<p>Lengthy waiting times have been a problem in Swedish health services for many years. In 1992, Sweden implemented a national maximum waiting-time guarantee (MWG) through an agreement between the Swedish Government and the Federation of Swedish County Councils. The “guarantee” assured patients that the waiting time between the decision-to-treat and the treatment itself would not exceed three months. The national MWG covered twelve different treatments/interventions and remained in force for five years. This dissertation describes the genesis of the MWG, its implementation, and its effects.</p><p>Four papers serve as a foundation for the dissertation. Paper I describes how the guarantee was implemented during the first two years. Paper II studies the impact that the MWG had on cataract surgery. Paper III uses the results of two questionnaire surveys of department heads to explain why the MWG, although successfully launched, became increasingly difficult to maintain. Paper IV analyses data from the national cataract register to determine how production and waiting times in cataract surgery were affected by termination of the MWG.</p><p>This dissertation confirms that waiting time for health care is a complex phenomenon resulting from multiple causes. “Guarantees” are of particular interest because they define what constitutes too long in reference to waiting times. Beyond that, they are only a framework for developing a plan of action. The positive effects of the MWG were transient and based on rationalisation, introduction of new technology, and stricter prioritisation. The MWG contributed towards empowering patients and slowing the expansion of treatment indications, but it was unsuccessful in levelling out the wide regional variations in surgical rates.</p>

Lengthy waiting times have been a problem in Swedish health services for many years. In 1992, Sweden implemented a national maximum waiting-time guarantee (MWG) through an agreement between the Swedish Government and the Federation of Swedish County Councils. The “guarantee” assured patients that the waiting time between the decision-to-treat and the treatment itself would not exceed three months. The national MWG covered twelve different treatments/interventions and remained in force for five years. This dissertation describes the genesis of the MWG, its implementation, and its effects. Four papers serve as a foundation for the dissertation. Paper I describes how the guarantee was implemented during the first two years. Paper II studies the impact that the MWG had on cataract surgery. Paper III uses the results of two questionnaire surveys of department heads to explain why the MWG, although successfully launched, became increasingly difficult to maintain. Paper IV analyses data from the national cataract register to determine how production and waiting times in cataract surgery were affected by termination of the MWG. This dissertation confirms that waiting time for health care is a complex phenomenon resulting from multiple causes. “Guarantees” are of particular interest because they define what constitutes too long in reference to waiting times. Beyond that, they are only a framework for developing a plan of action. The positive effects of the MWG were transient and based on rationalisation, introduction of new technology, and stricter prioritisation. The MWG contributed towards empowering patients and slowing the expansion of treatment indications, but it was unsuccessful in levelling out the wide regional variations in surgical rates.

En esta investigación se ha desarrollado un método basado en el análisis de un corpus que facilita la identificación semiautomática del vocabulario especializado, combinando criterios cualitativos y cuantitativos, y en función de las variables de frecuencia, distribución, restricción y representatividad de una unidad léxica en el dominio especializado. Se ha diseñado y recopilado un corpus lingüístico especializado del inglés escrito, profesional y académico, de la Ingeniería de Telecomunicaciones (5,5 millones de palabras).El repertorio obtenido comprende las formas especializadas, con diferentes grados de especialización, estadísticamente más significativas y representativas. Entre ellas se encuentran términos puramente técnicos que no aparecerían en otro dominio, y unidades léxicas propias del lenguaje general, del académico y de otras áreas del saber que adquieren un significado especial en las telecomunicaciones.La caracterización léxica se complementa con el estudio de las relaciones sintagmáticas, mediante la exploración de los colocados contiguos, colocados significativos, combinaciones especializadas y clusters. / A corpus-based method has been developed to facilitate the semi-automatic detection of specialized vocabulary, by combining qualitative and quantitative criteria in relation to the variables of frequency, distribution, restriction and representativiness of a lexical unit in a specialized domain. The specific corpus designed and compiled for research purposes covers the academic and professional written English of Telecommunication Engineering (5.5 millions words).The obtained lexical repertoire is a list of the statistically most significant and representative specialized forms within a range of different degrees of specialization. There are both highly technical terms restricted to the domain and lexical units from the general, academic and other subject areas language, which activate a specialized meaning in telecommunications.The lexical characterization is completed with the study of sintagmatic relations by exploring adjacent collocates, significant collocates, specialized combinations and clusters.

Applications must be able to synchronize accesses to operating system (OS) resources in order to ensure correctness in the face of concurrency and system failures. This thesis proposes system transactions, with which the programmer specifies atomic updates to heterogeneous system resources and the OS guarantees atomicity, consistency, isolation, and durability (ACID). This thesis provides a model for system transactions as a concurrency control mechanism. System transactions efficiently and cleanly solve long-standing concurrency problems that are difficult to address with other techniques. For example, malicious users can exploit race conditions between distinct system calls in privileged applications, gaining administrative access to a system. Programmers can eliminate these vulnerabilities by eliminating these race conditions with system transactions. Similarly, failed software installations can leave a system unusable. System transactions can roll back an unsuccessful software installation without disturbing concurrent, independent updates to the file system. This thesis describes the design and implementation of TxOS, a variant of Linux 2.6.22 that implements system transactions. The thesis contributes new implementation techniques that yield fast, serializable transactions with strong isolation and fairness between system transactions and non-transactional activity. Using system transactions, programmers can build applications with better performance or stronger correctness guarantees from simpler code. For instance, wrapping an installation of OpenSSH in a system transaction guarantees that a failed installation will be rolled back completely. These atomicity properties are provided by the OS, requiring no modification to the installer itself and adding only 10% performance overhead. The prototype implementation of system transactions also minimizes non-transactional overheads. For instance, a non-transactional compilation of Linux incurs negligible (less than 2%) overhead on TxOS. Finally, this thesis describes a new lock-free linked list algorithm, called OLF, for optimistic, lock-free lists. OLF addresses key limitations of prior algorithms, which sacrifice functionality for performance. Prior lock-free list algorithms can safely insert or delete a single item, but cannot atomically compose multiple operations (e.g., atomically move an item between two lists). OLF provides both arbitrary composition of list operations as well as performance scalability close to previous lock-free list designs. OLF also removes previous requirements for dynamic memory allocation and garbage collection of list nodes, making it suitable for low-level system software, such as the Linux kernel. We replace lists in the Linux kernel's directory cache with OLF lists, which currently requires a coarse-grained lock to ensure invariants across multiple lists. OLF lists in the Linux kernel improve performance of a filesystem metadata microbenchmark by 3x over unmodified Linux at 8 CPUs. The TxOS prototype demonstrates that a mature OS running on commodity hardware can provide system transactions at a reasonable performance cost. As a practical OS abstraction for application developers, system transactions facilitate writing correct application code in the presence of concurrency and system failures. The OLF algorithm demonstrates that application developers can have both the functionality of locks and the performance scalability of a lock-free linked list. / text

As the Internet becomes the ubiquitous infrastructure for various applications, demands on the reliability, availability and security of routing protocols in the Internet are becoming more stringent. Unfortunately, failures are still common in the daily operation of a network. Service disruption for even a short time can seriously affect the quality of real-time applications, such as VoIP and video on demand applications. Moreover, critical business and government applications require routing protocols to be robust against malicious attacks, such as denial of Service attacks. This dissertation proposes three techniques to address some reliability and security concerns in intra-domain (distance vector) routing protocols and inter-domain (path vector) routing protocols. The first technique addresses the problem of service disruption that arises from sudden link failures in distance vector routing protocols. We consider two types of link failures: single link failures and shared risk link group failures. For single link failures, we propose an IP fast reroute mechanism to reroute packets around the failed links. This fast reroute mechanism is the first that does not require complete knowledge of the network topology and does not require changing of the original routing protocol. This mechanism proactively computes a set of relay nodes that can be used to tunnel the rerouted packets immediately after the detection of a link or node failure. The mechanism includes an algorithm for a node to automatically identify itself as a candidate relay node for a reroute link and notify the source node of the reroute link of its candidacy. The source node can then decide the validity of a candidate relay node. The mechanism also includes an algorithm to suppress redundant notification messages. We then extend our IP fast reroute mechanism for single link failures to accommodate shared risk link group failures. We achieve this goal by introducing one more bit information. Through simulations, I show that the proposed mechanisms succeed in rerouting around failed links about 100% of the time, with the length of the reroute path being comparable to the length of the re-converged shortest path. The second technique addresses the problem that arises from allowing any node to route data packets to any other node in the network (and consequently allow any adversary node to launch DoS attacks against other nodes in the network). To solve this problem, we propose a blocking option to allow a node u to block a specified set of nodes and prevent each of them from sending or forwarding packets to node u. The blocking option intends to discard violating packets near the adversary nodes that generated them rather than near their ultimate destinations. We then discuss unintentionally blocked nodes, called blind nodes and extend the routing protocols to allow each node to communicate with its blind nodes via some special nodes called joint nodes. Finally, I show, through extensive simulation, that the average number of blind nodes is close to zero when the average number of blocked nodes is small. The third technique addresses the problem that arises when a set of malicious ASes in the Internet collude to hijack an IP prefix from its legitimate owner in BGP. (Note that none of previous proposals for protecting BGP against IP prefix hijacking is effective when malicious ASes can collude.) To solve this problem, we propose an extension of BGP in which each listed AS in an advertised route supplies a certified full list of all its peers. Then I present an optimization where each AS in an advertised route supplies only a balanced peer list, that is much smaller than its full peer list. Using real Internet topology data, I demonstrate that the average, and largest, balanced peer list is 92% smaller than the corresponding full peer list. Furthermore, in order to handle the dynamics of the Internet topology, we propose algorithms on how to issue certificates to reflect the latest changes of the Internet topology graph. Although the results in this dissertation are presented in the context of distance vector and path vector routing protocols, many of these results can be extended to link state routing protocols as well. / text

La demande d'applications pour les plateformes mobiles a explosé ces dernières années. Chaque compagnie souhaite maintenant offrir pour ces nouveaux appareils les mêmes services que ceux offerts traditionnellement sur internet. Cependant, ces entreprises n'ont bien souvent que peu ou pas de connaissances concernant le développement et le déploiement de tels services. Généralement, la solution choisie consiste à externaliser ce travail en le sous-traitant à une autre compagnie. Dans ce contexte, il est souvent compliqué de s'assurer d'une part que le sous-traitant respecte le cahier des charges et d'autre part que le travail fourni est conforme aux recommandations émises par les fabricants des plateformes mobiles. Afin de pallier au second problème, nous avons créé un système de listes de vérification interactives pour plateformes mobiles. Ce système permet d'évaluer le niveau de conformité des différents composants de l'interface d'une application développée pour une plateforme mobile avec les recommandations du fabricant de cette plateforme. La solution retenue permet de se concentrer sur certains éléments particuliers de l'interface et pallie ainsi aux limites des listes de vérification classiques qui sont souvent trop longues et peu pratiques. La solution retenue offre de plus la possibilité de comparer facilement les caractéristiques des plateformes mobiles entre elles. Pour réaliser ce système, nous avons consulté de nombreux documents portant sur l'univers des plateformes mobiles afin de mieux appréhender leurs spécificités. Suite à l'étude de différentes plateformes, deux d’entre elles, soit iOS et BlackBerry, ont été retenues (il faut noter que la compagnie où s'est effectuée la recherche disposait déjà d'applications pour ces plateformes). Nous avons ensuite analysé plus finement la documentation technique fournie par chacun des fabricants afin d'en extraire les points importants. Afin que les données soient comparables, nous avons créé une nomenclature commune regroupant les composants de l'interface graphique en grandes familles (ex. : barres, saisie d'information, …) en tenant compte également du type d'interaction avec l'appareil (ex. : écran tactile). Nous avons ensuite conçu une solution permettant d'évaluer le niveau de conformité d'une application. L'idée retenue se base sur des listes de vérification permettant de systématiser le processus d'évaluation. Pour pallier aux limites de ces listes, souvent trop longues, nous permettons à l'utilisateur, via un ensemble de filtres, de se concentrer sur un sous-ensemble de composants de l’interface qu'il souhaite évaluer. L'implémentation de cette solution a été réalisée en totalité grâce à des technologies libres et de standard ouvert. De cette façon, nous nous sommes assurés de la portabilité de la solution développée et de l’absence de coûts supplémentaires liés à l'achat de licences. Le système utilise les standards web et repose sur une architecture basée sur le système d'exploitation GNU/Linux, le serveur web Apache, la base de données MySQL et le langage de scripts PHP. Ces logiciels ont déjà fait leurs preuves aussi bien pour les entreprises que pour les particuliers. De plus, la communauté très active qui s'est constituée autour de ces logiciels assure un bon support et une grande stabilité. Après avoir fait le choix de l’environnement de développement, la phase d'implémentation s'est ensuite déroulée en plusieurs étapes. Tout d'abord, l'information a été structurée selon la nomenclature mentionnée plus haut afin de créer le schéma de la base de données. Ensuite, toutes les pages ont été codées avec le langage à balises HTML et les scripts PHP pour le côté serveur et avec JavaScript pour le côté client. Enfin, l'information peut être affichée grâce aux feuilles de style en cascade (CSS), une technologie web permettant de séparer le fond de la forme en matière de mise en page. Nous avons choisi un modèle de développement itératif qui a impliqué les principaux utilisateurs dès les premières étapes de la conception du système. Cette implication s’est poursuivie jusqu’à la fin du projet afin de s'assurer que les fonctionnalités mises en place répondaient aux attentes. L’architecture modulaire qui a été retenue permet également d’adapter facilement le système aux besoins futurs. Afin de mieux comprendre comment on utilise le système, on passe en revue les différentes étapes nécessaires à la réalisation d'une évaluation. Enfin, on a réalisé une étude avec quatre utilisateurs pour évaluer l'utilisabilité du système et recueillir leur niveau de satisfaction. / The need for mobile platforms has increased in the last decade. Companies offering traditional internet services now want to move their applications on these new devices. But, most of the time, these companies do not really have the knowledge to create such applications and often ask a third party company to do the job for them. In this context, it is difficult to evaluate if the solution developed follows the recommendations of the device maker. A system based on interactive check lists has thus been created for this purpose. This system enables the evaluation of the conformity level of an application with the recommendations of the device maker, thanks to numerous filters that let the user focus on specific parts of the graphic interface. The idea behind the project was first to address some problematic issues with classical check lists and to enable the comparison of several mobile platforms with regard to specific interface components. To create this system, a lot of information about mobile platforms has first been collected. After reviewing many mobile platforms, it was decided to focus on iOS and BlackBerry, since the company where the research was performed had already applications running on them. For each platform, the major recommandations to be satisfied were identified. Also, to be sure that the extracted recommendations could be compared, a common nomenclature has been created, where the recommandations are grouped by interface components (ex: bars, data input,…) and by the type of interaction (ex: touch screen). After these preliminary steps, a solution for evaluating the level of compliance was created. We favored a check list approach because it offers a systematic evaluation process. To avoid lists of excessive length, filters were introduced in the system to allow the user to focus on particular aspects of the interface. The implementation was totally realized with open source technologies and open standards. This choice was motivated by the portability of the developed system and by the absence of licence fees. The system relies on web standards and runs on an architecture made of the CNU/Linux operating system, Apache web server, MySQL database and the script language PHP. This software has already proven its reliability for enterprises and for home users. Furthermore, the community evolving around this software offers a good support and ensures a high level of stability. After setting up the development environment, the implementation phase was engaged and took place over a number of phases. The first phase was the creation of the database structure, using the aforementioned nomenclature. The next phase was dedicated to the coding of the different web pages, thanks to the tag language HTML and the PHP scripts on the server side and JavaScript on the client side. Finally, the web page setting was developed using the cascading style sheet (CSS), a web technology that segregates the substance from the style of the web content. We chose an iterative development model where the end users were involved from the early stages of the project. This approach provides a guarantee that the user requirements are fulfilled and that any new developments will be in accordance with the expectations. Furthermore, the system is such that it can be easily modified to tackle future needs. To be able to understand how we use the systeme, we are reviewing the different steps needed to realise an evaluation. Finally, we have made a study with four users to evaluate the usability of the system and to gather their satisfaction level. / L'ensemble de mon travail a été réalisé grâce a l'utilisation de logiciel libre.

No description available.

INTRODUÇÃO: O transplante hepático (TxH) vem mudando o curso de doenças graves, incapacitantes e potencialmente fatais, se tornando o tratamento de escolha quando há falência do órgão. OBJETIVO: Comparar as taxas de TxH, exclusão e sobrevida entre candidatos com cirrose descompensada (CIR), situações especiais (SPE) e carcinoma hepatocelular (HCC). MÉTODOS:Foram realizados dois estudos em 358 pacientes: uma coorte retrospectiva (agosto de 2008 - julho de 2009, incluindo 189 pacientes listados) e uma prospectiva (de novembro de 2012 a maio de 2014, com um período de acompanhamento até novembro de 2015, incluindo 169 candidatos a transplante hepático, comparando CIR, HCC e SPE. Foram avaliadas as seguintes variáveis: K-in (taxas de entrada da lista de espera: K-1in se CIR, K-2in se HCC e K-3in se SPE); K-out (taxa de TxH); K-1out (drop out no grupo CIR); K-2out (drop out no grupo HCC) e K-3out(drop out no grupo SPE). RESULTADOS: Na coorte retrospectiva, 112 casos (59,3%) tinham CIR, 63 (33,3%) com HCC e 14 (7,4%) se enquadraram em SPE. Os tempos médios de avaliação até a inscrição em lista para TxH foram 194 dias (IC 95% 152-236), 36 dias (IC95% 21-50) e 98 dias (IC95% 0-308) para CIR, HCC e SPE, respectivamente (P <0,001). Dos 86 pacientes transplantados (K-out = 45,5%), 31 tinham CIR (K-1in = 27,7%), 44 HCC (K-2in = 69,8%) e 11 SPE (K-3in = 88,6%) (P <0,001). As taxas de drop out foram maiores em CIR (K-1out = 64,3%, K-2out = 30,2%, K-3out = 21,4%, P <0,001). O hazar ratio (HR) para TxH foi 85% (IC95% 1,35-2,55) maior em HCC do que CIR. Na coorte prospectiva, 110 dos 167 pacientes avaliados foram listados (K-in = 65,9%). Os tempos médios de avaliação foram de 783 dias (IC95% 330-1236), 52 dias (IC95% 17-87) e 184 dias (IC95% 19-349) para CIR, HCC e SPE, respectivamente (P <0,001). Em relação ao TxH, o K1-in foi 21,7%, K2-in, 76,4% e K3-in, 92,3 % (P <0,001). K-out foi 57,3% (63/110), K1-out = 50%, K2-out = 21,1% e K3-out = 3,84% (P <0,001). HR para TxH foi 329% superior em HCC do que CIR (HR = 4,29; IC95%: 2,74-6,72). CONCLUSÃO: Neste estudo, os pacientes com cirrose descompensada tiveram um tempo de avaliação para transplante significativamente maior que os outros grupos avaliados, bem como maior taxa de drop out em lista. A taxa de transplante foi significativamente menor nos pacientes com cirrose descompensada, demonstrando que as políticas de alocação de órgãos merecem ser revistas. / INTRODUCTION: Liver transplantation (LT) has been changing the course of serious, incapacitating and potentially fatal diseases becoming the treatment of choice when there is organ failure. AIM: To compare transplant, delisting, and survival rates between candidates with decompensated cirrhosis (CIR), special conditions (SPE), and hepatocellular carcinoma (HCC). METHODS: We carried out two studies with 358 patientes: a retrospective one (Aug 2008-Jul 2009, including 189 enlisted patients) and another prospective (Nov 2012-May 2014, with a follow-up period up to Nov 2015, including 169 LT candidates), comparing CIR, HCC, and SPE. The following variables were assessed: K-in (rates of waitlist entry – K-1in if CIR, K-2in if HCC, and K-3in if SPE); K-out (rate of LT); K-1out (drop-out in CIR); K-2out (drop-out in HCC); and K-3 out (drop-out in SPE). RESULTS: In the retrospective study, 112 cases (59.3%) were due to CIR, 63 (33.3%) to HCC, and 14 (7.4%) to SPE. The average time from selection to enlisting was 194 days (CI95% 152-236), 36 days (CI95% 21-50), and 98 days (CI95% 0-308) for CIR, HCC, and SPE, respectively (P<0.001). Of the 86 transplanted patients (K-out = 45.5%), 31 had CIR (K-1in = 27.7%), 44 HCC (K-2in = 69.8%), and 11 SPE (K-3in = 88.6%) (P<0.001). Drop-out rates were higher in CIR (K-1out = 64.3%, K-2out = 30.2%, K-3out = 21.4%, P<0.001). The hazar ratio (HR) for LT was 85% (CI95% 1.35-2.55) higher in HCC than CIR. In the prospective study, 110 out of 167 evaluated patients were enlisted (K-in = 65.9%). The average time from selection to enlisting was 783 days (CI95% 330-1236), 52 days (CI95% 17-87), and 184 days (CI95% 19-349) for CIR, HCC, and SPE, respectively (P<0.001). Regarding LT, K1-in was 21.7%, K2-in, 76.4%, and K3-in, 92.3% (P<0.001). K-out was 57.3% (63/110), K1-out = 50%, K2-out = 21.1%, and K3-out = 3.84% (P<0.001). HR for LT was 329% times higher in HCC than CIR (HR = 4.29; CI95% 2.74–6.72).CONCLUSION: In this study, patients with decompensated cirrhosis had a time evaluation for transplantation significantly higher than other evaluated groups as well as a higher rate of waiting list drop out. Transplant rate was significantly lower in patients with decompensated cirrhosis, demonstrating that organ allocation policies deserve to be reviewed.

INTRODUÇÃO: O transplante hepático (TxH) vem mudando o curso de doenças graves, incapacitantes e potencialmente fatais, se tornando o tratamento de escolha quando há falência do órgão. OBJETIVO: Comparar as taxas de TxH, exclusão e sobrevida entre candidatos com cirrose descompensada (CIR), situações especiais (SPE) e carcinoma hepatocelular (HCC). MÉTODOS:Foram realizados dois estudos em 358 pacientes: uma coorte retrospectiva (agosto de 2008 - julho de 2009, incluindo 189 pacientes listados) e uma prospectiva (de novembro de 2012 a maio de 2014, com um período de acompanhamento até novembro de 2015, incluindo 169 candidatos a transplante hepático, comparando CIR, HCC e SPE. Foram avaliadas as seguintes variáveis: K-in (taxas de entrada da lista de espera: K-1in se CIR, K-2in se HCC e K-3in se SPE); K-out (taxa de TxH); K-1out (drop out no grupo CIR); K-2out (drop out no grupo HCC) e K-3out(drop out no grupo SPE). RESULTADOS: Na coorte retrospectiva, 112 casos (59,3%) tinham CIR, 63 (33,3%) com HCC e 14 (7,4%) se enquadraram em SPE. Os tempos médios de avaliação até a inscrição em lista para TxH foram 194 dias (IC 95% 152-236), 36 dias (IC95% 21-50) e 98 dias (IC95% 0-308) para CIR, HCC e SPE, respectivamente (P <0,001). Dos 86 pacientes transplantados (K-out = 45,5%), 31 tinham CIR (K-1in = 27,7%), 44 HCC (K-2in = 69,8%) e 11 SPE (K-3in = 88,6%) (P <0,001). As taxas de drop out foram maiores em CIR (K-1out = 64,3%, K-2out = 30,2%, K-3out = 21,4%, P <0,001). O hazar ratio (HR) para TxH foi 85% (IC95% 1,35-2,55) maior em HCC do que CIR. Na coorte prospectiva, 110 dos 167 pacientes avaliados foram listados (K-in = 65,9%). Os tempos médios de avaliação foram de 783 dias (IC95% 330-1236), 52 dias (IC95% 17-87) e 184 dias (IC95% 19-349) para CIR, HCC e SPE, respectivamente (P <0,001). Em relação ao TxH, o K1-in foi 21,7%, K2-in, 76,4% e K3-in, 92,3 % (P <0,001). K-out foi 57,3% (63/110), K1-out = 50%, K2-out = 21,1% e K3-out = 3,84% (P <0,001). HR para TxH foi 329% superior em HCC do que CIR (HR = 4,29; IC95%: 2,74-6,72). CONCLUSÃO: Neste estudo, os pacientes com cirrose descompensada tiveram um tempo de avaliação para transplante significativamente maior que os outros grupos avaliados, bem como maior taxa de drop out em lista. A taxa de transplante foi significativamente menor nos pacientes com cirrose descompensada, demonstrando que as políticas de alocação de órgãos merecem ser revistas. / INTRODUCTION: Liver transplantation (LT) has been changing the course of serious, incapacitating and potentially fatal diseases becoming the treatment of choice when there is organ failure. AIM: To compare transplant, delisting, and survival rates between candidates with decompensated cirrhosis (CIR), special conditions (SPE), and hepatocellular carcinoma (HCC). METHODS: We carried out two studies with 358 patientes: a retrospective one (Aug 2008-Jul 2009, including 189 enlisted patients) and another prospective (Nov 2012-May 2014, with a follow-up period up to Nov 2015, including 169 LT candidates), comparing CIR, HCC, and SPE. The following variables were assessed: K-in (rates of waitlist entry – K-1in if CIR, K-2in if HCC, and K-3in if SPE); K-out (rate of LT); K-1out (drop-out in CIR); K-2out (drop-out in HCC); and K-3 out (drop-out in SPE). RESULTS: In the retrospective study, 112 cases (59.3%) were due to CIR, 63 (33.3%) to HCC, and 14 (7.4%) to SPE. The average time from selection to enlisting was 194 days (CI95% 152-236), 36 days (CI95% 21-50), and 98 days (CI95% 0-308) for CIR, HCC, and SPE, respectively (P<0.001). Of the 86 transplanted patients (K-out = 45.5%), 31 had CIR (K-1in = 27.7%), 44 HCC (K-2in = 69.8%), and 11 SPE (K-3in = 88.6%) (P<0.001). Drop-out rates were higher in CIR (K-1out = 64.3%, K-2out = 30.2%, K-3out = 21.4%, P<0.001). The hazar ratio (HR) for LT was 85% (CI95% 1.35-2.55) higher in HCC than CIR. In the prospective study, 110 out of 167 evaluated patients were enlisted (K-in = 65.9%). The average time from selection to enlisting was 783 days (CI95% 330-1236), 52 days (CI95% 17-87), and 184 days (CI95% 19-349) for CIR, HCC, and SPE, respectively (P<0.001). Regarding LT, K1-in was 21.7%, K2-in, 76.4%, and K3-in, 92.3% (P<0.001). K-out was 57.3% (63/110), K1-out = 50%, K2-out = 21.1%, and K3-out = 3.84% (P<0.001). HR for LT was 329% times higher in HCC than CIR (HR = 4.29; CI95% 2.74–6.72).CONCLUSION: In this study, patients with decompensated cirrhosis had a time evaluation for transplantation significantly higher than other evaluated groups as well as a higher rate of waiting list drop out. Transplant rate was significantly lower in patients with decompensated cirrhosis, demonstrating that organ allocation policies deserve to be reviewed.

This thesis deals with the regulation of advertising of medicinal products aimed at healthcare professionals. The thesis is focused on a deeper analysis of selected provisions, their critical assessment in light of courts' as well as the State Institute for Drug Control's decisions and proposals of possible improvements of the current status. The aim of this thesis is to explore the scope of the current legislation and to evaluate the regulation of the advertising of medicinal products aimed at healthcare professionals from its sufficiency and appropriateness point of view. The aim is also to suggest possible solutions for improving problematic parts. The introduction briefly describes the two fundamental terms, human medicinal products and advertising, along with basic introduction of the price and reimbursement of medicinal products. The introductory section also identifies reasons for the exclusive regulation of this type of advertising. Basic aspects of the regulation are introduces as well. The following section critically evaluates the term healthcare professional in relation to the status of nurses and patients. This is followed by a summary of the basic European Union's regulation that is reflected by those Czech laws regulating advertising of medicinal products aimed at healthcare...