The focus of this thesis is in the development and application of a normative framework for handling both variability and uncertainty in making decisions using economic evaluation. The framework builds on the recent work which takes an intuitive Bayesian approach to handling uncertainty as well as adding a similar approach for the handling of variability. The technique of stratified cost effectiveness analysis is introduced as an innovative, intuitive and theoretically sound basis for consideration of variability with respect to cost effectiveness. The technique requires the identification of patient strata where there are differences between strata but individual strata are relatively homogenous. For handling uncertainty, the normative framework requires a twofold approach. First, the cost effectiveness of therapies within each patient stratum must be assessed using probabilistic analysis. Secondly, techniques for estimation of the expected value of perfect information should be applied to determine an efficient research plan for the disease of interest. For the latter, a new technique for estimating EVPI based on quadrature is described which is both accurate and allows simpler calculation of the expected value of sample information. In addition the unit normal loss integral method previously ignored as a method of estimating EVPPI is shown to be appropriate in specific circumstances. The normative framework is applied to decisions relating to the public funding of the treatment of osteoporosis in the province of Ontario. The optimal limited use criteria would be to fund treatment with alendronate for women aged 75 years and over with previous fracture and 77 years and over with no previous fracture. An efficient research plan would fund a randomised controlled trial comparing etidronate to no therapy with a sample size of 640. Certain other research studies are of lesser value. Subsequent to the analysis contained in this thesis, the province of Ontario revised there limited use criteria to be broadly in line with the conclusions of this analysis. Thus, the application of the framework to this area demonstrates both its feasibility and acceptability. The normative framework developed in this thesis provides an optimal solution for decision makers in terms of handling uncertainty and variability in economic evaluation. Further research refining methods for estimating information value and considering other forms of uncertainty within models will enhance the framework.

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Made available in DSpace on 2014-12-17T15:39:05Z (GMT). No. of bitstreams: 1 SimoneLM.pdf: 2058286 bytes, checksum: ea0a70978c6d7173bf0a2707eb033844 (MD5) Previous issue date: 2002-01-17 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The present study analyses the variability of the meaning of the work among young people on the transition from university to professional life, divided according to: university levels, knowledge area and graduation course. A hundred seventeen young people answered the questionaries structured on the components of the meaning of work. Semi-structured interviews were also made with parts of the sample about the themes related to the meaning of work on this way the information of the questionaries became complete. The answers of the interviews were studied through the analysis of the thematic contents. The results of such analysis and the answers of the questionaries were registered on the data base SPSS for Windows. The results of the statistic analysis made indicated that: (1) the centrality of work and the articulations among stronger spheres do not present variability according to level, area or course; (2) the course makes more difference values factors and descriptives factors than area and level; (3) the hierarchy of values presents variability according to area and the descriptive hierarchy presents variability according to course; (4) the level makes more difference specific attributes of the meaning of the work than area and course; (5) the standards of the meaning of work do not present variability according to level, area and course, but present variability according to type of the work market evaluation and planning the future work. In summary, the meaning of work present variability according to level, area and course of the young people, when studied in facets, except for the work centrality / O presente estudo objetiva analisar a variabilidade do significado do trabalho entre jovens na transi??o estudante universit?rio-profissional, dividindo esta amostra de sujeitos por grau universit?rio, ?rea de conhecimento e curso de gradua??o. Aplicaram-se, em 117 jovens, question?rios estruturados sobre os componentes do significado do trabalho. Realizaram-se tamb?m entrevistas semi-estruturadas, com uma sub-amostra desses jovens, sobre os temas relativos ao significado do trabalho, aprofundando e complementando as informa??es levantadas atrav?s dos question?rios. As respostas ?s entrevistas foram exploradas atrav?s de an?lise de conte?do tem?tica. Os resultados de tal an?lise e as respostas aos question?rios foram registrados na forma de banco de dados do SPSS for windows. Os resultados das an?lises estat?sticas desenvolvidas indicam que: (1) a centralidade do trabalho e as articula??es entre as esferas mais fortes n?o apresentam variabilidade por grau, ?rea ou curso; (2) o curso diferencia, mais do que a ?rea e o grau, os fatores valorativos e descritivos; (3) A hierarquia valorativa apresenta variabilidade por ?rea e a hierarquia descritiva, por curso; (4) o grau diferencia, mais do que a ?rea e o curso, os atributos espec?ficos do significado do trabalho; (5) os padr?es do significado do trabalho n?o apresentam variabilidade por grau, ?rea e curso, mas variam de acordo com a avalia??o do mercado de trabalho e o projeto futuro de trabalho. Em suma, os significados atribu?dos ao trabalho exceto com rela??o ? centralidade do trabalho podem apresentar variabilidade conforme o grau, a ?rea e o curso do jovem quando estudados em suas facetas

Thesis deals with the study of palate morphology and variability of patients with UCLP, using modern methods of geometric morphometrics. Dental plaster casts of UCLP patients (average age 14,8) and the control group (average age 14,7) were used for evaluation. The models were scanned using a 3D scanner. For evaluation of total variability of patients with orofacial clefts, previously rated dental casts of BCLP patients (whose age ranged from 12,1 to 16,5) were also included. All patients were operated and treated at The Clinic of Plastic Surgery in Prague. The results are in accordance with literature, which describes the basic size and shape differences in the morphology of the palate in different types of clefts (e.g. narrowing of the palate in UCLP and BCLP and asymmetry of palatal vault in UCLP). Using "Dense correspondense models analysis" average surface models were computed and new informations about the shape and premaxila position were gained. Different location and slope of the palate in different types of clefts and within control group were detected by superimposition of average models and FESA. UCLP palate have typically asymetric palate vault with a maximum height in front of the cleft palate and at the back in the side without malformations. Variability of the shape of palate for each group...