Infrastructure systems are critical to a country’s prosperity. It is extremely important to manage the infrastructure systems efficiently in order to avoid wastage and to maximize benefits. Deterioration of infrastructure systems is one of the primary issues in civil engineering today. This problem has been widely acknowledged by engineering community in numerous studies. We need to evolve efficient strategies to tackle the problem of infrastructure deterioration and to efficiently operate infrastructure. In this research, we propose stochastic models to predict the process of deterioration in engineering systems and to perform life-cycle analysis (LCA) of deteriorating engineering systems. LCA has been recognized, over the years, as a highly informative tool for helping the decision making process in infrastructure management. In this research, we propose a stochastic model, SSA, to accurately predict the effect of deterioration processes in engineering systems. The SSA model addresses some of the important and ignored areas in the existing models such as the effect of deterioration on both capacity and demands of systems and accounting for different types of failures in assessing the life-span of a deteriorating system. Furthermore, this research proposes RTLCA, a renewal theory based LCA model, to predict the life-cycle performance of deteriorating systems taking into account not only the life-time reliability but also the costs associated with operating a system. In addition, this research investigates the effect of seismic degradation on the reliability of reinforced concrete (RC) bridges. For this purpose, we model the seismic degradation process in the RC bridge columns which are the primary lateral load resisting system in a bridge. Thereafter, the RTLCA model along with SSA model is used to study the life-cycle of an example RC bridge located in seismic regions accounting for seismic degradation. It is expected that the models proposed in this research will be helpful in better managing our infrastructure systems.

Bakgrund: Kliniskt omdöme kan beskrivas som förmågan att på ett insiktsfullt sätt identifiera och agera på en förändring eller ett behov relaterat till patientens hälsotillstånd. Kliniskt omdöme kommer till sin spets i komplexa situationer som exempelvis när en patient plötsligt försämras. Det har skett en akademisering av sjuksköterskeutbildningen som gett sjuksköterskor en stadigare teoretisk grund men det kliniska omdömet behöver utvecklas efter examen. Syfte: Syftet var att beskriva faktorer som påverkar utvecklingen av nyexaminerade sjuksköterskans (NS) kliniska omdöme. Metod: Metoden som användes var litteraturöversikt, baserad på tio vetenskapliga artiklar varav åtta kvalitativ metod och två mixad metod. Artiklarna hämtades ur databaserna CINAHL Complete och PubMed. Resultat: Faktorer som påverkar utvecklingen av NS kliniska omdöme sammanfattas under tre huvudteman: Förvärvandet av kliniska förmågor, Ansvarsfull kommunikation och Integrerat stöd. NS behöver utveckla förmågan att identifiera relevanta förändringar, tolka dem i relation till en helhetsbild av patienten, prioritera åtgärder samt kommunicera med kollegor. Utvecklande av kliniskt omdöme underlättas i ett positivt arbetsklimat med stöd av erfarna sjuksköterskor (ES). Vårderfarenheter ger teoretiska kunskaper en ny mening, vilket också bidrar till utvecklandet av kliniskt omdöme. Diskussion: Resultatet diskuterades med utgångspunkt i Benners teori för hur sjuksköterskans kliniska omdöme utvecklas från novisens till expertens. NS är inte mogen att hantera komplexa kliniska situationer och organisationen måste utformas för att ge NS det stöd som behövs för att utveckla det kliniska omdömet. Tillgången till ES, reflektion och ett rimligt arbetstempo är viktiga stöttande faktorer, men sällan en självklarhet i vården. / Background: Clinical judgement can be described as the ability to wisely identify and act upon changes in - or needs of a patient’s - health status. Clinical judgement is most applicable to complex situations such as caring for deteriorating patients. As nursing was included in higher education nurses have acquired a more solid theoretical knowledge base, however their clinical judgement needs to be further developed post graduation. Aim: The aim of was to describe factors influencing the development of newly graduated nurse’s (NN) clinical judgment. Method: The method consists of a literature review based upon ten scientific articles, of which eight were qualitative and two followed a mixed method. The articles were retrieved from CINAHL Complete and PubMed databases. Results: Contributing factors to the development of NN clinical judgment were grouped into three main themes: Development of clinical abilities, Responsible communication and Integrated support. NN needs to develop the ability to recognise relevant changes, relate them to a holistic assessment of the patient and to communicate findings. The development of clinical judgment is supported by a positive work climate and by access to experienced nurses. Caring for patients adds a new dimension to theoretical knowledge and contributes to the development of clinical judgment. Discussion: The results were discussed using Benner´s theory of how the clinical judgement of nurses develops from novice to expert. NN is not able to safely handle complex clinical situations without the support of experienced staff. It is also essential for the development of clinical judgment that NN is given a reasonable workload and opportunities for reflection. However, there may often be a lack of these supporting factors in nursing organisations today.

This study explores the use of early warning scores (EWS) in deteriorating patients. These are widely used tools to measure vital signs and highlight abnormal physiology in acutely unwell patients. Measurements of the process in the management of the deteriorating patient includes time to first assessment of such patients. The level of clinician involved in the subsequent management is also investigated to determine whether escalation of care was appropriate. This work is a retrospective case note analysis of the recognition and management of deteriorating patients prior to critical care admission. Research Questions 1. What violations in the optimum process are associated with sub-optimal recognition and management of deteriorating patients and delayed critical care admission in patients triggering early warning scores in acute care wards? 2. Are there independent variables which can predict the delay in the recognition and management of deteriorating patients and subsequent critical care admission? Methods The literature was reviewed to determine the optimum process of recognition and management of deteriorating patients in acute care wards. A data collection tool was then specifically designed and locally validated to extract objective data from the case records. A sample of 157 patients admitted to critical care from acute wards over a 6 month period were included in the study. The case records were then retrospectively reviewed and information was extracted using the data collection tool. Results The accuracy and frequency of early warning scores were measured and findings demonstrated that 59% of Early Warning Scores (EWS) were miscalculated. The most frequent of those miscalculated were the intermediate scores (4 or 5) (error rate - 52%) followed by the higher scores (6 or more) (error rate - 32%). The least frequently miscalculated were the lower scores (0 -3) (error rate 15%). Descriptive data from the sample such as age, ward, diagnosis, time of hospital admission, time and day of transfer / EWS triggering were included. From the total case records reviewed, 110 patients had abnormal Early Warning Scores (4 or more) and were included in the inferential data analysis. The independent variables related to the processes objectively measurable in the recognition and management of deteriorating patients were included. After descriptive analysis the independent variables were cross-tabulated with the dependent variable using Pearson chi-square. The dependent variable was identified from the literature. This was whether time from triggering an abnormal EWS to critical care admission was delayed more than 6 hours. The subsequent predictor variables were then entered in to a binary logistic regression model for statistical analysis using SPSS version 21 software. Binominal Logistic Regression Analysis identified three significant variables predicting delay of the recognition and management of deteriorating patients. • Frequency of EWS measurement not increased appropriately • Length of stay prior to critical care admission 12-36 hours • If no consultant review during 6 hours of abnormal EWS Implications for Future Practice This study highlights areas of risk in the detection of patients’ clinical deterioration in acute wards. These findings should guide quality improvement to prevent unnecessary morbidity and mortality. As a key area of patient risk included the lack of frequency and accuracy of EWS measurements, staff education is required to ensure staff are given the appropriate knowledge to understand the use of the tool. Regular review of the frequency of measurement is also required as this was statistically significant in the delay to critical care admission. The high risk time from admission of 12-36 hours needs further investigation. This study also highlights the need for senior decision makers to be involved in the care of deteriorating patients to improve outcomes.

The classic flow shop problem assumes that jobs make only single passes through the processing machines and that the processing times are not affected by the length of the delay before jobs are processed. These assumptions are being relaxed in recent papers that consider reentrance problems and those with schedule deterioration. In this study, these two assumptions are both relaxed, and a model of a reentrant flowshop with a deteriorating schedule is considered. A linear programming formulation of the problem is first presented. Three solution heuristics are considered under different deterioration scenarios. It was observed that both Nawaz Enscor and Ham (NEH) algorithm and Genetic Algorithm (GA) performed much better than the Campbell Dudek and Smith (CDS) algorithm. Overall, when considering both the quality of solution and computational time together, the NEH algorithm seems to have performed much better than the others as the size of problems increases. This model would find useful applications in some metallurgical and manufacturing processes where such problems are usually encountered. / Dissertation (MEng (Industrial Engineering))--University of Pretoria, 2021. / Industrial and Systems Engineering / MEng (Industrial Engineering) / Unrestricted

No description available.

Import sanctions were used to a very limited extent against South Africa in the early sixties and latter half of the seventies to clearly signal the international community's disapproval of the country's apartheid policy. In the middle eighties South Africa was further exposed to a two year wave of export and financial sanctions. This was after the government had already committed itself to move away from apartheid as a policy that was no longer deemed feasible. All these sanctions were lifted in the early nineties after the abolition of apartheid but before negotiations for a new constitutional dispensation had firmly got under way. Contrary to some popular impressions, the 1985-87 sanctions were also severe1y limited in scope and nature, with the result that their economic impact was only marginal at best. They were introduced at a time when the country unexpectedly had to face a foreign debt crisis and had to drastically adjust the economy downward, not unlike that experienced by many other developing countries. The severe recession and greater socio-political unrest that followed did not lead to an escalation of sanctions, but nevertheless threatened to make large parts of the country ungovernable. The evidence is that sanctions only played a minor role in bringing about this poor and deteriorating state of affairs. The political aims of abolishing apartheid and preparing the way for negotiations was achieved mainly as a result of certain internal political developments, together with the political implications of such major other outside developments as the economic collapse of Sub-Saharan Africa and the Soviet Union. South Africa's experience with sanctions confirms that as elsewhere their economic impact as an instrument of foreign policy was invariably exaggerated, whereas their contribution in explaining the subsequent course of political events was at best uncertain. / Department of Economics / Ph.D. (Economics)

Thesis (MBA (Business Management))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Purpose – The health care industry is faced with numerous challenges ranging from rising medical costs, poor state of hospitals, deteriorating health care services and an increasing number of hospital deaths. All these disparities present tremendous challenges for the health care managers in charge of the health care services. As a result, they are forced to try new management methods that will assist their organizations to remain cost effective and efficient. Total Quality Management (TQM) constitutes an appropriate response to these challenges and it has become the strategy of choice to improve organization’s performance and patient satisfaction. However, in practice the implementation of TQM is often unsuccessful. Certain barriers have been identified which prevent the successful implementation of TQM in other industries as well as in the health care industry. The main aim of this research is to investigate the barriers to the successful implementation of Total Quality Management in Kraaifontein health care service organization in the Western Cape Province, 2008. Design/methodology/approach – The study employed a quasi-qualitative and quantitative case study. For the quantitative section a questionnaire with a 5–point Likert style scale was used to quantify the response (strongly disagree=1; strongly agree=5). For the qualitative section a focus group discussion was conducted to verify the results obtained from the questionnaire which addressed the challenges of TQM implementation. The statistical population of this research consisted of all health care workers working the pharmacy department who were involved in the implementation of TQM in their organization. Data was analyzed using appropriate statistical procedures. The mean score of each of the dimensions was used as a representative performance indicator and the coefficient of variation (CV) was used as a general measure of standardized skewness on the performance of each dimension. A high means score indicated desired outcomes while low scores indicated poor outcomes. Findings – Major barriers that were encountered during the implementation of TQM in this case study included the lack of top management active involvement and full commitment in the initiative, rigid organizational structure, culture towards quality changes that inhibited communication between management and employees which in turn hindered employee empowerment. Other obstacles that were encountered were lack of continuous improvement processes and initiative, improper evaluation, the lack of a recognition and reward system for team work, poor collection and analysis of data that resulted in difficulty to convert this data into meaningful information to improve quality. The absence of an integrated performance measurement system also exhibited a problem as employees were not aware what was being assessed during performance appraisals. Lack of evidence based decision making, poor communication and inflexible organizational structure and culture were also viewed as barriers. Research limitations/implications – Although conducted in Kraaifontein health care facility, it is expected that the results of the study may be relevant on a broader scale to other health care departments and facilities. The results could assist the health care managers to develop a plan that addresses the barriers and challenges faced during the implementation of TQM, yielding fruitful results which allow TQM to be implemented easily, effectively, efficiently and successfully in health care facilities. / AFRIKAANSE OPSOMMING: Doel – Die gesondheidsorg sektor het vele uitdagings wat wissel van stygende mediese kostes, lae standaarde in hospitale, die agteruitgang van gesondheidsorg dienste, en die toename in sterftes in hospitale. Hierdie en ander probleme stel groot uitdagings aan diegene verantwoordelik vir die lewering van gesondheidsorg, met die gevolg dat diesulkes nuwe bestuursmetodes moet vind om te verseker dat hulle organisasies steeds koste-effektief en doeltreffend funksioneer. Totale Gehalte Bestuur (TGB) is ‘n geskikte en toepaslike alternatief om genoemde probleme aan te spreek, en word toenemend as oplossing gesien om organisasies se dienslewering te verbeter, en pasiënt-tevredenheid te verseker. Die implementering van TGB blyk egter nie altyd suksesvol te wees nie. Daar is spesifieke struikelblokke geidentifiseer wat as redes aangevoer word vir die onsuksesvolle implementering van TGB in verskeie sektore, insluitend die van gesondheidsorg. Die hoof doel van hierdie navorsing was om die struikelblokke te ondersoek wat verhoed dat TGB suskesvol toegepas word in Kraaifontein gesondheidsdienste in die Weskaap, 2008. Ontwerp/Metode/Benadering – Die studie was ‘n kwasi kwalitatiewe en kwantitatiewe gevallestudie; vir die kwantitatiewe komponent is ‘n 5 punt Likert tipe skaal gebruik om die response (verskil beslis = 1; stem beslis saam = 5) te kwantifiseer. Die kwalitatiewe komponent het ‘n fokusgroep bespreking behels, waartydends die resultate van die vraelys geverifiëer is, wat die uitdagings van die implementering van TGB uitgewys het. Die statistiese populasie vir hierdie navorsing was al die gesondheidsorg werknemers in diens van die aptekers-departement, wat betrokke was in die implemetering van TGB in hulle organisasie. Die data is geanaliseer met toepaslike statistiese metodes. Die gemiddelde telling van elkeen van die dimensies was gebruik as ‘n verteenwoordigende aanduiding van prestasie, en die koëfisiënt van veranderlikheid was gebruik as ‘n algemene maatstaf van die gestandardiseerde skeefheid soos gemeet op elkeen van die dimensies. ‘n Hoë gemiddelde telling was ‘n aanduiding van die beoogde uitkomste, en lae tellings aanduidend van swak uitkomste. Bevindinge – Belangrike uitdagings wat ondervind is tydens die implementering van die TGB in hierdie gevallestudie sluit in, die gebrek aan aktiewe betrokkenheid en toewyding van die topbestuur vir hierdie inisiatief, rigiede organisatoriese strukture, die kultuur teenoor gehalte veranderinge wat kommunikasie tussen bestuur en werknemers belemmer, wat op sy beurt werknemer-bemagtiging verhoed. Ander struikelblokke wat geidentifiseer is, was ‘n afwesigheid van voortdurende verbeteringsprosesse en inisiatief, swak evaluering, ‘n gebrek aan ‘n sisteem vir erkenning en vergoeding vir spanwerk, swak data insameling en ontleding, wat tot probleme gelei het om die data in betekenisvolle inligting te verwerk wat kon lei tot ‘n verbetering in gehalte. Die afwesigheid van ‘n geintegreerde prestasie-beoordeling sisteem is ook as probleem geidentifiseer omdat werknemers nie ingelig was oor wat die prestasie-beoordelings behels nie. Die gebrek aan navorsingsgesteunde besluitneming, swak kommunikasie, en onbuigsame organisatoriese strukture en kultuur, was ook gesien as struikelblokke. Navorsing-beperkinge/implikasies – Alhoewel die studie in Kraaifontein gesondheidsorgfasiliteit gedoen is, word dit aanvaar dat die bevindinge van hierdie studie ook van toepassing is op ander gesondheidsorg departmente en fasiliteite. Die resultate kan gesondheidsorgbestuurders help om die uitdagings en struikelblokke te identifiseer in die implementering van TGB. Hierdie identifikasie kan lei tot ’n meer effektiewe en suksesvolle implementering van TGB in gesondheidsorgfasiliteite.

The implicit assumption in conventional inventory models is that the stored products maintain the same utility forever, i.e., they can be stored for an infinite period of time without losing their value or characteristics. However, generally speaking, almost all products experience some sort of deterioration over time. Some products have very small deterioration rates, and henceforth the effect of such deterioration can be neglected. Some products may be subject to significant rates of deterioration. Fruits, vegetables, drugs, alcohol and radioactive materials are examples that can experience significant deterioration during storage. Therefore the effect of deterioration must be explicitly taken into account in developing inventory models for such products. In most existing deteriorating inventory models, time is treated as a continuous variable, which is not exactly the case in practice. In real-life problems time factor is always measured on a discrete scale only, i.e. in terms of complete units of days, weeks, etc. In this research, we present several discrete-in-time inventory models and identify optimal ordering policies for a single deteriorating product by minimizing the expected overall costs over the planning horizon. The various conditions have been considered, e.g. periodic review, time-varying deterioration rate, waiting-time-dependent partial backlogging, time-dependent demand, stochastic demand etc. The objective of our research is two-fold: (a) To obtain optimal order quantity and useful insights for the inventory control of a single deteriorating product over a discrete time horizon with deterministic demand, variable deterioration rates and waiting-time-dependent partial backlogging ratios; (b) To identify optimal ordering policy for a single deteriorating product over a finite horizon with stochastic demand and partial backlogging. The explicit ordering policy will be developed for some special cases. Through computational experiments and sensitivity analysis, a thorough and insightful understanding of deteriorating inventory management will be achieved.

Import sanctions were used to a very limited extent against South Africa in the early sixties and latter half of the seventies to clearly signal the international community's disapproval of the country's apartheid policy. In the middle eighties South Africa was further exposed to a two year wave of export and financial sanctions. This was after the government had already committed itself to move away from apartheid as a policy that was no longer deemed feasible. All these sanctions were lifted in the early nineties after the abolition of apartheid but before negotiations for a new constitutional dispensation had firmly got under way. Contrary to some popular impressions, the 1985-87 sanctions were also severe1y limited in scope and nature, with the result that their economic impact was only marginal at best. They were introduced at a time when the country unexpectedly had to face a foreign debt crisis and had to drastically adjust the economy downward, not unlike that experienced by many other developing countries. The severe recession and greater socio-political unrest that followed did not lead to an escalation of sanctions, but nevertheless threatened to make large parts of the country ungovernable. The evidence is that sanctions only played a minor role in bringing about this poor and deteriorating state of affairs. The political aims of abolishing apartheid and preparing the way for negotiations was achieved mainly as a result of certain internal political developments, together with the political implications of such major other outside developments as the economic collapse of Sub-Saharan Africa and the Soviet Union. South Africa's experience with sanctions confirms that as elsewhere their economic impact as an instrument of foreign policy was invariably exaggerated, whereas their contribution in explaining the subsequent course of political events was at best uncertain. / Department of Economics / Ph.D. (Economics)

Under sommaren 2023 präglades Sverige av koranbränningar och ett försämrat säkerhetsläge. Studien undersöker svenska partiledares kriskommunikation på plattformen Instagram under denna period och studiens syfte är således att undersöka hur svenska partiledare använde plattformen Instagram som kommunikationskanal för kriskommunikation under sommaren 2023. Med hjälp av en kvalitativ innehållsanalys, med semiotiska och retoriska inslag, har vi analyserat sju svenska partiledares Instagram-inlägg under denna tidsperiod. Analysen gjordes med hjälp av ett kodschema och endast de inlägg som var relaterade till ämnet analyserades. Studien utgår från en socialkonstruktivistisk teori, gestaltningsteori, samt teorier om medialisering och medielogik. Med hjälp av retoriska begrepp som ethos, pathos och logos samt de semiotiska begreppen denotation, konnotation och myt kunde analysen utvecklas ytterligare. Studiens resultat visar att partiledarna främst använder Instagram för att förmedla information om krisen, upprätthålla en politisk och sakkunnig image, samt påvisa de åtgärder man gör gällande krisen. Partiledarna visar sällan upp en personlig sida utan är sakliga och opersonliga i sin kommunikation. I resultatet går det även att finna en pågående maktkamp, regeringen och oppositionen emellan. De två allianserna är i en påtaglig konflikt gällande vilka som gör mest för landet i krisen. Sammanfattningsvis går det att visa på att Instagram används av politiker för att förmedla fakta till befolkningen och detta sker genom en envägskommunikation. Även om tidigare forskning visar att det är fördelaktigt för en politiker att vara personlig och nära sin publik i en kriskommunikation, är detta inte något vi kan se hos de svenska partiledarna. / During the summer of 2023, Sweden was marked by Quran burnings and a deteriorating security situation. This study examines the crisis communication of Swedish party leaders on Instagram during this period, with the aim of investigating how Swedish party leaders used Instagram as a channel for crisis communication in the summer of 2023. Through a qualitative content analysis, with an incorporation of semiotic and rhetorical elements, we analyzed the Instagram posts of seven Swedish party leaders during this period. The analysis was conducted using a code scheme, and only posts related to the topic were analyzed. The study is based on a social constructivist theory, narrative theory, as well as theories of mediatization and media logic. Using rhetorical concepts such as ethos, pathos, and logos, as well as semiotic concepts like denotation, connation, and myth, the analysis was further developed.  The results of the study showed that Swedish party leaders primarily used Instagram to convey information about the crisis, maintain a political and knowledgeable image, and demonstrate the measures taken regarding the crisis. Party leaders rarely showed a personal side but rather maintained a factual and impersonal communication style. The results also reveal an ongoing power struggle between the government and the opposition. The two alliances are in a noticeable conflict regarding who is doing the right things for the country during the crisis. In summary, it can be shown that Instagram is used by politicans to convey facts to the population, and this occurs through one-way communication. Altough previous research indicates that it is advantageous for a politican to be personal and close to their audience in crisis communication, this is not observed among Swedish party leaders.