The two types of physicians in the United States healthcare system differ based on the type of medical education they receive. The first type train at allopathic medical schools and upon completion, students are awarded their Doctorate of Medicine and are then known as MDs. The second, less known type of medical education is that of osteopathy. Students that go to osteopathic medical schools earn a degree of Doctor of Osteopathic Medicine, and are thus considered DOs. This literature review analyzed public satisfaction with MDs or DOs since there are fundamental differences in the core philosophies of the two. It also answers whether this translates into better clinical outcomes and a more positive prognosis for the patient. The purpose of this study was to find any noticeable differences that translated into actual practice and discuss the implications they may have for the future of healthcare. Although no conclusion could be made, based on findings discussed throughout this paper, one may speculate that patients are more satisfied with a DO as opposed to an MD. Furthermore, as a patients' satisfaction is indicative of their health related quality of life, it is possible that patients that visit DO physicians would most likely have a better health related quality of life.

Between the years 2005 and 2015 cars and trucks have increased with 7, 7 percent inGothenburg. This will mean that in 2035 there will be 47 140 more vehicles. 70.000 of the550.000 people in Gothenburg is being exposed by a noise that is over the limit of 55 dBA. Vehicles incomplete combustion of hydrocarbons leads to a number of additional health problems. According to the Swedish transport department, closer to 3000 people dies prematurely in Sweden each year due to traffic air pollution.A measure to prevent and reduce the intense traffic involves emission requirements, congestion and traffic regulations. The city center of Gothenburg will on the first of October 2016 introduce a prohibition for heavy traffic around the area close to Domkyrkan between 11am - 05am a clock. The purpose of this study has been to investigate if a regulation of heavy traffic can be used as an instrument to contribute to a sustainable and environment adjusted city without affect the residents feeling of an attractive city center. On behalf of the municipal entity Traffic office Gothenburg City and the organization Innerstaden Göteborg a customer satisfaction index analysis (CSI) has been done. Performed in order to measure customer satisfaction before the regulation. The CSI model which is a result from this paper will be re-used after the regulation in order to identify the effects of the traffic regulation. CSI is a statistical method built upon indicators (questions) and latent variables (quality factors) related to a set of indicators. CSI is measured by the respondents answering questions through a 1-10 point scale where 1 is the lowest rating and 10 is the highest ratings. There are three standard questions which average rating creates the CSI value: How satisfied are you with the overall environment as it is today? How well meets the environment your expectations? How well relate this specific area with an ideal inner city environment?

A completely satisfactory water distribution network should fulfill its basic requirements such as providing the expected quality and quantity of water with the desired residual pressures during its lifetime. A water distribution network should accommodate the abnormal conditions caused by failures. These types of failures can be classified into two groups / mechanical failures and hydraulic failures. Mechanical failure is caused due to malfunctioning of the network elements such as pipe breakage, power outage and pump failure. On the other hand, hydraulic failure, considers system failure due to distributed flow and pressure head which are inadequate at one or more demand points.This study deals with the calculation of the hydraulic system reliability of an existing water distribution network regarding the Modified Chandapillai model while calculating the partially satisfied nodes. A case study was carried out on a part of Ankara Water Distribution Network, N8-1. After the modeling of the network, skeletonization and determination of nodal service areas were carried out. The daily demand curves for the area were drawn using the data that were taken from SCADA of the water utility. The daily demand curves of different days were joined and one representative mean daily demand curve together with the standard deviation values was obtained. The friction coefficient values of the pipes and storage tank water elevation were taken as other uncertainty parameters for the model. Bao and Mays (1990) approach were carried together with the hydraulic network solver program prepared by Nohutcu (2002) based on Modified Chandapillai model. The sensitivity analysis for the effects of system characteristics and model assumptions were carried out to see the effects of the parameters on the calculations and to investigate the way of improving the hydraulic reliability of the network. The storage tank should be located at a higher level for improving the reliability of the network. Also having the storage tank water level nearly full level helps in improving the reliability in daily management. Moreover, the hydraulic system reliability is highly dependent on the pumps as the lowest reliability factors were the ones with the no pump scenarios. Determining the required pressures for nodes are very important since they are the dominant factors that effects the reliability calculations. On the other hand, friction coefficient parameters and type of probability distribution function do not have dominant effect on the results. Results of this study were helpful to see the effects of different parameters on the hydraulic reliability calculations and for assessment of the methods for improving the reliability for the network.

In X-ray computed tomography, motion of the object (breathing, for example) while X-ray projections are acquired for tomographic reconstruction leads to mo- tion artifacts in the reconstructed image. Object motion (such as that of breathing lungs) during acquisition of a computed tomography scan causes artifacts in the reconstructed image due to the reason that the source and detectors require a finite amount of time to rotate around the object while acquiring measurements even as the object is changing with time. With traditional reconstruction algorithms, the object is assumed to be stationary while data is acquired. However, in the case of dynamic tomography, the projection data that is acquired is not consistent, as it is data measured from an object that is deformed at each view angle of measurement. In this work, we propose a method for estimation of general (non-rigid) small motion for dynamic tomography from motion-corrupted projection data. For a static object, the Helgason-Ludwig consistency conditions impose some structure on the moments of the projections. However in the case of dynamic object (result- ing in motion-corrupted projections) this is violated. In the proposed method, we estimate motion parameters of the general motion model from the moments of the dynamic projections. The dynamic object can be modeled as f (g(x, t)) where g is a time-dependent warping function. The non-linear problem of solving a system involving composition of functions is dealt with in the Fourier transform space where it simplifies into a problem involving multiplicatively separable functions. The system is then linearized to solve for object motion. We assume a general basis function in our model. For numerical simulations, we use polynomial and B-spline basis functions as special cases of the basis functions. Simulation is performed by applying known deformations to the Shepp-Logan phantom, to a head slice of the Visible Human phantom and a thorax slice of the Zubal phantom. Simulations are performed for projections generated by parallel- beam and fan-beam geometry. Simulation for fan-beam geometry are performed by rebinning the motion corrupted fan beam projections to parallel beam projections, followed by the proposed motion estimation method. Simulation for the Visible Human phantom and the thorax slice of the Zubal phantom are performed for fan- beam geometry. Poisson noise is also added to the generated dynamic projections before motion estimation is performed. To solve the ill-posed problem of motion estimation by the proposed method, we use a Tikhonov type regularization that involves minimizing an objective function that is the sum of a data discrepancy term, a term that penalizes temporal variation of motion, and another term to penalize large magnitudes of motion. Using the estimated motion, the original image has been reconstructed from the motion corrupted projection data, with the knowledge of the underlying motion which is estimated by the proposed algorithm, by an algebraic technique similar to the dynamic SART algorithm from the literature. Here, a SART-type coefficient matrix is computed using ray tracing with rays whose paths are warped according to the estimated motion. The dynamic image at t = 0 is then reconstructed with using the computed dynamic SART matrix.

<p>This thesis emphasizes on surveying the state-of-the-art in software requirements specification with a focus on, autonomic, self-adapting software systems. Since various requirements are brought forward accord with environments, modeling requirements for adaptive software systems may be changed at run-time. Nowadays, Keep All Objectives Satisfied (KAOS) is an effective method to build goal model. Various manipulations, such as change, remove, active and de-active goals, appear new goals, could mediate conflicts among goals in adaptive software system. At specification time, specifications of event sequences to be monitored are generated from requirements specification.</p>

This thesis emphasizes on surveying the state-of-the-art in software requirements specification with a focus on, autonomic, self-adapting software systems. Since various requirements are brought forward accord with environments, modeling requirements for adaptive software systems may be changed at run-time. Nowadays, Keep All Objectives Satisfied (KAOS) is an effective method to build goal model. Various manipulations, such as change, remove, active and de-active goals, appear new goals, could mediate conflicts among goals in adaptive software system. At specification time, specifications of event sequences to be monitored are generated from requirements specification.

The diploma thesis was processed at a hotel in town Boskovice. It analyses and evaluates hotel services and areas associated with their provision. The aim of the diploma thesis is a proposal for improvement of a staffing services, technical support and extension of the supply of services leading to an increase of hotel occupancy.

Syftet med den här studien är att utforska initiativ som ökar kundnöjdheten i en kommunal verksamhet. En kommun, Helsingborg, som lyckats väl i att utveckla en hög kundnöjdhet i den nationella undersökningen Nöjd Kund Index inom myndighetsområdet bygglov har studerats. Studien har bedrivits utifrån tre forskningsfrågor: (1) Vilka initiativ har gjorts för att öka kundnöjdheten i NKI-undersökningen med avsikt att höja resultatet i den övergripande mätningen samt inom de underliggande bedömningsområdena?; (2) Utifrån tagna initiativ, vilka hörnstenar för offensiv kvalitetsutveckling har varit mest använda?; (3) Vilka övriga effekter kan en verksamhet uppnå genom att jobba med ett utvecklingsarbete i syfte med att öka kundnöjdheten i NKI-undersökningen?Studien tillämpar en kvalitativ metod med djupintervjuer som gjordes i Helsingborg men även i en annan kommun, Borås, som användes som referensobjekt.Studiens resultat visar på ett stort antal initiativ som kan tas för att öka kundnöjdheten. Studien bekräftar också tidigare belägg för vad som driver resultat och visar på en rad positiva effekter som ett utvecklingsarbete kan ha på verksamheter. Studien visar även att värderingarna för offensiv kvalitetsutveckling i hörnstensmodellen är väl förenliga med Tillitsbaserad Styrning och Ledning, TSL och visar att resultat som TSL åstadkommit i statliga verksamheter även är giltiga på kommunal nivå. / The purpose of this study is to explore initiatives that increase customer satisfaction within a municipality. One municipality, Helsingborg, which has succeeded in increasing customer satisfaction in the area of building permits in the national survey Satisfied Customer Index, SCI, has been studied. Three research questions have informed the study: (1) What initiatives have been introduced to increase customer satisfaction in the SCI survey, with the intention of improving results both in the overall survey and in the underlying assessment areas? (2) Based on the initiatives introduced, which cornerstones for offensive quality development have been most widely used?; (3) What other outcomes can an organisation achieve through development work aimed at increasing customer satisfaction in the SCI survey?The study applies a qualitative method with in-depth interviews conducted in Helsingborg, as well as in another municipality, Borås, which serves here as a point of comparison.The study’s result indicates a number of initiatives that can be introduced to increase customer satisfaction. The study also confirms previous evidence of what drives results and shows a number of positive effects that development work can have on organisations. The study also demonstrates that the values for Total Quality Management are compatible with Trust Based Governance and Management, and that previous results for the latter on the national level are also valid at municipal levels. / <p>2020-06-26</p>

This study, quantitative determinants of need and demand for primary health care in the District of Columbia (DCPC), analysed data over a twenty-year period from 1985 to 2004, on need and demand for primary care using standard and epidemiologically innovative statistical measures for physician distributions and socio-demographic characteristics in the District of Columbia (DC). The study attempted to answer the question: Using U.S census-based small area aggregations, Census Tract Groupings (CTGs), that are not zip-code areas or legislative/political boundaries, can a multivariate predictive model be developed using physician distributions, primary care service index (PCSI) and composite need scores (CNS) to explain variations in primary care visits shortages? Primary care visits shortages and priority scores (PCPS) were calculated, analysed and presented for CTGs in the District of Columbia from 1985 to 2004. Results indicated that the abundant supply of DC-based physicians – indicated by decreasing population per physician ratios of 239 (1985) to 146 (2004) – appear to be a long-term trend. As raw physician counts increased, the ratio of satisfied visits to demand decreased, from 2.62 (1985) to 1.80 (in 2004). This result appears to indicate that, due to inequities in distribution of primary care physicians in DC’s small areas, the increasing numbers of primary care physicians were by themselves, not sufficient to address the city’s overall primary care visits need. Epidemiological profiles and physician distribution analytical methods appear to be useful for small area analysis of urban primary care shortage areas and for setting priorities. Physician rates per 1,000 pop may be a necessary but not sufficient statistic for estimating urban primary health care needs / Health Studies / D. Litt. et Phil. (Health Studies)

In most cases in a deceased person’s estate, there are problems with co-ownership where more than one family member inherits the deceased family estate assets. To escape the perils of co-ownership the beneficiaries consensually agree to divide the inherited communallyshared asset/s. This agreement can take place immediately after the death of the family estate owner or some time later regarding some or all of the said assets. On the conclusion of the division agreement, the contractual party who receives the awarded assets enjoys sole ownership and the other contractual parties by agreement retract their ownership. In a jurisprudential content analysis of forty-six recorded family deceased division agreements from Old Babylonian Larsa and Nippur, essential elements are identified which are the framework and qualification requirements for a family deceased division agreement. Within this framework the concepts, terms and elements of the agreement are categorised as natural and incidental elements, which reflect the specific law traditions and choices of contractual parties and show the unique scribal traditions in the different Old Babylonian city-states of Larsa, Nippur and Sippar. The aim of the study is to shed a more focused light on the interpretation of recorded Old Babylonian division agreements and to show that the division agreement was a successful, timeless, estate administration mechanism and tool to obviate any undesirable consequences of co-ownership of the bequeathed property. / Old Testament & Ancient Near Eastern Studies / D. Litt. et Phil. (Ancient Near Eastern Studies)