The Ottawa Hospital cancels hundreds of elective surgeries every year due to a lack of beds, and has an average weekday occupancy rate above 100%. Our approach to addressing these issues, by way of informing administrators of resource needs, was to model the flow of patients coming and going from the hospital. We used administrative data from the Ottawa Hospital to build a time-series model of emergency department admissions, and studied models that would predict next-day discharge of patients currently taking up hospital beds. In the latter, we considered population-averaged models for groups of patients based on their primary medical condition, as well as subject-specific models. We included the random effects from subject-specific variation to improve on predictive accuracy over the population- averaged approach. The result was a model that provided more realistic probabilities of discharge, and stable predictive accuracy over patient length of stay.

The Ottawa Hospital cancels hundreds of elective surgeries every year due to a lack of beds, and has an average weekday occupancy rate above 100%. Our approach to addressing these issues, by way of informing administrators of resource needs, was to model the flow of patients coming and going from the hospital. We used administrative data from the Ottawa Hospital to build a time-series model of emergency department admissions, and studied models that would predict next-day discharge of patients currently taking up hospital beds. In the latter, we considered population-averaged models for groups of patients based on their primary medical condition, as well as subject-specific models. We included the random effects from subject-specific variation to improve on predictive accuracy over the population- averaged approach. The result was a model that provided more realistic probabilities of discharge, and stable predictive accuracy over patient length of stay.

This report is about the current outdoor environment in the housing area Brunnsbacken in the city of Eskilstuna. The report examines the various factors in the outdoor environment that can affect the physical and psychic well being of the elderly people through availability and inclusion. The research methods that are affected are qualitative and has been implemented in order to give insight and knowledge about the way elderly people view the outdoor stay in their neighborhood, but also through analysis produce an informed design suggestion. / Denna rapport handlar om dagens utomhusmiljö i bostadsområdet Brunnsbacken i Eskilstuna. I rapporten granskas de olika faktorer i utomhusmiljön som kan påverka äldres fysiska och psykiska välmående genom tillgänglighet och inkludering. De forskningsmetoder som berörs är kvalitativa och har använts i syfte att ge insikt och kunskap om de äldres syn på utomhusvistelsen i sin närmiljö, men också genom analys kunna ta fram ett välgrundat gestaltningsförslag.

Hepatocellular carcinoma (HCC) is the second most common cancer in Taiwan and transcatheter arterial chemoembolization (TACE) is now the mainstay of treatment for noncurative HCC. Due to increasing medical costs yearly and financial problem of the Bureau of National Health Insurance, it is important to reduce medical resource utilization including hospital stay and medical costs. The aim is to figure out the risk factors of extended hospital stay, and increased in-hospital medical costs in hepatocellular carcinoma patients receiving transcatheter arterial chemoembolization. The result of this study should be available for further improvement of medical care quality in the limited medical resource. From January 2008 to January 2010, 162 patients (121 male and 41 female) with histologically proven hepatocellular carcinoma underwent TACE only (131 pts) or TACE followed by catheter placement for hepatic artery infusion chemotherapy (HAIC) (31pts) at district teaching hospital. The extended hospital stay (EHS) and extended post-procedure stay (EPS) are defined as stay larger than their median values (11 & 7 days respectively). Clinical demographic, disease factors, tumor factors, procedure (TACE)-related factors and complications are used to identify the univariate factors related to EHS and EPS statistically. To find out predictors of EHS, EPS and increased in-hospital medical costs, multiple linear regression analyses are used. The risk factors for EPS are procedure-related, including complications and procedure methods ( TACE + HAIC related to TACE only) (R2=.367, p<.001), while those for EHS are complications, encephalopathy, procedure methods, Child-Pugh classification C (related to classification A) and age (R2=.490, p<.001). The predictors for increased in-hospital medical costs include procedure methods, AJCC stage IV, T4 stage, hepatoencephalopathy and complications (R2=0.615, p<.001). Taking total hospital stay into consideration, the most important risk factor related to increased medical cost is total hosptial stay itself. The most powerful risk factor for EPS, EHS is procedure-related complication. The different procedure methods also affect hospital stay and medical costs. In order to reduce medical resource utilization, we should avoid post-procedure complication and pay attention to cirrhotic degree as well as American Joint Committee of Cancer (AJCC) tumor stage system. The result of this study can provide some ideas to adjust medical expense polices for the Bureau of National Health Insurance and to control medical cost for the hospitals.

Schnellläuferstrategien sind Lagerstrategien, welche den Durchsatz von Lagern durch geeignete Wahl der Lagerorte im Lager steigern. Die verschiedenen existierenden Strategien wurden bisher uneinheitlich beschrieben und umgesetzt. Aussagen zu Durchsatzsteigerungen fallen schwer. Die existierenden Strategien werden systematisiert und als Vergleichsbasis für die neue Strategie &amp;quot;Dynamische Zonierung&amp;quot; herangezogen. Die &amp;quot;Dynamische Zonierung&amp;quot; ist dabei sowohl die einfachste als auch die leistungsfähigste Schnellläuferstrategie. Dafür sorgt die konsequente Anwendung zweier Verfahren, welche bereits einzeln sinnvoll sind, aber erst gemeinsam ihr volles Potential entfalten: Erstens erübrigt die Abbildung der Verweildauerverteilung auf die Fahrzeitverteilung jegliche Zonierung. Damit entfallen die Aufwände für Planung und Berechnung von Zonengrenzen und -zuordnungen. Gleichzeitig kann so die bei Zonenbildung unvermeidliche Abbildungsunschärfe beseitigt werden. Eine von einer optimalen Zuordnung abweichende Lagerortwahl resultiert nun ausschließlich aus Prognosefehlern. Zweites stellt die lagereinheitsbasierte Verweildauerbetrachtung die korrekte Umsetzung des als optimal nachgewiesenen Cube-Per-Order-Kriteriums dar. Ohne Zwang zur Zonenbildung fehlen die der Verwendung lagereinheitsbasierter Verweildauern sonst entgegenstehenden algorithmischen Mehraufwände. Dass auch die Prognose lagereinheitsbasierter Verweildauern für Teile des Sortimentes nicht zu Mehraufwand sondern zur Vereinfachung des Verfahrens führt, spricht zusätzlich für die lagereinheitsbasierte Betrachtung. Auch bei herkömmlicher artikelorientierter Betrachtungsweise kann die Dynamische Zonierung dadurch Leistungsvorteile herausarbeiten. / Turnover-based storage strategies are strategies in warehousing which increase the system throughput by choosing favorable storage locations. Existing strategies have been described and implemented inconsistently when compared to each other. Statements on strategy gains are difficult. Therefore a categorization of turnover-based strategies is devised. The existing strategies serve as basis of comparison for the new strategy &amp;quot;Dynamic Zoning&amp;quot;. &amp;quot;Dynamic Zoning&amp;quot; proves to be the simplest turnover-based strategy while giving the highest performance at the same time. This is accomplished by combining two methods. These methods are reasonable when used separately, but only reach their full potential when used together. First, mapping the dwell time (duration of stay) probability distribution to the travel time probability distribution lets zones become obsolete. Efforts to plan and calculate zones can be avoided and the inevitable imprecision when mapping to zones vanishes. Any deviation from the optimal storage location now results from errors in estimation. Second, dwell times must be based on unit loads which is the correct application of the cube-per-order-criterion for optimality. Without the need to use zones this does not result in extra effort to apply the strategy. For a part of the assortment the estimation of unit load dwell times is simpler than before too, making unit load dwell times even more appealing. However, even when using conventional article based dwell time estimates the strategy &amp;quot;Dynamic Zoning&amp;quot; results in higher performance than other strategies.

The Ottawa Hospital cancels hundreds of elective surgeries every year due to a lack of beds, and has an average weekday occupancy rate above 100%. Our approach to addressing these issues, by way of informing administrators of resource needs, was to model the flow of patients coming and going from the hospital. We used administrative data from the Ottawa Hospital to build a time-series model of emergency department admissions, and studied models that would predict next-day discharge of patients currently taking up hospital beds. In the latter, we considered population-averaged models for groups of patients based on their primary medical condition, as well as subject-specific models. We included the random effects from subject-specific variation to improve on predictive accuracy over the population- averaged approach. The result was a model that provided more realistic probabilities of discharge, and stable predictive accuracy over patient length of stay.

Thesis (M.Sc.)--Memorial University of Newfoundland, 2004. / Bibliography: leaves 98-100.

Submitted by Márcio Maia (marciokjmaia@gmail.com) on 2016-09-06T18:11:10Z No. of bitstreams: 1 aquivototal.pdf: 1783648 bytes, checksum: 35c51eb2f3badb5f0ce08e9be78f2d9b (MD5) / Made available in DSpace on 2016-09-06T18:11:11Z (GMT). No. of bitstreams: 1 aquivototal.pdf: 1783648 bytes, checksum: 35c51eb2f3badb5f0ce08e9be78f2d9b (MD5) Previous issue date: 2016-02-29 / The understanding about public policies context in contemporary society implies uncover the relationship between democracy, public policy and public space. In Brazilian educational field, an articulation between public policies and social-historical changes have influences in public policies guidelines. Spread and internalization of Vocational and Technological Education Federal Network has been taking place since 2008. It has expanded places supply in Brazil with regard to access and residence guarantee. In 2010, National Student Assistance Program (PNAES, in Portuguese) arises in Federal Network student assistance. This research aims to analyze policy management of student assistance programs at Education, Science and Technology Federal Institute of Paraíba. In order to do so, we are based on the following problem: how to proceed policy management of student assistance programs in Education, Science and Technology Federal Institute of Paraíba - Campus Campina Grande? Survey was focused on IFPB student assistance policy programs regarding to feeding, transportation, housing and work initiation. This is a field research, with primarily qualitative approach. However, it also makes use of quantitative benefits, which are typified as an exploratory, bibliographic and documental research. Content analysis was fundamental for data interpretation. Data collection with the subjects was stablished by two bases: a) mixed questionnaire for students served by student assistance programs (feeding, transportation, housing and work initiation), enrolled in high school integrated technical courses who joined in 2013; and b) interviews with managers directly related to issues interactions scope related to student assistance. Results show that, among students, mostly 65% of programs recipients realize how important such programs are for their permanence and performance. In observance of student performance, only 8.3% revealed to be retained in some series, whereas 23% were in a discipline dependence regime. Student Assistance Policy is understood by managers as greatly important to students’ stay, especially for low-income ones. Research revealed student residence programs relevance and showed that permanence and performance service is not only related to cash transfer student assistance programs. A high quality staying permeates a broad service character, as pointed out by the studied institution in its Student Assistance Policy. Nevertheless, Student Assistance Policy driving process at IFPB Campus Campina Grande still demands a larger structure, considering the need to promote public sphere activity according to student perspective in order to drive policy democratic process at the institution / Entender o contexto das políticas públicas na sociedade contemporânea implica descortinar as relações entre democracia, políticas públicas e espaço público. No Brasil, na educação profissional, a articulação das políticas de educação e as transformações sócio-históricas têm influências em suas diretrizes. A expansão e interiorização da Rede Federal de Educação Profissional e Tecnológica vem ocorrendo a partir do ano de 2008, ampliando a oferta de vagas no território nacional no tocante à garantia de acesso e à permanência. Em 2010, surge, no âmbito da assistência estudantil, na Rede Federal, o Programa Nacional de Assistência Estudantil (PNAES). Esta pesquisa busca analisar os programas do Política de Assistência Estudantil do Instituto Federal de Educação, Ciência e Tecnologia da Paraíba, partindo do seguinte problema: como se estruturam os programas de assistência estudantil do Instituto Federal de Educação, Ciência e Tecnologia da Paraíba - Campus Campina Grande no tocante à permanência e ao desempenho estudantil? A pesquisa delimitou como foco da política de assistência estudantil no IFPB os programas de alimentação, transporte, moradia e iniciação ao trabalho. Trata-se de uma pesquisa campo, prioritariamente de abordagem qualitativa, mas também se valendo de subsídios quantitativos, tipificada como exploratória, bibliográfica e documental, tendo na análise de conteúdo os fundamentos para a interpretação dos dados. A coleta de dados com os sujeitos da pesquisa deu-se através de duas bases: a) questionário misto para os alunos atendidos pelos programas da assistência estudantil (alimentação, transporte e moradia, iniciação ao trabalho), matriculados em cursos técnicos integrados ao ensino médio e que ingressaram no ano de 2013; e b) entrevista com os gestores que estão diretamente relacionados ao escopo de interações dos assuntos relacionados à assistência estudantil do IFPB-CG. Os resultados obtidos com os estudantes demonstram que, majoritariamente, 65% dos beneficiados dos programas percebem a importância destes para a permanência e para o desempenho estudantil. Na observância do desempenho estudantil, apenas 8,3% revelaram ter ficado retidos na série (ou repetiram) em algum ano e 23% ficaram em regime de dependência em disciplinas. A Política de Assistência Estudantil é entendida pelos gestores como de grande importância para a permanência dos estudantes, sobretudo para os de baixa renda. A pesquisa revelou a importância dos programas para a permanência discente, desvelando que o atendimento no tocante à permanência e ao desempenho não está apenas relacionado aos programas da assistência estudantil de transferência pecuniária. A permanência com qualidade perpassa por um caráter de atendimento amplo, já apontado pelo IFPB em sua Política de Assistência Estudantil. Conclui, no entanto, que o processo de condução da Política de Assistência Estudantil no IFPB, Campus Campina Grande, ainda demanda de uma maior estruturação, em relação à necessidade de fomento da atuação da esfera pública na perspectiva discente para uma condução do processo democrático da política na instituição.

Made available in DSpace on 2016-06-02T20:45:42Z (GMT). No. of bitstreams: 1 6639.pdf: 1822615 bytes, checksum: 173f92b21699ea3c0b7305de829736f1 (MD5) Previous issue date: 2014-12-02 / This research aimed at investigating the device called " overnight-stay " in moment of crisis the user of alcohol and other drugs , in the context of a Psychosocial Care Center Alcohol and Drugs 24 ( CAPS ad III ) , in Campinas SP . It was intended to characterize the users who occupied overnight-stay according to demographic data, data on the use of psychoactive substances, data relating to the commencement CAPSad III as well as characterize the bed occupancy rates and indications of the team for their use. This is a descriptive cross-sectional study (April / 2012 to March / 2013), using research roadmap and documentary record data from four sources: medical records, insertion records in overnight-stay, books and bank shift changes data team. As a complementary source of information we used interview with service managers. Data were organized and analyzed from a computerized database using the Excel program. The research pointed out that the bed night shelter was occupied by 167 users 315 times, most males (77,25%), single (46,11%), aged between 31 and 40 (36,53%), incomplete elementary education (40,12%), unemployed (51,50%) and living with a family member (50,30%) . The demand for treatment was mainly due to the use of multiple drugs (53, 89%), especially if alcohol linked to another substance, followed by the exclusive use of alcohol (39,52%). Most cases (81,43%) had a comorbidity, particularly psychiatric (51,23 %). The length of enrollment in CAPSadII patients for 6 months (36,53%) and equipment for emergency care were the services most have referred users (30,43%). Among the indications for insertion into overnight-stay, include the promotion of abstinence (34, 85%), psychiatric stabilization (21,08%) and the need for protected environment (20,64%). Changes in mental examination were significant (66, 67%), especially mood changes (29, 97%) and insomnia (22, 67%). Significant portions of users were on the streets (34,13%) which requires other joints and need of supporting this vulnerable population. The logic of overnight-stay occupancy rates and indications of the team for their use were characterized. The overnightstay in CAPSad III , is seen as an opportunity to expand attention to the crisis the user of alcohol and other drugs in the anti-asylum logic , as they allow the regulation and care of the team. His newly deployment within the network of care to the user of alcohol and other drugs brings relevance to this investigation given the fact that it can contribute to a better understanding and characterization as well as for actiong planning. / Esta pesquisa teve como objeto de investigação o dispositivo denominado leito de acolhimento noturno" na atenção à crise ao usuário de álcool e outras drogas, no contexto de um Centro de Atenção Psicossocial álcool e drogas 24h (CAPS ad III), no município de Campinas-SP. Pretendeu-se caracterizar os usuários que ocuparam o leito de acolhimento noturno segundo dados sociodemográficos, dados referentes ao uso de substâncias psicoativas, dados relativos à vinculação ao CAPSad III assim como caracterizar a ocupação dos leitos e as indicações da equipe para a sua utilização. Trata-se de um estudo descritivo de corte transversal (abril/2012 a março/2013), que em sua investigação utilizou dados de quatro fontes: prontuários, fichas de inserção no leito, livros de passagem de plantão e banco de dados da equipe. Os dados foram organizados e analisados a partir de um banco de dados informatizado utilizando o programa Excel. A análise indicou que o leito de acolhimento noturno foi ocupado 315 vezes por 167 usuários, sendo a maioria do gênero masculino (77,25%), solteiros (46,11%), faixa etária entre 31 e 40 anos (36,53%), ensino fundamental incompleto (40,12%), desempregados (51,50%) e moravam com algum familiar (50,30%). A procura pelo tratamento aconteceu principalmente devido ao uso de múltiplas drogas (53,89%), destacando-se o álcool associado à outra substância, seguido do uso exclusivo do álcool (39,52%). A maior parte dos casos (81,43%) apresentou alguma comorbidade, principalmente psiquiátrica (51,23%). O tempo de cadastro no CAPSadII foi de até 6 meses (36,53%) e os equipamentos de urgência e emergência foram os serviços que mais referenciaram os usuários (30,43%). Dentre as indicações para inserção no leito de acolhimento noturno destacam-se a promoção de abstinência (34,85%), estabilização psiquiátrica (21,08%) e a necessidade de ambiente protegido (20,64%). As alterações no exame psíquico foram significativas (66,67%), em especial as alterações de humor (29,97%) e insônia (22,67%). Destaca-se que 34,13% dos usuários estava em situação de rua, o que demanda outras articulações e necessidade de apoio a essa população vulnerável. A lógica de ocupação dos leitos e as indicações da equipe para a sua utilização foram caracterizadas. Os leitos de acolhimento noturno em CAPSad III são vistos enquanto possibilidades de ampliar a atenção à crise ao usuário de álcool e outras drogas na direção da integralidade do cuidado e autonomia da equipe. Sua recém implantação dentro da rede de cuidados ao usuário de álcool e outras drogas traz relevância para esta investigação tendo em vista que pode contribuir para um maior conhecimento e caracterização do serviço assim como no planejamento de ações.

Syftet med denna enkätstudie är att undersöka vilka kunskaper om allemansrätten elever i mellanstadiet besitter. Studien undersöker även vilka faktorer som kan påverka kunskapen om allemansrätten och hur inställningen till naturen påverkar kunskapen. I studien har 206 elever på 7 skolor deltagit. Skolorna är från olika områden i en region i södra Sverige och har grupperats i fyra grupper: storstadsskolor, förortsskola, kommundelsskolor och landsbygdsskolor. Resultatet visar på att elever anser att det är roligt att vara ute i naturen. De anser att natur är skogar, sjöar, ängar och hagar. Elevernas bild av vad natur är överensstämmer med tidigare forskning. De utövade oftast någon av följande aktiviteter bada, cykla jogga/springa eller gå promenader. Eleverna visade goda kunskaper om allemansrätten, de delar som de hade mindre kunskap om är fiskeregler i Sveriges 5 största sjöar och nyttjande av annans brygga. Det visade sig även att landsbygdsskolorna hade en aning bättre kunskap om allemansrätten än eleverna på resterande skolor. / The aim with this survey study is to investigate what knowledge 11-12-year olds have regarding the Swedish right of public access. The study also investigates what can affect the student’s knowledge of the right to public access and if their interest in nature affect their knowledge. 206 students participated in this study from 7 different schools, all of them are from the southern parts of Sweden. The schools are from different areas of the region represented by big city schools, a suburban school, schools close to a big city and countryside schools. The results show that the pupils enjoy spending time in nature. Nature according to the pupils are forests, lakes and fields. The pupils like to bicycle, hiking and jogging. The pupils had good knowledge of the Swedish right to public access, the parts that the students had least knowledge was about the fishing rights in Sweden’s five largest lakes and if you can use somebody else’s bridge.  The results also show that pupils from the countryside schools have some more knowledge of the Swedish right of public access than pupils from the other schools.