The goal of this thesis is to analyze the most appropriate use of the building in order to achieve maximum profit. A feasibility study was used to analyze the issue of profitability. The main points addressed in the feasibility study were the marketing plan, cash flow and risk assessment. The result of the thesis is a decision about the project's feasibility based on the project indicators.

The thesis is focused on the design of marketing strategy for expansion into foreign markets the company MONTI SYSTEMS, Ltd., which design, develop, implement and service the hardware and software components of the MONTI CONTROL information technology system for petrol stations. In the theoretical part, the knowledge from marketing is elaborated, followed by the analytical part of the company. The design part of the diploma thesis deals with concrete proposals of marketing strategy for expansion of business activities on the foreign market.

Synthétisés massivement à partir des années 1930, les PCB (polychlorobiphényles) sont de ces substances chimiques dont l’utilisation a été progressivement interdite à l’échelle mondiale pour des raisons sanitaires, après des décennies de production industrielle et d’usages divers aussi bien dans l’industrie que dans des produits de consommation courante dans les bureaux et les maisons. Ils sont décrits depuis la fin des années 1960 comme un polluant omniprésent dans l’environnement, s’accumulant dans les corps des êtres vivants, toxique, « persistant » (qui – où qu’il se trouve – ne se dégrade pas ou peu au fil du temps), et dont on ne sait aujourd’hui encore se débarrasser qu’en l’incinérant à très haute température. Cette famille de molécules a fait l’objet de nombreuses actions politiques dès le début des années 1970 : non seulement la production et l’utilisation de ces substances ont été progressivement interdites mais des dispositifs réglementaires et des filières industrielles ont été développés pour procéder à leur élimination.Cette thèse étudie comment des dommages, des problèmes, des dangers et des risques ont été associés aux PCB et comment tout ceci a été géré. Or, dans cette perspective, la contamination du monde par ces substances apparaît, au fil des cinq dernières décennies, comme un problème récalcitrant : la multiplication de dispositifs techniques et politiques visant à gérer les (potentiels) effets néfastes des PCB n’a pas suffi à éviter que de nouveaux problèmes n’émergent et que certains types de problèmes déjà pris en charge par le passé ne resurgissent.A partir d’archives, d’entretiens semi-directifs et de documents collectés en ligne, cette thèse pose d’abord quelques jalons pour une histoire transnationale de la qualification et de la gestion des enjeux sanitaires et environnementaux liés aux PCB depuis le début de leur production industrielle en 1929. Elle s’intéresse ensuite plus particulièrement à trois "affaires" survenues en France, entre le milieu des années 1980 et aujourd’hui, au cours desquelles les PCB, à partir de problématisations locales, ont suscité l’intervention de différents acteurs, notamment des scientifiques, des associations et des pouvoirs publics. Elle éclaire ainsi les dynamiques scientifiques, techniques, industrielles, sociales et politiques qui, au-delà du consensus au sein de la communauté scientifique sur la persistance biochimique de ces composés, ont fait la récalcitrance politique du "problème PCB" au fil des décennies. / Massively synthesized from the 1930s, PCBs (polychlorinated biphenyls) are among the chemicals whose uses have been progressively banned at the global scale for sanitary reasons, after many decades of industrial production and varied usages in industry as well as in commodities into offices and households. They have been described since the end of the 1960s as an omnipresent pollutant in the environment, accumulating in the bodies of living organisms, toxic, "persistent" (which – wherever it is – does not, or almost not, degrade over time), and which can be eliminated only by incineration at a very high temperature. These chemicals have been the subject of numerous political actions since the early 1970s: not only have the production and use of these substances been progressively banned, but regulatory devices and industrial sectors have been developed to carry their elimination out.This thesis examines how damages, problems, hazards and risks have been associated with PCBs and how all these have been managed. In this perspective, the world contamination by these substances appears, over the last five decades, as a recalcitrant problem: the multiplication of technical and political devices that have aimed at managing the (potential) adverse effects of PCBs have not prevent new problems from arising and certain types of problems already tackled in the past from resurfacing.Based on archives, interviews and documents collected online, this thesis first sets some milestones for a transnational history of the qualification and management of health and environmental issues related to PCBs since the beginning of their industrial production in 1929. It then focuses on three "cases" in France, between the mid-1980s and today, during which PCBs, from local problematization, prompted interventions of different actors, including scientists, associations and public authorities. Thus, it sheds light on scientific, technical, industrial, social and political dynamics that, beyond the consensus in scientific community on the biochemical persistence of these compounds, have made the political recalcitrance of the "PCB problem" over decades.

Partant de la prémisse de la nature flexible et complexe du principe de précaution en droit européen, le but de cette étude a été d'en donner une interprétation polycentrique, fondée sur la diversité plutôt que sur l’uniformité. Pour atteindre un tel objectif, une méthode issue du pluralisme méthodologique a été employée. Celle-ci nous a permis de rechercher la uniras multiplex parmi les différentes définitions et applications de ce principe. La thèse ici soutenue a consisté à démontrer que l'interprétation polycentrique du principe de précaution peut être construite à partir de deux concepts : l'anticipation et l'action. Dans la première partie de cette étude, il a été montré comment le principe de précaution permet d'anticiper le temps de l'action publique au stade de l'incertitude scientifique. Nous avons à cet égard expliqué que l'anticipation suppose la qualification par le droit et l'évaluation par la science des risques incertains. La seconde partie de cette étude a été finalisée à démontrer comment, une fois le temps de l'action anticipé, les décideurs doivent agir sur le fondement du principe de précaution. Nous avons soutenu, à cet égard, que l'action sur la base de ce principe a une portée et des conséquences distinctes sur le plan procédural et substantiel. Les décideurs ont, en effet à la fois une obligation de prise en compte et une faculté de mise en œuvre du principe de précaution. / By acknowledging the flexible and complex nature of the precautionary principle in EU law, the purpose of this work is to provide a polycentric interpretation of this principle based on diversity rather than uniformity. To achieve this objective, a methodology derived from the methodological pluralism is employed. This allows for the “unitas multiplex” between the different definitions and applications of the precautionary principle to be researched. The core claim is that the polycentric interpretation of the precautionary principle can be built on two concepts: anticipation and action. In the first part of this study, I argue that anticipation implies the qualification by law and the evaluation by science of uncertain risks. In the second part, I consider that, after having anticipated the time of action, decision-makers should act on the basis of the precautionary principle. However, the action undertaken has different meanings and consequences from the procedural and substantive perspective. From the procedural side, the decision-makers have the obligation to take into account this principle, white they remain free on the substantive side, to adopt a precautionary measure.

<p>The medication errors associated with intravenous (IV) administration may cause severe patient harm. To address this issue, smart infusion pumps now include a built-in dose error reduction system (DERS) to help ensure the safety of IV administration in clinical settings. However, a drug limit alert triggered by DERS may be overridden by the practitioners which can potentially cause patient harm, especially for high-risk medications. Most analytical measures used to estimate the associated risk of harm are frequency-based and only consider the overall drug performance rather than the severity impact from individual alerts. Unlike these other measures, the IV medication harm index attempts to quantify risk of harm for individual alerts. However, it is not known how well these measures describe the risk associated with alert-overridden scenarios. The goal of this research was (1) to quantitatively measure the risk for simulated individual alert-overridden infusions, (2) to compare these assessments against the risk scores obtained among four different analytical methods, and (3) to propose better risk quantification methods with a higher correlation to risk benchmarks than traditional measures, such as the IV Harm index. </p> <p>In this study, 25 domain experts (20 pharmacists and 5 nurses) were recruited to assess the risk (adjusted for risk benchmarks) for representative scenarios created based on hospital alert data. Four analytical methods were applied to quantify risk for the scenarios: the linear mixed models (Method A), the IV harm index (Method B), Huang and Moh’s matrix-based ranking method matrix-based method (Method C), and the analytical hierarchy process method, adjusted by linear mixed models (Method D). Method A used seven alert factors (identified as key risk factors) to build models for risk prediction, and Methods B and C used two out of seven factors to obtain risk scores. Method D used pairwise comparison surveys to calculate the risk priorities. The quantified scores from the four methods were evaluated in comparison to the risk benchmarks.</p> <p>Risk assessment results from the domain experts indicated that overdosing scenarios with continuous and bolus dose field limit types had significantly higher risks than those of bolus dose rate type. About the soft limit type, the expected risk in the group with a large soft maximum limit was significantly higher than the group with a small soft maximum limit. This significant difference could be found in the adult intensive care unit (AICU), but not in adult medical/surgical care unit (AMSU). The comparisons between four analytical methods and risk benchmarks showed that the risk scores from Method A (<i>ρ</i> = 0.94) and Method D (<i>ρ </i>= 0.87) were highly correlated to the risk benchmarks. The risk scores derived from Method B and Method C did not have a positive correlation with the benchmarks.</p> <p>This study demonstrated that the traditional IV harm index should include more risk factors, along with their interaction effects, for increased correlation with risk benchmarks. Furthermore, the linear mixed models and the adjusted AHP method allow for better risk quantification methods where the quantified scores most correlated with the benchmarks. These methods can provide risk-based analytical support to evaluate alert overrides of four high-risk medications, propofol, morphine, insulin, and heparin in the settings of adult intensive care unit (AICU) and adult medical/surgical care unit (AMSU). We believe that healthcare systems can use these analytical methods to efficiently identify the riskiest medication-care unit combinations (e.g. propofol in AICU), and reduce medication error/harm associated with infusions to enhance patient safety.</p> <p> </p>

IntroductionPreimplantation Genetic Diagnosis (PGD) was developed in the 1990s and has been used since to diagnose and discard embryos with genetic conditions or chromosomal abnormalities. CRISPR-Cas9 was discovered in 2012 and has been used in research, but has not become clinical practice on humans yet. CRISPR-Cas9 could potentially be applied to treat and prevent genetic disorders.AimThe aim was to investigate the ethical dilemmas of each method through a set of research questions. The ethics of applying PGD according to Swedish guidelines and applying CRISPR-Cas9 on humans was investigated.MethodologyThis was not a systematic literature review. Instead, articles have been selected based on their explanation of each method and uniqueness or volume of ethical arguments surrounding each method, that is of relevance for the discussed issues.ResultsArguments in favour of PGD addressed among other things the somatic and psychological health of future children and parents along with the economical benefits. Arguments against PGD addressed different dilemmas of discarding an embryo and thereby a future individual. Arguments against CRISPR-Cas9 addressed technical limitations, our limited knowledge of genetics and more. Arguments in favour addressed benefits in clinical medicine and research.ConclusionsPGD according to Swedish guidelines was found to be ethically acceptable, since its restrictive use that have not given room for ethically dubious applications. CRISPR-Cas9 was found not to be safe enough for human applications at this moment due to technical limitations. If these were to be solved, caution and restraint must be urged.

Depuis la fin des années 2000, les risques psychosociaux (stress, anxiété, burn-out…) sont au cœur des débats sociétaux. La littérature explique l’apparition accrue de ces phénomènes par la diffusion d'une culture du résultat exigeant toujours plus des individus et contrôlant leur performance grâce à un ensemble de dispositifs et d'outils de gestion. Parallèlement, pour prévenir les risques psychosociaux les organisations s'appuient également sur des outils de gestion. Cette thèse vise donc à répondre à la question de recherche suivante : dans quelle mesure les outils de gestion participent aux risques psychosociaux, à leur production et à leur prévention ? Pour y parvenir nous avons réalisé une étude exploratoire, puis, quatre études de cas au sein d’organisations privées et publiques selon un design qualitatif composé de 67 entretiens semi-directifs, de deux observations non participantes et de documentations internes et externes. En étudiant les relations systémiques entre perceptions du réel, individus et outils de gestion, nous approfondissons les mécanismes complexes liant culture du résultat, dispositifs de gestion et risques psychosociaux. / Since the late 2000s, psychosocial risks (job strain, anxiety, burn out…) are a debating point. The literature explains it by the dissemination of a results-oriented culture which demands more and more to people and controls their performance by using management tools. Furthermore, to prevent psychosocial risks organizations also use management tools. That's why we focus our attention on the use of management tools in organizations to study the complex links between management control and psychosocial risks. Thus, our thesis aim to answer the following research question: to what extent management tools participate to psychosocial risks, to their creation and to their prevention ? To do this, we have first made an exploratory study and then four case studies in private and public organizations. So our qualitative design is composed by collecting 67 semi-structured interviews, two non-participatory observations and internal and external documents. By studying mutual relationship between perceptions of reality, individuals and management tools, we explore the complex mechanisms binding results-oriented culture, management tools and psychosocial risks.

D. Tech (Department of Human Resource Management, Faculty of Management Sciences), Vaal University of Technology. / The expectation by South Africans is that the public sector must contribute positively to the economy. However, the general perception is that the public sector is failing to fulfil its mandate due to systemic problems in the entire public sector. Its supply chain in South Africa is both volatile and imperfect. This is demonstrated by the level of service delivery protests, which emanate from the feeling that the public is not receiving the quantity or quality service that they need. This study aimed to assess the relationship between supply chain risks, supply chain flexibility and supply chain performance in the South African public sector. A conceptual framework was developed, which included six supply chain risk factors, namely, government policies, supply complexity, availability of skills, supplier performance monitoring, information security and process efficiency, which feed into supply chain flexibility, which in turn leads to supply chain performance. Seven hypotheses underlying these relationships were put forward for testing. A quantitative approach using the cross-sectional survey design was adopted in which a questionnaire was distributed to 306 conveniently selected supply chain professionals who were based in Gauteng province. Items used in the survey questionnaire were adapted from previously validated scales. A confirmatory factor analysis was conducted to test the psychometric properties of the measurement instrument. Descriptive statistics were used to analyse the perceptions of respondents towards the factors under consideration in the study. Hypotheses were tested using the structural equation modelling approach. The results of the study show that the threat from supply chain risks in the South African public sector remains high, and that flexibility and performance of the supply chain remains unsatisfactory. Hypotheses tests showed that all six supply chain risks significantly predicted supply chain performance. While the other supply chain risks were positively related to supply chain flexibility, the relationship between the flexibility and supply complexity was negative. Amongst the supply chain risks considered in this study, availability of skills emerged as the strongest predictor of supply chain flexibility. The study further showed that supply chain flexibility significantly and positively predicts supply chain performance. Theoretically, the study provides a specific conceptualization of the relationship between supply chain risks, supply chain flexibility and supply chain performance within the South African public sector, where no such study has been conducted before. Practically, it provides information to supply chain professionals in the South African public sector regarding the improvement of supply chain performance. The study underscores that the performance public supply chain in South Africa can be improved by managing the six risks considered in this study, and their contribution to supply chain flexibility.

Charles University, Faculty of Pharmacy in Hradec Kralové Department of Social and Clinical Pharmacy Author Anna Faltysová Supervisor PharmDr. Jitka Pokladníková, Ph.D. Consultant PharmDr. Julie Zubrová Title of Diploma Thesis Analysis of the risks associated with using dietary supplements by patients in pre-operative period Objectives: The thesis deals with the problem of the dietary supplement use by patients in the time before surgery. The aim of the thesis is to evaluate the prevalence of dietary suplement use by patients before surgery. Another aim is to point to potential danger which could endanger the patient while irrational using of the dietary supplement before the medical interventions (interactions of dietary supplement, side effects of dietary supplement). Methodology: The questionnaire research was conducted in order to obtain the data. It was counducted between 9th May 2017 till 30th June 2018 at 9 departments of the University Hospital in Hradec Králové. In total 332 patients in the time before surgery were asked and 257 completed questionnaires were analysed. Results: From the results of the study we can see the prevalence of the dietary supplement use by the patients in the time before surgery, which amounts to 42 %. It was stated that most of the patients does not inform their...

Syftet med studien är att undersöka de risker som finns i samband med brand i däckhotell, samt utvärdera om samhällets krav på byggnadstekniskt brandskydd är tillräckligt för att hantera risknivån. Samhällets krav i studien är Boverkets byggregler BFS 2011:6 med ändring till och med BFS 2020:4 (BBR) och den kravställning som sker i enlighet med förenklad dimensionering. Kraven i BBR har kvantifierats för att möjliggöra en jämförelse mellan BBR och de verkliga förutsättningar som återfinns på däckhotell. Studien behandlar enbart tre av de fem punkter som BBR baseras på. Utveckling och spridning av brand och rök inom byggnadsverket ska begränsas, spridning av brand till närliggande byggnadsverk ska begränsas och hänsyn ska tas till räddningsmanskapets säkerhet vid brand. Det finns erfarenheter kring bränder i däcklager men ingen samlad bild av hur däckhotell bör hanteras i regelverken, eller om det är förenligt med byggreglernas intention och räddningstjänstens praktiska erfarenheter att utföra insats. Hur ska då brandskyddet utformas i däckhotell för att samhällets krav ska vara uppfyllt? I ett däcklager kan det handla om flera tusen däck som lagras samtidigt. Metodval för att besvara frågeställningarna var att utifrån verkliga däckhotell tillsammans med forskning och studier inom området, genomföra en rad olika analyser. Detta för att kunna besvara frågorna kvantitativt och/eller kvalitativt. Alla frågeställningar krävde dock flera antaganden för att vara möjliga att besvara. För att erhålla något att basera antagandena mot, genomfördes en fallstudie på verkliga däckhotell. Därefter skapades fem olika geometriska modeller baserade på de verkliga byggnaderna av volym, konstruktionsmaterial och ventilationsmöjligheter. Fallstudien visade även på stor variation på antalet däck som fanns placerade i däckhotell. Dock kan det konstateras att brandbelastningen i ett däckhotell överskrider 1600 MJ/m2 golvarea. Det konstruktionsmaterial byggnaden är uppförd med har stor inverkan på temperaturen i brandrummet. Däckhotell uppförda med en betongkonstruktion ger bättre förutsättningar för de brandavskiljande komponenterna att upprätthålla den brandbegränsande funktionen, detta i jämförelse med ett däckhotell uppfört av plåt med isoleringskärna. En brandcellsgräns som utsätts för den temperaturutveckling som sker i byggnad med väggar och tak av plåt-/isoleringskonstruktion, kommer eventuellt inte att begränsa brandspridningen under avsedd tid. De två skyddsbarriärerna som anges i BBR för att begränsa brandspridning mellan byggnader är skyddsavstånd eller att ytterväggen utformas som en brandcellsgräns, men där funktionen av en brandcellsgräns blir beroende av byggnadens konstruktionsmaterial. Fungerande skyddsavstånd är under förutsättning att öppningarna i fasad är begränsade och inte är större än en normal garageport. Syftet med att skydda närliggande byggnader uppfylls därmed inte. Skyddsavståndet bör vara i relation till arean på möjliga öppningar istället för ett fast värde. Ska skyddsavståndet vara fast bör det ske reglering av arean på möjliga öppningar och begränsa storleken eller kritisk strålningsnivå som får uppkomma på närliggande byggnad. Granskning av räddningsmanskapets säkerhet var en jämförelse mellan BBR och intervjuer på hur en räddningsinsats skulle kunna genomföras. Det som diskuterades var vilka risker branden och byggnaden utgör, samt hur dessa kan påverka genomförandet av insatsen. Brandtekniska åtgärder för att ta hänsyn till räddningsmanskapets säkerhet vid insats finns inte i erforderlig omfattning, vid brandteknisk projektering enligt förenklad dimensionering. Utan tidig detektion är risken överhängande att branden är för omfattande för att användning av invändiga brandposter för begränsning ska kunna vara möjlig. Dock är den enskilt viktigaste åtgärden för räddningsmanskapets säkerhet är att säkerställa tillgången till rätt mängd släckvatten vid byggnaden. Däckhotell placerade i containers är den enda byggnadsgeometri vilken kan projekteras enligt förenklad dimensionering. Den lagringsmetoden ger bäst möjlighet till en lyckad räddningsinsats och låg riskbild, och de är den enda modellen där brandcellsgränser helt klart skulle uppfylla sitt syfte både i klass EI 30 och EI 60. Containers har normalt inga fönster eller andra likvärdiga öppningar. / The aim of the thesis is mainly to investigate the risks that exist in case of fire in tire hotels and to evaluate whether society's requirements for fire protection in buildings are enough to manage this level of risk. Society's requirements in the study are Boverket's building regulations, BFS 2011:6 with amendments up to BFS 2020:4, (BBR) and the requirements that takes place in accordance with simplified design. The requirements in BBR have been quantified to enable a comparison between BBR and the actual conditions found in tire hotels. The study only treats three of the five items which BBR is based on. Development and spread of fire and smoke within the construction works is limited, spread of fire to adjacent construction works is limited and consideration has been taken to the rescue team's safety in case of fire. It exists some experience of fires in tire storage, but not a general picture of how a tire hotel should be design according to the building regulations, nor if it´s compatible with the building regulations' intention or the rescue team's practical experience of carrying out a rescue operation. The question is how the fire protection should be designed in tire hotels so that society's requirements can be fulfilled? When it can be thousands of tires which are stored at the same time in a tire hotel. The method to answer the questions was to carry out a few different analyses based on real tire hotels, together with research and studies in this area, so the questions could be answered quantitatively and/or qualitatively. However, all questions required some assumptions to be answered. To obtain something to base the assumptions against, a case study on real tire hotels was conducted. Five different geometric models were therefore created based on the buildings in terms of volume, construction materials and ventilation openings. The case study also showed a great variation in the number of tires that were stored in the hotels. Even with the variation, it can be stated that the fire load in a tire hotel exceeds 1600 MJ/m2 per floor area. The buildings construction material has a big impact on the fire temperature in the room. Tire hotels with a concrete construction provide better conditions for the fire-separation components to maintain the limiting function, in comparison with a construction of metal sheets with a core of insulation. A fire compartment boundary that is exposed to a temperature rise that occur in a metal structure, may not have the function over time it supposed to limit the spread of fire to other rooms during the intended time. BBR specifies two protective barriers to limit the spread of fire to adjacent construction, which are safety distances or that an exterior wall is designed as a fire compartment boundary. The function to limited fire spread by a fire compartment boundary is dependent on the building's construction material to fulfill its purpose. For a safety distance to work, the openings in the facade must be limited and not larger than a normal garage door. The purpose of protecting adjacent construction is therefore not fulfilled. The safety distance should be in relation to the area of ​​ openings instead of a fixed value. If the safety distance is a fixed value, the areas of openings should be regulated, if not, the size of the critical radiation that occur on an adjacent construction should be limited. Examination of the rescue team's safety was a comparison between BBR and interviews on how a rescue operation could be carried out. Under the interviews it was discussed what type of risks that are caused by the fire and the building, and how these risks can affect the implementation of the operation. The fire technical arrangements do not fulfill its purpose, to create the level of safety that are required for the rescue team when the fire technical design is according to a simplified design. Without early detection, the risk is imminent that the fire is too large for a person to use an indoor fire hydrant. The most important arrangements for the safety of the rescue team are however to ensure access to the right volume of water near the building. Tire hotels placed in containers are the only type of building which can be projected according to simplified design. This storage method provides the best opportunity for a successful rescue operation with a low risk.  Containers are also the only geometric model where fire compartment boundary would clearly fulfill its purpose, in both class EI 30 and EI 60. Containers have normally no windows or other equivalent openings.