels of productivity. Although there has been a significant advance in terms of production techniques in recent decades, the sugarcane yield, according to some studies in the literature, below its potential level. One of the alternatives to contribute to the productivity increase is the use of new techniques, such as Integrated Pest Management, for example. Papers that recently evaluated the agricultural productivity suggest that there are gains for the adopters of this technique. For the state of São Paulo, however, there are few empirical studies of impact assessment in the sugar and alcohol sector. Therefore, the objective of this study was to evaluate how the adoption of technology, in the specific case of the integrated pest management, can impact sugarcane\'s productivity in the Agricultural Production Units (UPA) of the State of São Paulo, which were in the Census Survey Of Agricultural Production Units (LUPA Project), published by the Institute of Agricultural Economics (IEA). For this purpose, the Propensity Score Matching method was implemented to measure the impact of technological adoption on productivity. Results suggested positive and significant effects, indicationg the Integrated Pest Management increases, approximately, the sugarcane productivity between 2,9 ton/ha to 4,4 ton/ha, according the empirical model specification. The analysis also highlighted a greater chance to adopt the integrated pest management by producers with highest levels of education, and the adopters of techniques of soil analysis, fertilization, and supervised seedlings.

Modelos GARCH tendo a normal e a t-Student como distribuições condicionais são amplamente utilizados para modelagem da volatilidade de dados financeiros. No entanto, tais distribuições podem não ser apropriadas para algumas séries com caudas pesadas e comportamento leptocúrtico. As chamadas distribuições estáveis podem ser mais adequadas para sua modelagem, como já explorado na literatura. Por outro lado, os modelos GAS (Generalized Autoregressive Score), com desenvolvimento recente, tratam-se de modelos dinâmicos que possuem em sua estrutura a função score (derivada do logaritmo da verossimilhança). Tal abordagem oferece uma direção natural para a evolução dos parâmetros da distribuição dos dados. Neste trabalho, é proposto um novo modelo GAS em conjunção com distribuições estáveis simétricas para a modelagem da volatilidade - de fato, é uma generalização do GARCH, pois, para uma particular escolha de distribuição estável e de estrutura do modelo, tem-se o clássico modelo GARCH gaussiano. Como em geral a função densidade das distribuições estáveis não possui forma analítica fechada, é apresentado seu procedimento de cálculo, bem como de suas derivadas, para o completo desenvolvimento do método de estimação dos parâmetros. Também são analisadas as condições de estacionariedade e a estrutura de dependência do modelo. Estudos de simulação são conduzidos, bem como uma aplicação a dados reais, para comparação entre modelos usuais, que utilizam distribuições normal e t-Student, e o modelo proposto, demonstrando a eficácia deste. / GARCH models with normal and t-Student conditional distributions are widely used for volatility modeling in financial data. However, such distributions may not be suitable for some heavy-tailed and leptokurtic series. The stable distributions may be more adequate to fit such characteristics, as already exploited in the literature. On the other hand, the recently developed GAS (Generalized Autoregressive Score) models are dynamic models in which the updating mechanism of the time-varying parameters is based on the score function (first derivative of the log-likelihood function). This provides the natural direction for updating the parameters, based on the complete density. We propose a new GAS model with symmetric stable distribution for volatility modeling. The model can be interpreted as a generalization of the GARCH models, since the classic gaussian GARCH model is derived from it by using particular choices of the stable distribution and the model structure. There are no closed analytical expressions for general stable densities in most cases, hence its numeric computation and derivatives are detailed for the sake of complete development of the estimation process. The stationarity conditions and the dependence structure of the model are analysed. Simulation studies, as well as an application to real data, are presented for comparisons between the usual models and the proposed model, illustrating the effectiveness of the latter.

[pt] O fomento à competitividade das firmas nacionais é etapa necessária para a construção de um projeto de desenvolvimento econômico e social sustentável de um país. Além dos benefícios macroeconômicos, há um consenso sobre a capacidade, do ponto de vista microeconômico, de que a atividade exportadora traga diversos benefícios para as firmas engajadas. Como reflexo da crescente integração econômica entre os países, o valor das exportações mundiais aumentou 130 por cento nos últimos dez anos. Neste cenário, o Brasil enfrenta na atualidade desafios complexos quanto à sua inserção externa, ligados a algumas questões centrais. Dentre elas, cabe destaque para a sua pequena participação relativa nas exportações mundiais, principalmente quando comparado à evolução dos demais países que compõem o bloco dos BRIC. Adicionalmente existe uma concentração, em termos de valor, das exportações nacionais em um número pequeno de empresas. Em terceiro lugar, há ainda o debate sobre a composição de sua pauta exportadora, em que a presença de commodities primárias vem aumentando de forma significativa no período recente, com redução de quase 40 por cento de valor dos bens manufaturados, tema especialmente preocupante quando se observa que não há indicações no cenário macroeconômico mundial de que esse ciclo de valorização de commodities se reverterá no curto prazo, de modo que seus impactos sobre as exportações nacionais tendem a persistir. Se já é sabido que todos os fatores desse processo não são controlados pelo governo brasileiro, a literatura registra a importância de que políticas governamentais possam ser influentes no desempenho de exportação das firmas. Neste sentido, assim como quase todos os países desenvolvidos e em desenvolvimento, o Brasil fortaleceu o seu compromisso com a assistência à exportação e desenvolveram programas completos para aumentar a atividade exportadora das firmas nacionais. Considerando que os recursos governamentais são escassos e exigem o máximo de esforços para a melhor eficiência alocativa, a pergunta relevante, e objeto de estudo desta tese, é avaliar qual o impacto sobre o desempenho exportador das empresas brasileiras exportadoras da participação em programas governamentais de apoio à exportação. A estratégia de pesquisa foi baseada na estimação de efeitos causais do tratamento por meio da técnica de propensity score matching (PSM) para os três programas avaliados: o BNDES-Exim, o Drawback e o Proex Financiamento. Trata-se de um método observacional ainda pouco aplicado na área de Negócios Internacionais, feito sobre um desenho quasi-experimental aplicado a determinação da inferência causal, que exige a utilização de grupos de controle e avaliações ex ante e ex post. Como as informações estavam disponíveis para a pesquisadora ao longo do período compreendido entre 2000 e 2007, foi realizada uma abordagem utilizando modelos em painel como forma de capturar efeitos intrínsecos da firma e da evolução temporal. Os resultados evidenciaram que a participação nos programas teve impacto no desempenho exportador das firmas apoiadas, mas que este impacto se manifestou de forma distinta entre os três programas e os diversos indicadores de desempenho exportador investigados. / [en] Fostering the competitiveness of domestic firms is a necessary step towards the construction of a project of economic and social development of a country. In addition to the macroeconomic benefits, there is a consensus of the microeconomic point of view on the ability that the export activity brings many benefits to firms engaged. Reflecting the increasing economic integration between the countries, the value of world exports increased by 130 percent over the last ten decade. In this scenario, Brazil currently faces complex challenges regarding its external insertion, regarding mainly some central issues. Among them, it is worth highlighting its relative small share in world exports, especially when compared to advances in other countries that make up the BRIC bloc. Additionally there is a concentration in terms of value of national exports in a small number of companies. Thirdly, there is an ongoing debate about the composition of Brazil s export basket, in which the presence of primary commodities has increased significantly in recent years, with a reduction of nearly 40 percent in value of manufactured goods. This issue is of particular concern when one considers there are no indications in the global macroeconomic environment that this cycle of commodities valuation should reverse in the short term, so that its impact on exports tend to persist. No matter it is known that all factors of this process cannot be controlled by Brazilian government, literature shows the importance of government policies that may be influential in the export performance of firms. In this sense, as almost all developed and developing countries, Brazil has strengthened its commitment to export assistance and have developed comprehensive programs to increase the export activity of domestic firms. Considering that government resources are scarce and require maximum efforts to better allocative efficiency, the relevant question, and the specific purpose of this dissertation is to evaluate the impact on the export performance of Brazilian exporters from participation in government export assistance programs. The research strategy was based on the estimation of the causal effects of treatment using the technique of propensity score matching (PSM) for the three evaluated programs: BNDES-Exim, Drawback and Proex Financiamento. It is a observational method rarely applied in the field of International Business, built on a quasi-experimental design applied to the determination of causal inference, which requires the use of ex ante and ex post control groups. As data was available to the researcher during the period comprised between 2000 and 2007, panel models were applied in order to capture intrinsic effects of the firm and the temporal evolution. The results showed that participation in the programs had an impact on the export performance of the firms supported, but this impact manifested differently among the three programs and the several indicators of export performance adopted.

Objectif : L’objectif est l’étude de plusieurs méthodes de prise en compte des facteurs de confusion, mesurés ou non mesurés, ce en situation observationnelle de population de patients psychotiques ou schizophrènes. Méthodes : Deux méthodes ont été utilisées : le score de propension (adaptés aux données mesurées) et les analyses de sensibilité (pour les informations non mesurées). Le champ d’application est celui de l’épidémiologie clinique en psychiatrie, et plus spécifiquement celui de la schizophrénie. Le développement s’appuie sur trois parties successives. La première partie met en exergue la question de la discussion du biais résiduel. Pour cela, on s’appuie sur les résultats d’une étude transversale d’exposition à un facteur contextuel (la prison), ce dans le cadre de la présence de troubles psychotiques (au sens axe DSM IV), à partir d’une méthodologie d’ajustement conventionnelle classique. La deuxième partie est une comparaison d’une technique d’ajustement classique à un ajustement par score de propension. Pour cela, on utilise les résultats issus d’une étude de cohorte avec la survenue d’un évènement selon l’exposition à un traitement en population schizophrène, à partir de l’utilisation du score de propension comme outil d’ajustement. La troisième partie est une synthèse sur la modélisation de l’incertitude et des biais de confusion non mesurés multiples. Les théories et méthodes sont décrites, puis appliquées aux résultats des deux études précédentes. Résultats : L’étude transversale, dont les résultats non montrés jusqu’à présent, permet de poser la problématique de la qualité de l’ajustement dans le cadre d’une exposition à un facteur en situation observationnelle. L’étude de cohorte permet de comparer une technique d’ajustement classique à un ajustement par score de propension (SP). Nous avons étudié plusieurs méthodes d’ajustement (multivarié standard, avec ajustement sur SP, avec appariement sur SP). Et nous mettons en évidence que, selon la méthode d’ajustement utilisée, les résultats obtenus sont différents. La méthode de stratification sur SP semble être la meilleure. Les méthodes de prise en compte des facteurs de confusion non mesurés sont ensuite étudiées. Une première étape fait état de l’apport des théories probabilistes et des techniques apparentées, ensuite une combinaison de ces théories est proposée avec une application pratique aux deux études présentées précédemment. Conclusion : Dans le cas des études observationnelles, l’objectif de ce travail a été d’étudier, de décrire et d’appliquer des techniques de modélisation pour mieux prendre en compte les différences initiales, potentiellement source de confusion. C’est un travail à la frontière entre la méthodologie, les biostatistiques et l’épidémiologie. Nous nous appuyons sur des difficultés rencontrées, en pratique en épidémiologie psychiatrique (pathologies mentales à étiologies multifactorielles et interdépendantes) pour proposer une approche pragmatique de la prise en compte optimale des facteurs de confusion potentiels, mesurés ou non mesurés. / Objective : To evaluate control methods for measured or unmeasured confusion bias, in observational situation of psychotic or schizophrenic patients. Methods : Propensity score method (for measured confusion bias) and analyses of sensibility (for unmeasured confusion bias) were applied in the field of psychiatric epidemiology, specifically in schizophrenia. In first, the question of residual bias was underlined by the results of a transversal study. The exposition at a contextual parameter (prison) was studied in link with psychotic disorders (DSM IV), with a classic control method.Second, to lead to an unbiased estimation of treatment effect, we compared a classic control method with a method based on propensity score. These approach were applied to a cohort of French schizophrenic patients where we studied the event (relapse) by the treatment exposition (polypharmacy or not).Third, we developed a synthesis on modelisation of uncertainty and non-measured confusion bias. Theories and methods were described, and then applied on results of previous studies. Results : The transversal study, with non-demonstrated results still then, allow us to reach the question of control quality in the case of exposition to a parameter in observational situation. The cohort study permit to compare a classic control method and propensity score (PS). We highlighted different results according to some control method. Stratification method on PS seemed to be the best method to predict relapse according to treatment exposition. Non-measured bias control methods were then described. And a combination of probabilistic methods was applied to the previous studies. Conclusion : In the case of observational studies, the objective was to study, to describe and to apply modelisation methods to take in account differences at baseline, potentially source of confusion bias. This research is at the crossroads of methodology, biostatistics and epidemiology.

Modelos GARCH tendo a normal e a t-Student como distribuições condicionais são amplamente utilizados para modelagem da volatilidade de dados financeiros. No entanto, tais distribuições podem não ser apropriadas para algumas séries com caudas pesadas e comportamento leptocúrtico. As chamadas distribuições estáveis podem ser mais adequadas para sua modelagem, como já explorado na literatura. Por outro lado, os modelos GAS (Generalized Autoregressive Score), com desenvolvimento recente, tratam-se de modelos dinâmicos que possuem em sua estrutura a função score (derivada do logaritmo da verossimilhança). Tal abordagem oferece uma direção natural para a evolução dos parâmetros da distribuição dos dados. Neste trabalho, é proposto um novo modelo GAS em conjunção com distribuições estáveis simétricas para a modelagem da volatilidade - de fato, é uma generalização do GARCH, pois, para uma particular escolha de distribuição estável e de estrutura do modelo, tem-se o clássico modelo GARCH gaussiano. Como em geral a função densidade das distribuições estáveis não possui forma analítica fechada, é apresentado seu procedimento de cálculo, bem como de suas derivadas, para o completo desenvolvimento do método de estimação dos parâmetros. Também são analisadas as condições de estacionariedade e a estrutura de dependência do modelo. Estudos de simulação são conduzidos, bem como uma aplicação a dados reais, para comparação entre modelos usuais, que utilizam distribuições normal e t-Student, e o modelo proposto, demonstrando a eficácia deste. / GARCH models with normal and t-Student conditional distributions are widely used for volatility modeling in financial data. However, such distributions may not be suitable for some heavy-tailed and leptokurtic series. The stable distributions may be more adequate to fit such characteristics, as already exploited in the literature. On the other hand, the recently developed GAS (Generalized Autoregressive Score) models are dynamic models in which the updating mechanism of the time-varying parameters is based on the score function (first derivative of the log-likelihood function). This provides the natural direction for updating the parameters, based on the complete density. We propose a new GAS model with symmetric stable distribution for volatility modeling. The model can be interpreted as a generalization of the GARCH models, since the classic gaussian GARCH model is derived from it by using particular choices of the stable distribution and the model structure. There are no closed analytical expressions for general stable densities in most cases, hence its numeric computation and derivatives are detailed for the sake of complete development of the estimation process. The stationarity conditions and the dependence structure of the model are analysed. Simulation studies, as well as an application to real data, are presented for comparisons between the usual models and the proposed model, illustrating the effectiveness of the latter.

Um dos principais desafios da agricultura, e mais especificamente da produção de cana-de-açúcar no Brasil, visando garantir o abastecimento do mercado doméstico e a competitividade nos mercados internacionais, é manter níveis elevados de produtividade. Embora tenha ocorrido um avanço significativo nas técnicas de produção nas últimas décadas, a produtividade desta lavoura se encontra, conforme alguns estudos disponíveis na literatura, aquém do seu nível potencial. Uma das alternativas para contribuir com o aumento da produtividade é a utilização de novas técnicas, como o Manejo Integrado de Pragas, por exemplo. Os trabalhos que avaliaram recentemente a produtividade do setor sugerem que há ganhos para os adotantes dessa técnica. Para o estado de São Paulo, porém, existem poucos estudos empíricos de avaliação de impacto no setor sucroalcooleiro. Portanto, o objetivo deste trabalho foi avaliar como a adoção de tecnologia, no caso o manejo integrado de pragas, pode impactar na produtividade da cana-de-açúcar nas Unidades de Produção Agropecuária (UPA) do estado de São Paulo, que constam no Levantamento Censitário de Unidades de Produção Agropecuárias (Projeto LUPA), do Instituto de Economia Agrícola (IEA). Para isto, utilizou-se o método de Propensity Score Matching (PSM) para medir o impacto da adoção tecnológica na produtividade. As estimativas mostraram efeitos positivos e significativos, indicando que o manejo integrado de pragas pode aumentar de 2,9 ton/ha a 4,4 ton/ha, aproximadamente, a produtividade da cana de açúcar. Os resultados indicam, também, que há maiores chances de adotar o manejo integrado de pragas osprodutores que apresentaram maiores níveis de instrução, os adeptos de técnicas de análise de solo, de adubação, mudas fiscalizadas entre outros. / One of the main challenges of agriculture, and more specifically of the production of sugarcane in Brazil, in order to guarantee domestic supply and competitiveness on the international markets, is to maintain high levels of productivity. Although there has been a significant advance in terms of production techniques in recent decades, the sugarcane yield, according to some studies in the literature, below its potential level. One of the alternatives to contribute to the productivity increase is the use of new techniques, such as Integrated Pest Management, for example. Papers that recently evaluated the agricultural productivity suggest that there are gains for the adopters of this technique. For the state of São Paulo, however, there are few empirical studies of impact assessment in the sugar and alcohol sector. Therefore, the objective of this study was to evaluate how the adoption of technology, in the specific case of the integrated pest management, can impact sugarcane\'s productivity in the Agricultural Production Units (UPA) of the State of São Paulo, which were in the Census Survey Of Agricultural Production Units (LUPA Project), published by the Institute of Agricultural Economics (IEA). For this purpose, the Propensity Score Matching method was implemented to measure the impact of technological adoption on productivity. Results suggested positive and significant effects, indicationg the Integrated Pest Management increases, approximately, the sugarcane productivity between 2,9 ton/ha to 4,4 ton/ha, according the empirical model specification. The analysis also highlighted a greater chance to adopt the integrated pest management by producers with highest levels of education, and the adopters of techniques of soil analysis, fertilization, and supervised seedlings.

The essence of the most advantageous tender (MAT) is to allow the procuring authorities to carry out a comprehensive assessment on the technical merits, quality, function, terms and prices of tenders in accordance with the judging criteria listed on the tendering document. In this way, the award of contract can be determined that ensures the best quality within the budget and encourages good competition among tendering parties while eliminate vicious undercutting. Scandals arose from recent procurement projects such as the ETC procurement project, High Speed Rail vibration reduction project, the procurement of Kuan-hwa Fast Attack Boat Guide-Missile (F-ABG), and the construction of the southern courtyard of the National Palace museum have attracted great attention. On March 22, 2006, the Premier announced that ¡§Award to the lowest tender should be made the rule while the MAT should be the exception¡¨ in future government procurement projects. This announcement highlighted the flaws and problems yet to be improved within the existing system. After studying related literatures, conducting a thorough analysis of the current situation and different case studies of the tender selection process, this paper conducted a survey among the people involved in government procurement to find out how they think of the selection of the most advantageous tender legally and in practice, the function of the tender selection committee, the management and the efficiency of the selection process. Suggestions for improvement are put forward based on the findings and analysis. The survey found that the Ranking Method while considering the price factor and the Overall Evaluation Score Method are the most frequently used tendering methods in the past experience of our interviewees. Price may be a crucial factor in determining the most advantageous tender. The most important factor in the award selection process is technical merits. The process of selecting the most advantageous tender is most susceptible to flaws and scandals. The inappropriate appointment of the committee members is the main cause of these flaws. In practice, the selection of committee members itself is of great difficulty. The expertise, personal bias, as well as one¡¦s understanding of the procurement could all affect the fairness and credibility of the tendering process. Besides these committee members, top officials in the procuring institutions also play important roles in the decision-making process. Cognitive differences among interviewees in the understanding of the legal institutions of the MAT selection, the functions of the selection committee, the execution of the MAT selection, the management mechanisms of the MAT selection may be caused by elements such the institutions they work for, the nature of their works, the job title, the training hours they received, whether they are professionally accredited. Yet, different years of experience did not contribute to such differences. People with different job title, nature of work, years of experience, and training hours did cause significant difference in the understanding of the efficiency of the MAT selection. Working at different institutions and professional accreditation, however, did not result in such difference. Based on the above findings, a way forward has been provided: a set of comprehensive regulations for the most advantageous tender selection should be established. A standard of procedure and module should be designed. The decision authority of the procuring institution should be defined in order to actually fulfill the need of the procurement. A comprehensive list of suggested professionals should be compiled to assist different kinds of procurements. This list would ensure the fairness of the selection process. Specify the judging criteria for prices, weights of evaluating elements, and the scoring principle. Determine a set of reasonable scoring method for prices. Provide professional training for procurement professionals. Enhance the efficiency of the MAT selection. Committee members should receive professional training in order to improve the credibility of the selection process. A performance evaluation mechanism should be established in order to improve efficiency and put the government¡¦s budget to the best use.

Abstract The aim of the studie was to investigate if the Pediatric Early Warning Score system, PEWS, is an useful instrument on a children's inpatient ward, regarding the detecting of deterioration in children's vital signs. For this, a quantitative descriptive design with qualitative elements was used. Method: Study specific questionnaires were distributed to 86 persons (helpnurses, nurses and doctors). Of these, 36 answered and sent back the surveys. Results: Of 36 responses 25 felt experienced a faster detection of deterioration of vital signs in the child. Many felt that they had faster response from the physician on call by providing an assessment figure of the child's condition. Conclusion: Most of the persons experienced that the use of the assessment intrument PEWS detected a deterioration of the child´s vital signs earlier than before using the instrument. Staff experienced greater security in their work when they had a tool to help and they also experienced an earlier response from physicians. / SAMMANFATTNING   Syftet med studien var att undersöka om bedömningsinstrumentet Pediatric Early Warning Score, PEWS, är till användning och vägledning på barnavdelning med avseende att upptäcka försämring av barns vitalparametrar. För detta användes en beskrivande kvantitativ design med kvalitativa inslag. Metod: Ett studiespecifikt enkätformulär gick ut till 86 personer (undersköterskor, sjuksköterskor och läkare på två pediatriska vårdavdelningar). Av dessa besvarades 36 enkäter. Resultat: Av 36 svarande ansåg 25 att man snabbare upptäckte försämring av vitalparametrarna hos barnet. Många ansåg att de fick snabbare gensvar från jourläkare genom att uppge en bedömningssiffra över barnets hälsotillstånd. Slutsats: Med hjälp av bedömningsinstrumentet PEWS upplevde personalen att en upptäckt av försämring av barnets vitalparametrar gjordes tidigare, samt att gensvar från jourläkare erhölls snabbare. Personalen upplevde en ökad trygghet i sitt arbete då man hade ett arbetsredskap till hjälp.