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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
31

Controles geoarqueológicos e modelos morfoestratigráficos: implicações para o estudo das ocupações pré-históricas na costa sul-sudeste do Brasil / Geoarchaeological Controls and Morphostratigraphic Models: implications for the study of prehistoric occupation on the south-southeast coast Brazil

Brochier, Laércio Loiola 18 February 2009 (has links)
A presente tese refere-se a uma proposta de abordagem geoarqueológica voltada ao estudo de sítios arqueológicos costeiros, enfocando pressupostos teóricos e metodológicos ligados à uma aproximação entre a Arqueologia, Geociências e Ciências da Informação. Objetivou em um primeiro momento, inserir questões e problemáticas relativas a necessidade de inclusão da incerteza no raciocínio e práticas arqueológicas, vislumbrando as possibilidades de seu tratamento. Neste sentido, a percepção do \"problema da não informação\" constituiu o argumento conceitual para a elaboração de um modelo de raciocínio dialético sobre a aquisição, geração, seleção e transmissão de informações na disciplina. Nessa perspectiva, sobreveio a necessidade da interação constante entre Teorias de Formação e de Recuperação, como passo essencial ao controle das perdas e ganhos informacionais e, ao tratamento das imperfeições, incompletudes, imprecisões e ambiguidades ligadas aos fenômenos arqueológicos e seu registro científico. Um dos aspectos explorados refere-se à percepção das incertezas e vieses envolvidos na interpretação das ocupações costeiras, notadamente quanto às problemáticas de origem e migração das primeiras populações nessas áreas. Em um modelo atual dicotômico entre o interior e o litoral, onde mesmo os sítios mais antigos (somente sambaquis) acham-se dispostos sobre a superfície dos terrenos, a percepção da dinâmica e complexidade dos sistemas costeiros, fica restrita ao enquadramento desses sítios em sucessões de cenários geomórficos e paeogeográficos. Deste modo, pouca atenção é dada às conseqüências de agentes dinâmicos sobre a configuração e seleção de sítios na atual paisagem costeira, bem como, à possibilidade de ocorrência e detecção de diferentes classes de sítios, que foram preservados em profundidade por meio de processos de capeamento sedimentar. Assim, em um segundo momento, foi proposto à utilização do conceito de \"Controles Geoarquelógicos\" (CG) no estudo e explicitação dos condicionantes naturais e analíticos envolvidos em uma pesquisa de caráter regional, cujo enfoque está nas relações informacionais estabelecidas entre sítios arqueológicos e meio (natural e analítico), e cujo resultado (síntese dialética) compreenderia a noção de evento arqueológico. Diante da explicitação da variabilidade envolvida na caracterização do Registro Arqueológico Regional (RAR), bem como, dos condicionantes complexos derivados da estrutura, dinâmica e evolução da paisagem, o evento arqueológico considerado na tese, compreendeu a investigação da probabilidade de preservação de sítios costeiros antigos (teoria de formação) e do seu potencial de detecção (teoria de recuperação). Neste sentido foi utilizado o raciocínio abdutivo para gerar hipóteses sobre a preservação ou não de sítios encobertos, tendo por base os modelos sedimentares e morfoestratigraficos produzidos para a costa sul-sudeste. Por sua vez, a busca de indicadores nas planícies costeiras de Guaratuba-PR e de Caraguatatuba SP, possibilitou apontar condicionantes (variáveis) favoráveis a geração de um modelo de trapeamento de sítios (capeamento e preservação sedimentar) para a região da Baía de Guaratuba. Por fim, foi testado o raciocínio probabilístico Bayesiano e a Teoria de Evidências (Dempster-Shafer) para a inclusão e representação da incerteza na pesquisa de sambaquis, visualizando um método de tratamento das evidências e inferências geradas em sistemas baseados em conhecimento. Esses mesmos métodos também permitiram determinar os pesos para os diferentes indicadores, e as condições de necessidade, suficiência e ambigüidade das variáveis na geração de mapas aplicados à predição da favorabilidade e suscetibilidade de sítios arqueológicos enterrados na planície costeira de Guaratuba. / This thesis refers to a proposal for a geoarchaeological approach focused on the study of coastal archaeological sites, concentrating on theoretical and methodological assumptions related to a closeness between the archeology, the Information Sciences and Geosciences. It aimed in a first moment, to insert issues and problems concerning the need for inclusion of uncertainty in archaeological reasoning and practice, foreseeing the possibilities of their treatment. In this sense, the perception of the \"no information problem\" was the argument for the conceptual development of a model of dialectical thinking about the acquisition, generation, selection and transmission of information in the discipline. Accordingly, the need for constant interaction between Formation and Recovery Theories became an essential step to the control of informational losses and gains, and the treatment of imperfections, incompleteness, inaccuracies and ambiguities relating to archaeological phenomena and their scientific record. One of the aspects exploited, is the perception of slants and uncertainties involved in the interpretation of coastal activities, notably on issues of origin and migration of the first people in those areas. In a current dichotomic model between the interior and the coast, where even the oldest sites (only sambaquis) are found placed on the surface of the land, the perception of the complexity and dynamics of the coastal systems, is restricted to the framework of these sites in a succession of geomorphic and paleogeographics \"scenarios\". Thus, little attention is given to the dynamic agents consequences on the configuration and selection of sites in the coastal landscape, and the possibility of occurrence and detection of different classes of sites, which were preserved indepth by a sedimental capstone process. Therefore, in a second moment, it was proposed to use the concept of \"geoarchaeological control \" (GC) in the study and explanation of natural and analytical conditions involved in a research of regional manner, whose focus is on the informational relations established between archaeological sites and the environment (natural and analytical), whose result (dialectical synthesis) understand the concept of the archaeological event. Given the explicit characterization of the variability involved in the Regional Archaeological Record (RAR), as well as the complex condition agent derived from the structure, dynamics and evolution of the landscape, the archaeological event considered in the thesis, understand the research of the probability of preservation of ancient coastal sites (formation theory) and its potential for detection (recovery theory). In this sense abdutive reasoning was used to generate hypotheses about the preservation or not of covered sites, based on the sedimentary and morphostratigraphic models produced for the south-southeast coast. In turn, the search for indicators in the coastal plains of Guaratuba- PR and Caraguatatuba-SP, it made possible to point constraints (variables) favorable to the generation of a trap model for sites (sedimental capstone and preservation) for the region of Guaratuba Bay. Finally it was tested the probabilistic bayesian reasoning and Evidence Theory (Dempster-Shafer) for the inclusion and representation of uncertainty in the research of sambaquis foreseeing a method of treatment of the evidence and inferences generated by knowledge-based systems. These methods also allowed to determine the weights for different indicators, and the conditions of necessity, sufficiency and ambiguity of the variables in the generation of maps applied to the prediction of favorability and susceptibility of buried archaeological sites in the coastal plain of Guaratuba.
32

Towards the improvement of food flavor analysis through the modelling of olfactometry data and expert knowledge integration / Innover dans l'analyse de la flaveur des aliments : développer une approche de modélisation associant résultats d’analyse et dires d’experts

Roche, Alice 25 October 2018 (has links)
Parmi les dimensions sensorielles engagées dans la perception de la flaveur, la composante odorante est déterminante car elle porte le plus souvent l’identité et la typicité d’un aliment. L’analyse chimique de la composante odorante repose sur une stratégie séparative qui permet d’identifier les différents odorants présents dans l’aliment. Cependant, la perception des odorants en mélange induit des interactions au niveau perceptif qui ne sont pas prises en compte dans les techniques séparatives. Les mécanismes sous-jacents aux interactions perceptives sont mal connus, ce qui limite les possibilités de prédiction de l’odeur d’un aliment sur la base de sa composition chimique. En réponse à cette problématique deux approches émergent de la revue de la littérature. La première est basée sur la prédiction d’odeur d’après la structure moléculaire des odorants. Cependant, les études concernent des odorants seuls et non leurs mélanges. La seconde repose sur la recombinaison d’odorants en mélange après l’étape d’analyse séparative, mais le choix des odorants à associer est essentiellement empirique. Ainsi, deux questions se posent : Comment prédire l'odeur de mélanges de molécules d’après la structure moléculaire des odorants? Comment améliorer l'analyse de la flaveur dans le but de prédire l'odeur d’aliments complexes composés de plusieurs dizaine d’odorants en mélanges? Ces deux questions ont été abordées dans cette thèse dont les travaux sont décrits dans ce manuscrit selon deux axes principaux.Le premier axe décrit l'utilisation et le développement d’un modèle basé sur le concept des distances angulaires calculées à partir de la structure moléculaire des odorants avec pour objectif de prédire la similarité perceptive de mélanges plus ou moins complexes d’odorants. Les résultats soulignent l'importance de prendre en compte la dimension d'intensité des odorants afin d’améliorer la qualité de la prédiction. Des perspectives d’amélioration du modèle sont dégagées pour permettre de dépasser la dimension de similarité et prédire des dimensions qualitatives de l’odeur.Le deuxième axe présente une démarche originale d’intégration de connaissances liées à l’expertise dans la procédure d'analyse de la flaveur. Ainsi, trois types de données hétérogènes sont agrégés dans un modèle mathématique global : des données chimiques, des données sensorielles et des connaissances d’experts aromaticiens. L'expertise est intégrée à travers la création d'une ontologie qui est ensuite associée à une approche de logique floue optimisée par algorithme évolutionnaire. Le modèle développé permet de prédire le profil odorant de seize vins rouges sur la base de leur composition en odorants. Au final, l’ensemble des travaux menés dans cette thèse apporte des résultats originaux permettant une meilleure compréhension de la construction des odeurs des aliments et permet d’élaborer des hypothèses quant aux relations sous-jacentes de l'espace perceptif des odeurs en mélanges complexes. / Among the sensory dimensions involved in food flavor, the odor component is critical because it often determines the identity and the typicality of the food. Chemical flavor analysis provides a list of the odorants contained in a food product but is not sufficient to predict the odor resulting from their mixture. Indeed, odor perception relies on the processing by the olfactory system of many odorants embedded in complex mixtures and several perceptual interactions can occur. Thus, the prediction of the perceptual outcome of a complex odor mixture remains challenging and two main approaches emerge from the literature review. On the one hand, predictive approaches based on the molecular structure of odorants have been proposed but have been limited to single odorants only. On the other hand, methodologies relying on recombination strategies after the chemical analyses of flavor have been successfully applied to identify those odorants that are key to the food odor. However, the choices of odorants to be recombined are mostly based on empirical approaches. Thus, two questions arise: How can we predict the odor quality of a mixture on the basis of the molecular structure of its odorants? How can we improve food flavor analysis in order to predict the odor of a food containing several tens of odorants? These two questions are at the basis of the thesis and of this manuscript which is divided in two main axes.The first axis describes the development of a model based on the concept of angle distances computed from the molecular structure of odorants in order to predict the odor similarity between mixtures. The results highlight the importance of taking into account the odor intensity dimension to reach a good prediction level. Moreover, several perspectives are proposed to extend the model prediction beyond the similarity dimension and to predict more qualitative dimensions of odors.The second axis presents an innovative strategy which allows integrating experts’ knowledge in the flavor analysis procedure. Three different types of heterogeneous data are embedded in a mathematical model: chemical data, sensory data and knowledge from expert flavorists. Experts’ knowledge is integrated owing to the development of an ontology, which is further used to define fuzzy rules optimized by evolutionary algorithms. The final output of the model is the prediction of red wines’ odor profile on the basis of their odorants’ composition. Overall, the thesis work brings original results allowing a better understanding of food odor construction and gives insights on the underlying relationships within the odor perceptual space for complex mixtures.
33

Méthodologie d’analyse structurelle et de restauration d’oeuvres sculptées / Methodology of structural analysis and restoration sculpted artworks

Michel, Laura 10 December 2013 (has links)
Actuellement, la restauration des oeuvres d’art, notamment des statues fracturées, repose sur des techniqueséprouvées, mais empiriques. Les statues endommagées comportent souvent des parties brisées. Leur restaurationconsiste la plupart du temps à les rassembler. Ainsi apparait la nécessité de prendre en compte lespropriétés mécaniques des interfaces entre les différentes parties brisées, ce qui permet de limiter l’ampleur desréparations et ainsi, de mieux conserver l’intégrité de l’oeuvre. Par ailleurs, les techniques numériques d’acquisition3D font leur entrée au service de la conservation du patrimoine. Cette thèse propose une méthodologiecapable d’utiliser des données issues d’une acquisition 3D pour simuler les opérations de restauration et leurseffets sur la structure de l’oeuvre. Les processus de restauration peuvent ainsi être testés et optimisés.Un scanner laser est utilisé pour l’acquisition de la géométrie des oeuvres, ce qui nous permet de reconstruireun modèle 3D pour la simulation numérique. Les calculs sont menés dans le cadre de la mécanique des milieuxcontinus déformables avec FLAC3D. Pour vérifier tous les points clés garantissant la stabilité mécanique, lecomportement des éléments de renforts et celui des interfaces entre les blocs ont été considérés. À partirdes résultats de ces études, une critique des stratégies de restauration mises en oeuvre ou envisageables estproposée.De plus, plusieurs méthodes de caractérisation visant à retrouver la provenance du matériau et/ou estimerles propriétés mécaniques de l’oeuvre sont proposées : caractérisations physico-chimiques et minéralogiques,essais non destructifs et destructifs. Une campagne expérimentale visant à caractériser le comportement desfractures en contact frottant avec acquisition de l’état de surface a été réalisée. Une analyse des corrélationsentre les propriétés mécaniques et morphologique des interfaces est ensuite élaborée. Enfin nous proposonsdes modèles prédictifs construits par régressions linéaires multiples et multivariées. Cette étude permet desimuler le comportement d’une oeuvre fracturée. / Currently, the artworks restoration, including broken statues, are based on proven but empirical techniques. Damaged statues often have broken parts. Restoration mainly consists in joining these parts. Thus appears the necessity of taking into account the interfaces mechanical properties between the different broken parts, reducing thereby the extent of repairs and thus better maintain the integrity of the work. Beside this, digital 3D acquisition techniques become more and more popular among the cultural heritage community. This thesis proposes a methodology able to use 3D acquisition datas to simulate the restoration operations and their effects on the structure. The restoration strategy can thus be tested and optimized. A laser scanner is used to acquire the statue geometry, allowing to reconstruct a 3D model for numerical simulation. Computations are carried out within the framework of deformable continuum mechanics using the FLAC3D software. In order to check all the key points ensuring mechanical stability, the behavior of reinforcing elements and those of the interfaces between blocks were considered. From the results of the present studies, a critical analysis of implemented or possible restoration strategy is proposed. In addition, several characterization methods to find the material origin and/or estimate the mechanical properties of the work are proposed : physico-chemical and mineralogical characterizations, non-destructive and destructive tests. An experimental campaign to characterize the behavior of fractures in contact with surface acquisition was performed. An analysis of correlations between mechanical and morphological interfaces properties is then developed. Finally, we propose a predictive modelling based on multiple linear and multivariate regressions. This study allow the simulation of fractured artworks behaviour.
34

How to find the one that got away : predicting the distribution of temperate demersal fish from environmental variables

Chatfield, Brenton Sean January 2008 (has links)
Knowing where species are and understanding why is paramount for developing relevant and sustainable conservation and resource management strategies. The need for this information is becoming urgent as fishing activity, resource extraction and the impacts of coastal developments continue to put marine resources under increasing pressure. As logistical and financial constraints can restrict our ability to collect data in the marine environment, the ability to predict distributions based on known associations with different environmental variables would enhance our capacity to manage these resources. Before attempting to predict the distribution of species and groups of species, the underlying species-environment relationships must be examined to determine whether associations between species and the environment can: (i) be identified, (ii) be used to develop models that can accurately predict distributions, and (iii) are general enough to allow accurate predictions beyond the sampled area. Most studies to date have compared the composition of fish assemblages between sites to determine how different environmental variables influence distribution. While widely applied, these methods do not consider how individual species respond to multiple environmental gradients and they lack the ability to predict distributions across different combinations of variables along those gradients. This lack of prediction also limits our capacity to assess what marine biodiversity is presently threatened by global, regional, and local human pressures on marine ecosystems. '...' Thus, summarising and modelling species data at higher levels would result in models with poorer predictive accuracy and a loss of ecological information. The generality of the species-environment relationships defined by the models were assessed by evaluating the transferability of models between different areas. Models developed from data collected over a wider geographic extent could more accurately predict the distribution of species across a smaller spatial extent than vice versa. This indicated that while general theories of the ecology of temperate demersal fish can be defined, the actual patterns of distribution may vary from site to site, suggesting caution when using predictions beyond the sampled area for management purposes. Overall, species distribution modelling identified how different species and groups of species responded to the combined influence of multiple environmental gradients and was able to accurately predict distributions based on the defined associations. Their application has led to a greater understanding of the species environment relationships and will help to identify those areas that may be important for conservation. Their predictive ability will allow general predictions of distribution of fish species across unsurveyed areas and provides the ability to assess the potential impact from implementing different policy and management strategies.
35

Modelling the impact of mild food processing conditions on the microbiological safety of food

Mytilinaios, Ioannis January 2013 (has links)
There is significant interest by the food industry in applying milder processing conditions. A major area of research within predictive modelling has been the search for models which accurately predict the effect of combining multiple processes or hurdles. For a mild process, which has temperature as the major microbial injury step, the effect of the other combined hurdles in inhibiting growth of the injured organisms must be understood. The latter means that the inoculum size dependency of the time to growth must also be fully understood. This essentially links injury steps with the potential for growth. Herein, we have been developing the use of optical density (O.D) for obtaining growth rates and lag times using multiple inocula rather than using the traditional methods which use one single inoculum. All analyses were performed in the Bioscreen analyser which measures O.D. The time to detection (TTD) was defined as the time needed for each inoculum to reach an O.D=0.2 and O.D was related to microbial numbers with simple calibration curves. Several primary models were used to predict growth curves from O.D data and it was shown that the classic logistic, the Baranyi and the 3-phase linear model (3-PLM) were the most capable primary models of those examined while the modified Gompertz and modified logistic could not reproduce TTD data. Using the Malthusian approximation of the logistic model the effect of mild temperature shifts was studied. The data obtained showed that for mild temperature shifts, growth rates quickly changed to the new environment without the induction of lags. The growth of Listeria monocytogenes, Salmonella Typhimurium and Escherichia coli was studied at 30⁰C and/or 37⁰C, in different NaCl concentrations, pH and their combinations. The classical 3-parameter logistic with lag model was rearranged to provide the theoretical foundation for the observed TTD and accurate growth rates and lag times could be estimated. As the conditions became more unfavourable, the lag time increased while the growth rate decreased. Also, the growth rate was found to be independent from the inoculum size; the inoculum size affected only the TTD. The Minimum Inhibitory Concentration (MICNaCl and MICpH) was calculated using the Lambert and Pearson model (LPM) and also the Growth/No Growth (G/NG) interface was determined using combinations of NaCl and pH. These data were transformed in rate to detection (RTD) and fitted with a response surface model (RSM) which was subsequently compared with the Extended LPM (ELPM). The LPM and the ELPM could analyse results from individual and combined inhibitors, respectively. Following a mild thermal process a lag due to thermal injury was also induced, the magnitude of which was dependent on the organism and environmental conditions; the observed distribution of the lags appeared, in general, to follow the Log-normal distribution. After the lag period due to injury, growth recommenced at the rate dictated by the growth environment present. Traditional growth curves were constructed and compared with the data obtained from the Bioscreen under the same conditions. From the results obtained, it can be suggested that the increased lag times and growth rates obtained from the traditional plate counts compared with the values obtained from the Bioscreen microbiological analyser, might be an artifact of the plating method or may be due to the use of the modified Gompertz to study the growth. In conclusion, O.D can be used to accurately determine growth parameters, to give a better understanding and quantify the G/NG interface and to examine a wealth of phenomena such as fluctuating temperatures and mild thermal treatments. The comparison between the traditional growth curves against the data obtained from the Bioscreen showed that the TTD method is a rapid, more accurate and cheaper method than the traditional plate count method which in combination with the models developed herein can offer new possibilities both to the research and the food industry.
36

The significance of genetic and ecological diversity in a wide-ranging insect pest, Paropsis atomaria Olivier (Coleoptera: Chrysomelidae)

Schutze, Mark Kurt January 2008 (has links)
Paropsis atomaria (Coleoptera; Chrysomelidae) is a eucalypt feeding leaf beetle endemic to southern and east coast Australia, and it is an emergent pest of the eucalypt hardwood industry. Paropsis atomaria was suspected to be a cryptic species complex based on apparent differences in life history characteristics between populations, its wide geographical distribution, and extensive host range within Eucalyptus. In this study genetic and ecological characters of P. atomaria were examined to determine the likelihood of a cryptic complex, and to identify the nature and causes of ecological variation within the taxon. Mitochondrial sequence variation of the gene COI was compared between populations from the east coast of Australia (South Australia to central Queensland) to assess genetic divergence between individuals from different localities and host plant of origin. Individuals from four collection localities used for the molecular analysis were then compared in a morphometric study to determine if observed genetic divergence was reflected by morphology, and common-garden trials using individuals from Lowmead (central Qld) and Canberra (ACT) were conducted to determine if morphological (body size) variation had a genetic component. Host plant utilisation (larval survival, development time, and pupal weight) by individuals from Lowmead and Canberra were then compared to determine whether differential host plant use had occurred between populations of P. atomaria; individuals from each population were reared on an allopatric and sympatric host eucalypt species (E. cloeziana and E. pilularis). Finally, developmental data from each population was compared and incorporated into a phenology modelling program (Dymex(tm)) using temperature as the principle factor explaining and predicting population phenology under field conditions. Molecular results demonstrated relatively low genetic divergence between populations of P. atomaria which is concomitant with the single species hypothesis, however, there is reduced gene flow between northern and southern populations, but no host plant related genetic structuring. Morphometric data revealed insufficient evidence to separate populations into different taxa; however a correlation between latitude and size of adults was discovered, with larger beetles found at lower latitudes (i.e., adhering to a converse Bergmann cline). Common garden experiments revealed body size to be driven by both genetic and environmental components. Host plant utilisation trials showed one host plant, E. cloeziana, to be superior for both northern and southern P. atomaria populations (increased larval survival and reduced larval development time). Eucalyptus pilularis had a negative effect on pupal weight for Lowmead (northern) individuals (to which it is allopatric), but not so for Canberra (southern) individuals. DYMEX(tm) modelling showed voltinism to be a highly plastic trait driven largely by temperature. Results from across all trials suggest that P. atomaria represents a single species with populations locally adapted to season length, with no evidence of differential host plant utilisation between populations. Further, voltinism is a seasonally plastic trait driven by temperature, but with secondary influential factors such as host plant quality. These data, taken combined, reveal phenotypic variability within P. atomaria as the product of multiple abiotic and biotic factors and representing a complex interplay between local adaptation, phenotypic plasticity, and seasonal plasticity. Implications for pest management include an understanding of population structure, nature of local adaptation and host use characteristics, and predictive models for development of seasonal control regimens.
37

Experimental field studies and predictive modelling of PCB and PCDD/F levels in Australian farmed Southern Bluefin Tuna (Thunnus maccoyii).

Phua, Samuel Tien Gin January 2008 (has links)
Farmed Southern Bluefin Tuna (SBT) (Thunnus maccoyii) is an important export product for South Australia (SA). It is exported to Japan, China, Korea and the United States for the sushi and sashimi markets. The primary purpose of SBT farming in SA is to fatten wild-caught juvenile fish (2-4 years of age with initial mean weights between 12-20 kg) over a period of approximately five months by feeding a selection of baitfish types. Farmers, farm managers and consumers of SBT all have an interest in managing chemical residues that have the potential to biomagnify in the fatty tissue of the farmed SBT fillets. Of particular interest are chemical residues of polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins / dibenzofurans (PCDD/Fs). This research presents the investigations and experimental validation of a predictive model that can be used to address the levels of residues in the fillets of farmed SBT at harvest from feeding (as the source) when applied to SBT aquaculture. An additional industry-focussed aim of this research was to determine if a Longer Term Holding (LTH) farming period, with a duration of an extra 12 months after a typical farming period of approximately five months, could produce SBT with higher condition index (CI) and lipid content, while keeping levels of PCBs and PCDD/Fs low, compared to the typical farming period. The justification for this research is that an adequate quantitative model is essential to help industry achieve targeted concentrations in the final fillet product by making scientific-based decisions on baitfish selection (baitfish strategies for the feeding of SBT), and longer term, to confidently demonstrate to local markets and importing countries that Australia is actively managing levels of PCBs and PCDD/Fs in farmed SBT, to ensure a high quality and safe product is delivered to the consumer. The novelty of this research is underpinned by four integrated stages, and the criteria for an adequate model established. The important criteria included: accurate predictions versus observed data demonstrated through the analysis of residual plots, potential physiological interpretation of model coefficients, parsimony – the model should be as simple as possible (but no simpler) and that the model should be easy to use. Firstly, a logical starting point was the development of a risk framework for residues in SBT. The developed framework was based on conventional principles of microbiological risk assessment highlighted in Codex Alimentarius. The risk framework consists of five governing principles: hazard identification, hazard characterisation, exposure assessment, risk characterisation and model validation. The advantages of the risk framework is that it provides a systematic research approach and permits information to be handled unambiguously, especially important for the niche SBT industry where chemical residue research is carried out for the first time. Secondly, because of a lack of available scientific data in context of this research, commercial-scale experimental field data for levels of PCBs and PCDD/Fs in typical farmed SBT as affected by feeding and growth were collected over 17 months at seven time intervals from Farm Delta Fishing Pty Ltd in 2005/06 (n = 50). Field data from another commercial company, Farm Alpha Fishing Pty Ltd, was collected over the typical farming period specific to this company, spanning 15 weeks at three time intervals in 2006, for validation work (n = 15). The data obtained from Farm Delta Fishing Pty Ltd revealed that whole weight of farmed SBT increased from 18.5 kg to 30.3 kg for a typical farming period, and subsequently to 41.0 kg by the end of the LTH farming period. A maximum mean CI of 24.0 ± 0.5 kg.m⁻³ and a maximum mean lipid content of 17.6 ± 0.5% was achieved at the third time interval of the typical farming period, for the baitfish types and ratios used as feed. There were no significant differences in the CI and lipid between the final harvests of the typical farming and LTH periods, i.e. even after an additional 12 months of farming. PCB and PCDD/F concentrations, however, increased between the final harvests of the typical farming and LTH periods. The data indicated that a typical farming period was sufficient to achieve a maximum CI and lipid content with lower concentrations of PCBs and PCDD/Fs in the fillets relative to the LTH farming period. For the third stage of this research, a quantitative model was synthesised and applied to the PCB and PCDD/F (2,3,7,8-TeCDF) data detected in farmed SBT fillets. Assimilation efficiencies for PCBs and 2,3,7,8-TeCDF in the fillets of SBT were obtained. An assimilation efficiency, or percentage retention (efficiency expressed as a percentage), in the fillet of SBT is a measure of the uptake of a chemical residue from food (baitfish) to the SBT fillet. For the WHO-PCBs, assimilation efficiencies based on SBT fillets ranged between 19.1 – 35.3 % with the exception of PCB 169. The highest assimilation efficiency of 35.3 %, with a range of 30.4 – 40.3 % (at the 95 % confidence level) was attributed to the most toxic PCB congener, PCB 126. An assimilation efficiency of 39.2 % was determined in SBT fillets for the congener 2,3,7,8-TeCDF, which was higher than the assimilation efficiencies determined for the WHO-PCB congeners. A residual plot as predicted value versus observed value indicated that the predictive model was neither under- or over-parameterised. However, when the predictive model was assessed against the data set from Farm Alpha Pty Ltd, the model over-predicted the actual PCB and PCDD/F concentrations. The over-prediction is attributed to possible overfeeding of SBT farmed by Farm Alpha Fishing Pty Ltd. From a food safety point of view, in the absence of ideal predictions because of a lack of ideal validation data sets, an over-prediction instead of under-prediction is preferred. In the fourth stage, the practical application of the predictive model was demonstrated. Because SBT fillets are retailed as tissue group-specific, i.e. akami (low fat), chu-toro (medium fat) and otoro (high fat) fillets, PCB and PCDD/F analyses were carried out on the three tissue groups for selected SBT (n = 7). Dietary modelling on SBT consumption in humans was carried out using findings from the predictive model and tissue-specific data. The baitfish strategy employed for the feeding of farmed SBT consequently affects dietary exposure to SBT consumers. Exposure to PCBs and PCDD/Fs is approximately seven times lower for the consumption of a skin-free, boneless akami fillet than for a comparable otoro fillet of the same size. This dietary exposure assessment accounted only for consumption of SBT tissue-specific fillets. The experimental field study and modelling work on PCB and PCDD/F concentrations in farmed SBT (fillets) outlined in this thesis importantly directs the need to re-evaluate a specific model to better cater for SBT farming practices where SBT fillets are produced for human consumption. Because conditions that normally pertain to commercial farming of wild-caught fish were studied, findings should be of interest to industries where other species of fish (for food) are farmed in sea-cages in the open ocean. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1342453 / Thesis (Ph.D.) -- University of Adelaide, School of Chemical Engineering, 2008
38

Experimental field studies and predictive modelling of PCB and PCDD/F levels in Australian farmed Southern Bluefin Tuna (Thunnus maccoyii).

Phua, Samuel Tien Gin January 2008 (has links)
Farmed Southern Bluefin Tuna (SBT) (Thunnus maccoyii) is an important export product for South Australia (SA). It is exported to Japan, China, Korea and the United States for the sushi and sashimi markets. The primary purpose of SBT farming in SA is to fatten wild-caught juvenile fish (2-4 years of age with initial mean weights between 12-20 kg) over a period of approximately five months by feeding a selection of baitfish types. Farmers, farm managers and consumers of SBT all have an interest in managing chemical residues that have the potential to biomagnify in the fatty tissue of the farmed SBT fillets. Of particular interest are chemical residues of polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins / dibenzofurans (PCDD/Fs). This research presents the investigations and experimental validation of a predictive model that can be used to address the levels of residues in the fillets of farmed SBT at harvest from feeding (as the source) when applied to SBT aquaculture. An additional industry-focussed aim of this research was to determine if a Longer Term Holding (LTH) farming period, with a duration of an extra 12 months after a typical farming period of approximately five months, could produce SBT with higher condition index (CI) and lipid content, while keeping levels of PCBs and PCDD/Fs low, compared to the typical farming period. The justification for this research is that an adequate quantitative model is essential to help industry achieve targeted concentrations in the final fillet product by making scientific-based decisions on baitfish selection (baitfish strategies for the feeding of SBT), and longer term, to confidently demonstrate to local markets and importing countries that Australia is actively managing levels of PCBs and PCDD/Fs in farmed SBT, to ensure a high quality and safe product is delivered to the consumer. The novelty of this research is underpinned by four integrated stages, and the criteria for an adequate model established. The important criteria included: accurate predictions versus observed data demonstrated through the analysis of residual plots, potential physiological interpretation of model coefficients, parsimony – the model should be as simple as possible (but no simpler) and that the model should be easy to use. Firstly, a logical starting point was the development of a risk framework for residues in SBT. The developed framework was based on conventional principles of microbiological risk assessment highlighted in Codex Alimentarius. The risk framework consists of five governing principles: hazard identification, hazard characterisation, exposure assessment, risk characterisation and model validation. The advantages of the risk framework is that it provides a systematic research approach and permits information to be handled unambiguously, especially important for the niche SBT industry where chemical residue research is carried out for the first time. Secondly, because of a lack of available scientific data in context of this research, commercial-scale experimental field data for levels of PCBs and PCDD/Fs in typical farmed SBT as affected by feeding and growth were collected over 17 months at seven time intervals from Farm Delta Fishing Pty Ltd in 2005/06 (n = 50). Field data from another commercial company, Farm Alpha Fishing Pty Ltd, was collected over the typical farming period specific to this company, spanning 15 weeks at three time intervals in 2006, for validation work (n = 15). The data obtained from Farm Delta Fishing Pty Ltd revealed that whole weight of farmed SBT increased from 18.5 kg to 30.3 kg for a typical farming period, and subsequently to 41.0 kg by the end of the LTH farming period. A maximum mean CI of 24.0 ± 0.5 kg.m⁻³ and a maximum mean lipid content of 17.6 ± 0.5% was achieved at the third time interval of the typical farming period, for the baitfish types and ratios used as feed. There were no significant differences in the CI and lipid between the final harvests of the typical farming and LTH periods, i.e. even after an additional 12 months of farming. PCB and PCDD/F concentrations, however, increased between the final harvests of the typical farming and LTH periods. The data indicated that a typical farming period was sufficient to achieve a maximum CI and lipid content with lower concentrations of PCBs and PCDD/Fs in the fillets relative to the LTH farming period. For the third stage of this research, a quantitative model was synthesised and applied to the PCB and PCDD/F (2,3,7,8-TeCDF) data detected in farmed SBT fillets. Assimilation efficiencies for PCBs and 2,3,7,8-TeCDF in the fillets of SBT were obtained. An assimilation efficiency, or percentage retention (efficiency expressed as a percentage), in the fillet of SBT is a measure of the uptake of a chemical residue from food (baitfish) to the SBT fillet. For the WHO-PCBs, assimilation efficiencies based on SBT fillets ranged between 19.1 – 35.3 % with the exception of PCB 169. The highest assimilation efficiency of 35.3 %, with a range of 30.4 – 40.3 % (at the 95 % confidence level) was attributed to the most toxic PCB congener, PCB 126. An assimilation efficiency of 39.2 % was determined in SBT fillets for the congener 2,3,7,8-TeCDF, which was higher than the assimilation efficiencies determined for the WHO-PCB congeners. A residual plot as predicted value versus observed value indicated that the predictive model was neither under- or over-parameterised. However, when the predictive model was assessed against the data set from Farm Alpha Pty Ltd, the model over-predicted the actual PCB and PCDD/F concentrations. The over-prediction is attributed to possible overfeeding of SBT farmed by Farm Alpha Fishing Pty Ltd. From a food safety point of view, in the absence of ideal predictions because of a lack of ideal validation data sets, an over-prediction instead of under-prediction is preferred. In the fourth stage, the practical application of the predictive model was demonstrated. Because SBT fillets are retailed as tissue group-specific, i.e. akami (low fat), chu-toro (medium fat) and otoro (high fat) fillets, PCB and PCDD/F analyses were carried out on the three tissue groups for selected SBT (n = 7). Dietary modelling on SBT consumption in humans was carried out using findings from the predictive model and tissue-specific data. The baitfish strategy employed for the feeding of farmed SBT consequently affects dietary exposure to SBT consumers. Exposure to PCBs and PCDD/Fs is approximately seven times lower for the consumption of a skin-free, boneless akami fillet than for a comparable otoro fillet of the same size. This dietary exposure assessment accounted only for consumption of SBT tissue-specific fillets. The experimental field study and modelling work on PCB and PCDD/F concentrations in farmed SBT (fillets) outlined in this thesis importantly directs the need to re-evaluate a specific model to better cater for SBT farming practices where SBT fillets are produced for human consumption. Because conditions that normally pertain to commercial farming of wild-caught fish were studied, findings should be of interest to industries where other species of fish (for food) are farmed in sea-cages in the open ocean. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1342453 / Thesis (Ph.D.) -- University of Adelaide, School of Chemical Engineering, 2008
39

Experimental field studies and predictive modelling of PCB and PCDD/F levels in Australian farmed Southern Bluefin Tuna (Thunnus maccoyii).

Phua, Samuel Tien Gin January 2008 (has links)
Farmed Southern Bluefin Tuna (SBT) (Thunnus maccoyii) is an important export product for South Australia (SA). It is exported to Japan, China, Korea and the United States for the sushi and sashimi markets. The primary purpose of SBT farming in SA is to fatten wild-caught juvenile fish (2-4 years of age with initial mean weights between 12-20 kg) over a period of approximately five months by feeding a selection of baitfish types. Farmers, farm managers and consumers of SBT all have an interest in managing chemical residues that have the potential to biomagnify in the fatty tissue of the farmed SBT fillets. Of particular interest are chemical residues of polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins / dibenzofurans (PCDD/Fs). This research presents the investigations and experimental validation of a predictive model that can be used to address the levels of residues in the fillets of farmed SBT at harvest from feeding (as the source) when applied to SBT aquaculture. An additional industry-focussed aim of this research was to determine if a Longer Term Holding (LTH) farming period, with a duration of an extra 12 months after a typical farming period of approximately five months, could produce SBT with higher condition index (CI) and lipid content, while keeping levels of PCBs and PCDD/Fs low, compared to the typical farming period. The justification for this research is that an adequate quantitative model is essential to help industry achieve targeted concentrations in the final fillet product by making scientific-based decisions on baitfish selection (baitfish strategies for the feeding of SBT), and longer term, to confidently demonstrate to local markets and importing countries that Australia is actively managing levels of PCBs and PCDD/Fs in farmed SBT, to ensure a high quality and safe product is delivered to the consumer. The novelty of this research is underpinned by four integrated stages, and the criteria for an adequate model established. The important criteria included: accurate predictions versus observed data demonstrated through the analysis of residual plots, potential physiological interpretation of model coefficients, parsimony – the model should be as simple as possible (but no simpler) and that the model should be easy to use. Firstly, a logical starting point was the development of a risk framework for residues in SBT. The developed framework was based on conventional principles of microbiological risk assessment highlighted in Codex Alimentarius. The risk framework consists of five governing principles: hazard identification, hazard characterisation, exposure assessment, risk characterisation and model validation. The advantages of the risk framework is that it provides a systematic research approach and permits information to be handled unambiguously, especially important for the niche SBT industry where chemical residue research is carried out for the first time. Secondly, because of a lack of available scientific data in context of this research, commercial-scale experimental field data for levels of PCBs and PCDD/Fs in typical farmed SBT as affected by feeding and growth were collected over 17 months at seven time intervals from Farm Delta Fishing Pty Ltd in 2005/06 (n = 50). Field data from another commercial company, Farm Alpha Fishing Pty Ltd, was collected over the typical farming period specific to this company, spanning 15 weeks at three time intervals in 2006, for validation work (n = 15). The data obtained from Farm Delta Fishing Pty Ltd revealed that whole weight of farmed SBT increased from 18.5 kg to 30.3 kg for a typical farming period, and subsequently to 41.0 kg by the end of the LTH farming period. A maximum mean CI of 24.0 ± 0.5 kg.m⁻³ and a maximum mean lipid content of 17.6 ± 0.5% was achieved at the third time interval of the typical farming period, for the baitfish types and ratios used as feed. There were no significant differences in the CI and lipid between the final harvests of the typical farming and LTH periods, i.e. even after an additional 12 months of farming. PCB and PCDD/F concentrations, however, increased between the final harvests of the typical farming and LTH periods. The data indicated that a typical farming period was sufficient to achieve a maximum CI and lipid content with lower concentrations of PCBs and PCDD/Fs in the fillets relative to the LTH farming period. For the third stage of this research, a quantitative model was synthesised and applied to the PCB and PCDD/F (2,3,7,8-TeCDF) data detected in farmed SBT fillets. Assimilation efficiencies for PCBs and 2,3,7,8-TeCDF in the fillets of SBT were obtained. An assimilation efficiency, or percentage retention (efficiency expressed as a percentage), in the fillet of SBT is a measure of the uptake of a chemical residue from food (baitfish) to the SBT fillet. For the WHO-PCBs, assimilation efficiencies based on SBT fillets ranged between 19.1 – 35.3 % with the exception of PCB 169. The highest assimilation efficiency of 35.3 %, with a range of 30.4 – 40.3 % (at the 95 % confidence level) was attributed to the most toxic PCB congener, PCB 126. An assimilation efficiency of 39.2 % was determined in SBT fillets for the congener 2,3,7,8-TeCDF, which was higher than the assimilation efficiencies determined for the WHO-PCB congeners. A residual plot as predicted value versus observed value indicated that the predictive model was neither under- or over-parameterised. However, when the predictive model was assessed against the data set from Farm Alpha Pty Ltd, the model over-predicted the actual PCB and PCDD/F concentrations. The over-prediction is attributed to possible overfeeding of SBT farmed by Farm Alpha Fishing Pty Ltd. From a food safety point of view, in the absence of ideal predictions because of a lack of ideal validation data sets, an over-prediction instead of under-prediction is preferred. In the fourth stage, the practical application of the predictive model was demonstrated. Because SBT fillets are retailed as tissue group-specific, i.e. akami (low fat), chu-toro (medium fat) and otoro (high fat) fillets, PCB and PCDD/F analyses were carried out on the three tissue groups for selected SBT (n = 7). Dietary modelling on SBT consumption in humans was carried out using findings from the predictive model and tissue-specific data. The baitfish strategy employed for the feeding of farmed SBT consequently affects dietary exposure to SBT consumers. Exposure to PCBs and PCDD/Fs is approximately seven times lower for the consumption of a skin-free, boneless akami fillet than for a comparable otoro fillet of the same size. This dietary exposure assessment accounted only for consumption of SBT tissue-specific fillets. The experimental field study and modelling work on PCB and PCDD/F concentrations in farmed SBT (fillets) outlined in this thesis importantly directs the need to re-evaluate a specific model to better cater for SBT farming practices where SBT fillets are produced for human consumption. Because conditions that normally pertain to commercial farming of wild-caught fish were studied, findings should be of interest to industries where other species of fish (for food) are farmed in sea-cages in the open ocean. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1342453 / Thesis (Ph.D.) -- University of Adelaide, School of Chemical Engineering, 2008
40

Applying patient-admission predictive algorithms in the South African healthcare system

Daffue, Ruan Albert 03 1900 (has links)
Thesis (MScEng)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Predictive analytics in healthcare has become one of the major focus areas in healthcare delivery worldwide. Due to the massive amount of healthcare data being captured, healthcare providers and health insurers are investing in predictive analytics and its enabling technologies to provide valuable insight into a large variety of healthcare outcomes. One of the latest developments in the field of healthcare predictive modelling (PM) was the launch of the Heritage Health Prize; a competition that challenges individuals from across the world to develop a predictive model that successfully identifies the patients at risk of admission to hospital from a given patient population. The patient-admission predictive algorithm (PAPA) is aimed at reducing the number of unnecessary hospitalisations that needlessly constrain healthcare service delivery worldwide. The aim of the research presented is to determine the feasibility and value of applying PAPAs in the South African healthcare system as part of a preventive care intervention strategy. A preventive care intervention strategy is a term used to describe an out-patient hospital service, aimed at providing preventive care in an effort to avoid unnecessary hospitalisations from occurring. The thesis utilises quantitative and qualitative techniques. This included a review of the current and historic PM applications in healthcare to determine the major expected shortfalls and barriers to implementation of PAPAs, as well as the institutional and operational requirements of these predictive algorithms. The literature study is concluded with a review of the current state of affairs in the South African healthcare system to, firstly, articulate the need for PAPAs and, secondly, to determine whether the public and private sectors provide a suitable platform for implementation (evaluated based on the operational and institutional requirements of PAPAs). Furthermore, a methodology to measure and analyse the potential value-add of a PAPA care intervention strategy was designed and developed. The methodology required a survey of the industry leaders in the private healthcare sector of South Africa to identify, firstly, the current performance foci and, secondly, the factors that compromise the performance of these organisations to deliver high quality, resource-effective care. A quantitative model was developed and applied to an industry leader in the private healthcare sector of South Africa, in order to gauge the resultant impact of a PAPA care intervention strategy on healthcare provider performance. Lastly, in an effort to ensure the seamless implementation and operation of PAPAs, an implementation framework was developed to address the strategic, tactical, and operational challenges of applying predictive analytics and preventive care strategies similar to PAPAs. The research found that the application of PAPAs in the public healthcare sector of South Africa is infeasible. The private healthcare sector, however, was considered a suitable platform to implement PAPAs, as this sector satisfies the institutional and operational requirements of PAPAs. The value-add model found that a PAPA intervention strategy will add significant value to the performance of healthcare providers in the private healthcare sector of South Africa. Noteworthy improvements are expected in the ability of healthcare provider’s to coordinate patient care, patient-practitioner relationships, inventory service levels, and staffing level efficiency and effectiveness. A slight decrease in the financial operating margin, however, was documented. The value-add methodology and implementation support framework provides a suitable platform for future researchers to explore the collaboration of preventive care and PM in an effort to improve healthcare resource management in hospitals. In conclusion, patient-admission predictive algorithms provide improved evidence-based decision making for preventive care intervention strategies. An efficient and effective preventive care intervention strategy improves healthcare provider performance and, therefore, adds significant value to these organisations. With the proper planning and implementation support, the application of PAPA care intervention strategies will change the way healthcare is delivered worldwide. / AFRIKAANSE OPSOMMING: Vooruitskattingsanalises in gesondheidsorg het ontwikkel in een van die mees belangrike fokusareas in die lewering van kwaliteit gesondheidsorg in ontwikkelde lande. Gesondheidsorgverskaffers en lewensversekeraars belê in vooruitskattingsanalise en ooreenstemmende tegnologieë om groot hoeveelhede gesondheidsorg pasiënt-data vas te lê, wat waardevolle insigte bied ten opsigte van ʼn groot verskeidenheid van gesondheidsorg-uitkomstes. Een van die nuutste ontwikkelinge in die veld van gesondheidsorg vooruitskattingsanalises, was die bekendstelling van die “Heritage Health Prize”, 'n kompetisie wat individue regoor die wêreld uitdaag om 'n vooruitskattingsalgoritme te ontwikkel wat pasiënte identifiseer wat hoogs waarskynlik gehospitaliseer gaan word in die volgende jaar en as bron-intensief beskou word as gevolg van die beraamde tyd wat hierdie individue in die hospitaal sal deurbring. Die pasiënt-toelating vooruitskattingsalgoritme (PTVA) het ten doel om onnodige hospitaliserings te identifiseer en te voorkom tem einde verbeterde hulpbronbestuur in gesondheidsorg wêreldwyd te bewerkstellig. Die doel van die hierdie projek is om die uitvoerbaarheid en waarde van die toepassing van PTVAs, as 'n voorkomende sorg intervensiestrategie, in die Suid-Afrikaanse gesondheidsorgstelsel te bepaal. 'n Voorkomende sorg intervensiestrategie poog om onnodige hospitaliserings te verhoed deur die nodige sorgmaatreëls te verskaf aan hoë-riskio pasiënte, sonder om hierdie individue noodwendig te hospitaliseer. Die tesis maak gebruik van kwantitatiewe en kwalitatiewe tegnieke. Dit sluit in 'n hersiening van die huidige en historiese vooruitskattings modelle in die gesondheidsorgsektor om die verwagte struikelblokke in die implementering van PTVAs te identifiseer, asook die institusionele en operasionele vereistes van hierdie vooruitskattingsalgoritmes te bepaal. Die literatuurstudie word afgesluit met 'n oorsig van die huidige stand van sake in die Suid-Afrikaanse gesondheidsorgstelsel om, eerstens, die behoefte vir PTVAs te identifiseer en, tweedens, om te bepaal of die openbare en private sektore 'n geskikte platform vir implementering bied (gebaseer op die operasionele en institusionele vereistes van PTVAs). Verder word 'n metodologie ontwerp en ontwikkel om die potensiële waarde-toevoeging van 'n PTVA sorg intervensiestrategie te bepaal. Die metode vereis 'n steekproef van die industrieleiers in die private gesondheidsorgsektor van Suid-Afrika om die volgende te identifiseer: die huidige hoë-prioriteit sleutel prestasie aanwysers (SPAs), en die faktore wat die prestasie van hierdie organisasies komprimeer om hoë gehalte, hulpbron-effektiewe sorg te lewer. 'n Kwantitatiewe model is ontwikkel en toegepas op een industrieleier in die private Stellenbosch gesondheidsorgsektor van Suid-Afrika, om die gevolglike impak van 'n PTVA sorg intervensiestrategie op prestasieverbetering te meet. Ten slotte, in 'n poging om te verseker dat die implementering en werking van PTVAs glad verloop, is 'n implementeringsraamwerk ontwikkel om die strategiese, taktiese en operasionele uitdagings aan te spreek in die toepassing van vooruitskattings analises en voorkomende sorg strategieë soortgelyk aan PTVAs. Die navorsing het bevind dat die toepassing van PTVAS in die openbare gesondheidsorgsektor van Suid-Afrika nie lewensvatbaar is nie. Die private gesondheidsorgsektor word egter beskou as 'n geskikte platform om PTVAs te implementeer, weens die bevrediging van die institusionele en operasionele vereistes van PTVAs. Die waarde-toevoegings model het bevind dat 'n PTVA intervensiestrategie beduidende waarde kan toevoeg tot die prestasieverbetering van gesondheidsorgverskaffers in die private gesondheidsorgsektor van Suid-Afrika. Die grootste verbetering word in die volgende SPAs verwag; sorg koördinasie, dokter-pasiënt verhoudings, voorraad diensvlakke, en personeel doeltreffendheid en effektiwiteit. 'n Effense afname in die finansiële bedryfsmarge word egter gedokumenteer. 'n Implementering-ondersteuningsraamwerk is ontwikkel in 'n poging om die sleutel strategiese, taktiese en operasionele faktore in die implementering en uitvoering van 'n PTVA sorg intervensiestrategie uit te lig. Die waarde-toevoegings metodologie en implementering ondersteuning raamwerk bied 'n geskikte platform vir toekomstige navorsers om die rol van vooruitskattings modelle in voorkomende sorg te ondersoek, in 'n poging om hulpbronbestuur in hospitale te verbeter. Ten slotte, PTVAs verbeter bewysgebaseerde besluitneming vir voorkomende sorg intervensiestrategieë. 'n Doeltreffende en effektiewe voorkomende sorg intervensiestrategie voeg aansienlike waarde tot die algehele prestasieverbetering van gesondheidsorgverskaffers. Met behoorlike beplanning en ondersteuning met implementering, sal PTVA sorg intervensiestrategieë die manier waarop gesondheidsorg gelewer word, wêreldwyd verander.

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