Denna uppsats syftar till att diskutera påverkan av artificiell intelligens (AI) på programutvecklingsprocessen, både nuvarande och framtida. Fokus ligger på att undersöka hur programmerare och testare har kommit i kontakt med AI hittills och i vilken utsträckning de tror att AI kan utnyttjas i framtida programutvecklingsprocesser. Detta är särskilt relevant att undersöka eftersom AI-tekniken utvecklas snabbt och det finns redan verktyg som potentiellt kan underlätta programmerares och testares arbete. Uppsatsen är skriven på svenska. Forskningen är av kvalitativ karaktär och omfattar en litteraturgenomgång för att undersöka tidigare forskning om ämnet, samt kvalitativa semistrukturerade intervjuer. Intervjuerna genomfördes med både testare och utvecklare för att få en bättre täckande bild av området för programutveckling. Totalt genomfördes fem semistrukturerade intervjuer där djupgående frågor ställdes för att förstå individernas tankar kring ämnet och deras motiv. Resultaten av studien visar att våra respondenter inte i stor utsträckning använder AI idag. Detta trots att både litteraturen och respondenterna själva påpekar att det finns verktyg som skulle kunna användas i båda processerna av programmering och testning. En slutsats är att det finns olika etiska och juridiska frågor som behöver redas ut innan verktygen kan börja utnyttjas. Dock är både respondenterna och tidigare forskning överens om att AI i framtiden kan förändra sättet som programutvecklingsprocessen utförs på, eftersom AI kan användas som ett verktyg för att effektivisera och potentiellt förbättra kvaliteten på tester och programmering. Detta kan leda till förändringar i rollerna för testare och programmerare. / This thesis aims to discuss the impact of artificial intelligence (AI) on the software development process, both current and future. The focus is on examining how programmers and testers have come into contact with AI so far and to what extent they believe that AI can be utilized in future software development processes. This is particularly relevant to investigate because AI technology is developing rapidly and there are already tools that can potentially facilitate the work of programmers and testers. The thesis is written in swedish. The research is of a qualitative nature and includes a literature review to examine previous research on the subject, as well as qualitative semi-structured interviews. The interviews were conducted with both testers and developers to get a more comprehensive picture of the software development field. A total of five semi-structured interviews were conducted where in-depth questions were asked to understand the individuals' thoughts on the subject and their motives. The results of the study show that our respondents do not use AI to a large extent today. This despite the fact that both the literature and the respondents themselves point out that there are tools that could be used in both processes of programming and testing. One conclusion is that there are various ethical and legal issues that need to be sorted out before the tools can begin to be used. However, both respondents and previous research agree that in the future AI may change the way the software development process is carried out, as AI can be used as a tool to streamline and potentially improve the quality of testing and programming. This can lead to changes in the roles of testers and programmers.

Ett identifierat problem inom modebranschen idag är den mängd returer som utförs till följd av felbeställningar av kläder som är köpta online. Tre anledningar till felbeställningar som leder till returer är att konsumenterna inte kan prova plaggen innan köp, produktbilderna är missvisande, eller att storleks beskrivningen inte överensstämmer med verklig storlek. Denna studien undersöker om det finns ett samband mellan felbeställningar och att konsumenter inte fysiskt kan prova de kläder som de köper online. Vidare syftar denna studien till att undersöka om innovativ digital teknik kan bidra till en lösning av det identifierade problemet. Studien är utförd genom en blandad forskningsmetod där information kring tidigare forskning och ny data samlats in genom litteraturstudier, intervjuer och enkätundersökningar. Studien förstärker den initiala hypotesen att det i dagsläget finns väldigt lite forskning kring kopplingen Metaverse, e-handel och digital provning. Studien visar dock att det finns ett intresse från både konsumenter och producenter att lära sig mer om Metaverse och eventuellt implementera och använda tekniken i framtiden. För att detta ska ske behöver teknologin utvecklas och man behöver också göra stora ekonomiska insatser. / An identified problem in the fashion industry today is the amount of returns made due to incorrect orders for clothes purchased online. Three reasons for incorrect orders that lead to returns are that consumers can not try on the garments before buying, the product images are misleading, or the size description does not correspond to the actual size. This paper examines whether there is a link between wrong orders and whether consumers can not physically try on the clothes they buy online. Furthermore, this paper investigates whether innovative digital technology can contribute to a solution to the identified problem. The paper was carried out through a mixed research method where information about previous research and new data was collected through literature studies, interviews, and questionnaires. The paper strengthens the initial hypothesis that there is currently very little research on the Metaverse connection, e-commerce, and digital testing. However, the paper shows that consumers and producers are interested in learning more about Metaverse and possibly implementing and using the technology in the future. For this to happen, technology needs to be developed and great financial efforts also need to be made.

This thesis delves into the digital transformation of private banking, emphasizing the challenge of balancing technology with the personalized service that high-net-worth clients expect. Employing frameworks like Relationship Marketing, the Technology Acceptance Model, and Customer Experience Management, it examines the integration and impact of digital tools on client relationships and operational efficiency in private banking. The research, informed by interviews with industry professionals, explores the adoption of digital practices, highlighting a trend towards operational efficiency yet revealing a gap in achieving the depth of personalization characteristic of private banking. The study concludes by exploring the future of digitalization in the sector, suggesting a strategic approach where technological advancements complement the foundational elements of private banking. This balanced integration is vital for maintaining the essence of bespoke advice and trust that defines the client-advisor bond in an increasingly digital financial landscape. / Denna avhandling fördjupar sig i den digitala omvandlingen av private banking-sektorn, med betoning på utmaningen att balansera teknik med den personliga service som kunder med hög nettoförmögenhet förväntar sig. Genom att använda ramverk som Relationsmarknadsföring, teknikacceptansmodellen och kundupplevelsehantering, undersöks integrationen och effekten av digitala verktyg på kundrelationer och operationell effektivitet inom private banking. Forskningen, som är baserad på intervjuer med anställda inom private banking, undersöker införandet av digitala processer och belyser en trend mot operationell effektivitet, men visar även en brist på att uppnå den djupgående personalisering som är karaktäristisk inom private banking. Studien avslutas med att analysera framtiden för digitalisering inom sektorn, och föreslår en strategisk metod där tekniska framsteg kompletterar de grundläggande elementen i private banking-verksamhet. Denna balanserade integration är avgörande för att bevara essensen av skräddarsydd rådgivning och förtroende som definierar bandet mellan klient och rådgivare i ett alltmer digitalt landskap.

Genetic variation was examined in two endangered mussel species, Epioblasma brevidens and E. capsaeformis, and a common species Lampsilis fasciola, in the Clinch River, TN, by screening mitochondrial DNA (mtDNA) sequences and nuclear DNA microsatellites. These species use fish hosts with varying dispersal capabilities, ranging from low, moderate, and high, respectively. Patterns of mtDNA polymorphism exhibited different trends for long-term population sizes for each species during the Holocene (~10,000 ya to present); namely, E. brevidens has declined over time, E. capsaeformis has remained stable, and L. fasciola has expanded. Long-term effective population size (Ne) was smallest in E. brevidens, intermediate in E. capsaeformis, and highest in L. fasciola. Moderately diverged mtDNA lineages, perhaps indicative of secondary contact, were observed in E. brevidens and E. capsaeformis. High levels of gene flow (Nm) were estimated among demes of L. fasciola using traditional F-statistics and likelihood estimates of Nm, whereas such metrics were lower in E. brevidens and E. capsaeformis. Data are consistent with population dynamics and life history traits of each species and their fish hosts. Age, shell growth, and population demography of Epioblasma brevidens, E. capsaeformis, and Lampsilis fasciola were studied from 2004-2007 in a 32-km reach of the Clinch River, TN. Observed maximum age and length of E. brevidens was 28 y and 71.5 mm for males and 11 y and 56.6 mm for females; of E. capsaeformis, 12 y and 54.6 mm for males and 9 y and 48.6 mm for females; and of L. fasciola, 45 y and 91.3 mm for males and 13 y and 62.6 mm for females. For all three species, observed maximum age and length was greater among males than females. Estimated population size in this river reach was approximately 43,000 individuals for E. brevidens, 579,000 individuals for E. capsaeformis, and 30,000 individuals for L. fasciola. Mean recruitment y-1 of 1 y-old E. brevidens ranged from 7.1% to 20%, of E. capsaeformis from 4.0% to 32.4%, and of L. fasciola from 5.8% to 25.6%. Population growth rate y-1 was 24.9% for E. brevidens, 34.6% for E. capsaeformis, and -22.4% for L. fasciola. Mortality rates of females were higher than for males of E. capsaeformis and L. fasciola, but not E. brevidens. Juvenile mussels were collected but temporally and spatially variable in occurrence, and a significant component of the age-class structure of all three species. Recruitment was very high during 2006-2007 for E. capsaeformis and other species, likely due to low river discharges in the spring-summer of 2005-2007. Surplus individuals of E. brevidens and E. capsaeformis are currently available to conduct translocations for restoration purposes. Population modeling of Epioblasma brevidens and E. capsaeformis in the Clinch River was conducted to determine suitable harvest levels for translocation of sub-adults and adults, and to determine quantitative criteria for evaluating performance and recovery of extant and reintroduced populations. For both species, the recommended annual harvest was <1% of local population size to minimize risk of decline. Reintroduction modeling indicated that size of the initial population created during a 5 y build-up phase greatly affected final population size at 25 y, being similar to size at the end of the build-up phase, especially when expected growth rate was low, (e.g., 1-2%). Excluding age-0 individuals, age-1 juveniles or recruits on average comprised approximately 11% and 15% of a stable population of each species, respectively. The age-class distribution of a stable or growing population was characterized by multiple cohorts, to include juvenile recruits, sub-adults, and adults. Molecular genetic and demographic data indicated that the ratio of Ne/Nc was ~5% for both species. Based on this ratio and predicted declines of genetic variation at different population sizes, target sizes for reintroduced or recovered populations of each species should be ≥5,000 individuals (Ne=250) and ≥10,000 individuals (Ne=500), respectively, and should be comprised of multiple smaller demes spread throughout a river. Populations of both species are currently large enough to sustain harvest for translocation and reintroduction purposes, offering an effective species recovery strategy. / Ph. D.

No / AIMS: The aims of this study were to determine the recording of drug sensitivities of elderly care home residents, to describe the nature of sensitivities and to identify and describe discrepancies in the documentation of drug sensitivity status in general practices, pharmacies and care homes. METHODS: A random sample of residents within a purposive sample of care homes (nursing and residential) was selected. A clinical pharmacist inspected the GP medical record, the medicines administration record, and the care home record for each resident to identify drug sensitivities and discrepancies between records and to describe the nature of the recorded sensitivities. RESULTS: The records of 121 residents in 31 care homes were studied. Thirty-one (26%) residents had at least one documented drug sensitivity in one of the sources inspected, with 48 sensitivities in total recorded. There was no description of the nature of the sensitivities recorded in 39/48 (81%) cases. The number of sensitivities recorded on the medicines administration record, care home record and the GP record were 3 (6%), 29 (60%) and 35 (73%), respectively. Only two sensitivities were simultaneously recorded on all three records. CONCLUSIONS: It was of concern that over 90% of drug sensitivities were not recorded on the medicines administration record which is the final checking document when administering medication. The reason for this was that the dispensing pharmacy was responsible for generating the medicines administration record; however, drug sensitivity status is seldom shared between the GP and the dispensing pharmacy. Printing sensitivities on prescriptions would help to resolve this.

Das Phänomen der Armut zählt zu den größten Problemen der Großstädte. Die im Fokus dieser Arbeit stehende Armut in zwei Städten kann nur mit einer breiteren Betrachtung der sozialen Ungleichheit, zunehmender Arbeitslosigkeit, der Verschlechterung von Arbeits- und Lebensbedingungen, der Einkommensdisparitäten etc. verstanden werden. Diese Merkmale sind in zunehmendem Maße in Städten der Industrieländer wie Berlin zu spüren. Die wachsende Ausbreitung von Armut in den industrialisierten Gesellschaften sowie in den sogenannten Schwellenländern führte zu einer breiteren Diskussion über das Armutsphänomen auf internationaler Ebene. In der vorliegenden Arbeit wird das Phänomen der Armut in zwei Großstädten untersucht. Mexiko-Stadt und Berlin sind zwei unterschiedliche Städte mit ähnlichen sozialen Problemen. Mexiko-Stadt ist die ,typische’ Stadt in einem Schwellenland, die sich von Städten der Industrieländer durch den Grad der sozialen Ungleichheit, die ausgeprägte Kluft zwischen arm und reich sowohl strukturell als auch funktionell deutlich unterscheidet. Berlin andererseits nähert sich nach der Wiedervereinigung den Problemen anderer großen Metropolen an. In den letzten Jahren traten folgende Phänomene auf: das Entstehen neuer Formen der Armut, eine wachsende Zahl von Sozialhilfeempfängern, eine zunehmende Migrationsbevölkerung ohne wirtschaftliche Perspektiven u.a. Die Studie fasst Untersuchungsergebnisse und Berichte über Armut in Mexiko-Stadt und Berlin zusammen. Es handelt sich nicht um die Erhebung neuer empirischer Daten, sondern um die Selektion, Darstellung und Analyse verschiedener Studien zu Armut in beiden Städten. Die Analyse widmet sich der Armut unter dem Gesichtspunkt gemeinsamer Aspekte, verschiedener Charakteristiken und der jeweiligen Entwicklungstrends in den zwei untersuchten Städten. / The phenomenon of poverty is one of the most serious problems of big cities. The focus of this doctoral thesis is an examination of poverty in two major cities, which must be understood on a broader basis while considering social inequality, rising unemployment, deterioration of working and living conditions, income disparities, etc. These increasing characteristics are notable in cities of developed countries such as Berlin. The growing spread of poverty in industrialized societies and in emerging countries has led to a broader discussion about the phenomenon of poverty at the international level. This doctoral thesis analyzes the phenomenon of poverty in two major cities. Mexico City and Berlin are two different cities with similar social problems. Mexico City is a ,typicalʼ city in a emerging country, which is structurally as well as functionally different from cities of developed countries by the degree of social inequality and the pronounced gap between rich and poor. On the other hand, after its reunification Berlin faces problems of other large cities. In recent years the following phenomena have occurred: the emergence of new forms of poverty, a growing number of welfare recipients, an increasing migrant population without economic prospects etc. This study summarizes investigative findings and reports on poverty in Mexico City and Berlin together. The goal is not to collect new empirical data, but rather to emphasize the selection, presentation and analysis of various studies on poverty in both cities. The analysis focuses on poverty from the standpoint of common aspects, differing characteristics and the respective development trends in the two researched cities.

Die vorliegende Arbeit analysiert die Phänologie photosynthetisch aktiver Vegetation mit Hilfe von NDVI Zeitreihen für einen Zeitraum von 24 Jahren (AVHRR‑GIMMS Daten). Neben einer Datierung des jahreszeitlichen Wechsels zwischen Wachstums-, Reife- und Seneszenzphase wird das Ziel verfolgt, Trends sowohl in phänologischen Ereignissen (Start-of-Season) als auch im NDVI zu identifizieren. Das, in der semi-ariden Sahelregion gelegene, Untersuchungsgebiet weist mit zwei sich teilweise überlagernden Vegetationsperioden eine komplexe Phänologie auf, deren Modellierung durch die sowohl in ihren Zeitpunkten als auch in ihren Ausprägungen hoch variablen Vegetationsabläufe erschwert wird. Vor diesem Hintergrund ist zunächst ein, auf der Fourieranalyse basierender, Ansatz zur flexiblen Glättung der NDVI Zeitreihen entwickelt worden. Um für die Trendanalyse lineare Regressionsverfahren einsetzen zu können, sind die Zeitreihen nach dem Komponentenmodell untergliedert worden (Subtraktion der Saisonfigur). Alternativ kam der saisonale MANN-KENDALL Trendtest zur Anwendung. Die NDVI Zeitreihen wurden ebenfalls auf Änderungen im mehrjährigen Mittelwert (Bruchpunkte) untersucht. Alle Auswertungen sind in einer eigenen Applikation umgesetzt worden. Es konnte gezeigt werden, daß Änderungen im NDVI Niveau eher abrupt als graduell verlaufen. Langfristige Trends weisen nur geringe Anstiege auf. Die Vegetation erholte sich von der Dürre 1984/85 nur im südlichen Teil des Untersuchungsgebietes, im Norden dominieren langfristig negative Trends. Brüche im mean der NDVI Zeitreihen korrelieren mit Brüchen im Abflußverhalten des Niger.

Les effets du changement climatique sur la biodiversité à l’échelle du globe sont maintenant sans équivoque. Parmi les écosystèmes affectés, les cours d’eau sont particulièrement vulnérables aux fluctuations du climat. Les modifications de structure et de composition des communautés aquatiques constituent alors un signal intégrateur des réponses écologiques à ces changements climatiques. Dans certaines circonstances, ce signal peut également être exacerbé, modéré ou potentiellement masqué par d’autres variations abiotiques.L’objectif de ce travail de thèse était donc d’évaluer l’effet relatif de différents facteurs de forçage sur les tendances d’évolution à long-terme des communautés de macroinvertébrés benthiques de grands cours d’eau, dans un contexte de changement climatique global. Nos investigations ont ciblé plus spécifiquement la Loire moyenne car, en tant que grande rivière de plaine, elle est particulièrement concernée par les problèmes liés aux stress multiples. En ce qui concerne le choix du compartiment biologique, la faune benthique a été sélectionnée pour son intérêt reconnu en bioévaluation des cours d’eau, notamment grâce à une grande diversité de réponses potentielles aux perturbations environnementales et à un certain nombre d’avantages méthodologiques.Dans un premier temps, nous nous sommes appliqués à caractériser les modifications temporelles de dix paramètres abiotiques majeurs sur trois décennies (1977-2008). Nous avons notamment mis en évidence le réchauffement graduel de la Loire (c. +1,2°C en moyenne annuelle sur les trois décades), couplé à une réduction significative du débit moyen (c. -25%), les deux tendances étant exacerbées en période chaude (mai-août). Dans le même temps, alors que ces modifications étaient susceptibles de provoquer une augmentation du niveau trophique du fleuve, nous avons souligné l’existence d’un effet confondant de l’amélioration des traitements d’épuration (i.e. réduction des apports en phosphore), se traduisant principalement par la baisse des concentrations en phosphates et la limitation des organismes phytoplanctoniques.Dans un second temps, nous nous sommes intéressés aux réponses structurelles et fonctionnelles long-terme (i.e. 30 ans) des invertébrés de la Loire à ces deux évolutions concomitantes majeures. En premier lieu, nous avons constaté que le réchauffement et, dans une moindre mesure, la réduction du débit sont impliqués dans la disparition ou le déclin progressif de taxons rhéophiles et psychrophiles (e.g. Chloroperlidae). En parallèle, ces modifications hydroclimatiques expliquent une majeure partie de l’apparition et de la colonisation de taxons limnophiles et thermophiles, comprenant certaines espèces invasives (e.g. Corbicula sp.). En termes de réponses fonctionnelles, ces changements s’illustrent par une évolution adaptative des profils de traits biologiques cohérente avec les prédictions a priori qu’il est possible de faire dans un cadre théorique. Toutefois, cette dérive progressive vers un assemblage généraliste et polluotolérant est partiellement confondue par l’amélioration de la qualité d’eau, qui explique l’apparition de nouveaux taxons polluo-sensibles lors des dernières années (e.g. Philopotamidae). Bien qu’aucune résilience taxonomique ou fonctionnelle ne soit constatée, cette tendance se manifeste, via les traits biologiques, par un transfert probable des ressources trophiques depuis les organismes phytoplanctoniques vers des biofilms épibenthiques et des macrophytes.Pour finir, nous avons exploré la variabilité spatiale multi-sites de ces tendances biotiques et abiotiques et montré que l’ensemble de ces résultats, qui corrobore déjà un certain nombre d’observations en Europe, constitue également un patron homogène le long de la Loire moyenne (sur près de 300 km) et entre différents hydrosystèmes (e.g. Loire, Seine, Meuse). / Evidence for climate change effects on biodiversity at global scale is now unequivocal. Among impaired ecosystems, running waters are particularly vulnerable to climate fluctuations. Changes in aquatic community structure and composition are then considered as integrative signals of the ecological responses to these climate changes. Under certain circumstances, these signals can be also exacerbated, confounded or potentially obscured by other abiotic variations.Therefore, the aim of this PhD was to assess the relative effect of different drivers on longterm trends in benthic macroinvertebrate communities, in the context of global climate change. Our investigations were focused more precisely on the Middle Loire River since, as lowland large river, it is particularly concerned by the potential impact of multiple stressors. Regarding the choice of the biological model, benthic fauna has been selected according to its acknowledged interest in bioassessment of running waters, especially thanks to a great diversity of potential responses to environmental disturbances and a number of methodological advantages.First, we investigated the temporal changes of ten major abiotic parameters over three decades (1977-2008). We highlighted the gradual warming of the Loire River (c. +1.2°C in the mean annual temperature over the three decades), coupled with a significant drop in mean discharge (c. -25%), both trends being exacerbated during the warm period (May-August). In the same time, although these changes were expected to induce a rise in the trophic level of the river, we emphasized a confounding effect of the wastewater treatment improvement (i.e. phosphorus input reduction), leading mainly to a drop in phosphate concentrations and a phytoplankton limitation.Second, we assessed the long-term structural and functional responses (i.e. over a 30-year period) of invertebrates of the Loire River to both major concomitant trends. On the one hand, we highlighted that water warming and to a lesser extent discharge reduction were significantly involved in the disappearance or decrease in rheophilic and psychrophilic taxa (e.g. Chloroperlidae). On the other hand, they explained also a major part of the appearance and increase of limnophilic and thermophilic taxa, including invasive species (e.g. Corbicula sp.). In terms of functional responses, these changes were illustrated by an adaptive evolution of the biological trait profiles in agreement with a priori predictions that is possible to make in a theoretical framework. However, this shift towards a generalist and pollution tolerant assemblage was partially confounded by improvement in water quality, explaining the settlement of new pollution-sensitive taxa during the last years (e.g. Philopotamidae). Although no taxonomic or functional resilience was observed, this trend was translated, via biological traits, into a probable transfer of trophic resources from phytoplankton to periphytic biofilms and macrophytes.Finally, we explored the multi-site spatial variability of these biotic and abiotic trends and we showed that our results as a whole, which supported already a number of observations in Europe, exhibited also a strong homogeneous pattern along the Middle Loire River (on nearly 300 km) and among different hydrosystems (e.g. Loire, Seine, Meuse).

Os Centros de Saúde do Rio de Janeiro são analisados enquanto uma organização estruturada para desempenhar, na área da saúde, parte das funções do aparato burocrático do Estado brasileiro. Seu papel institucional vincula-se à emergência de novos problemas sanitários numa sociedade em processo de urbanização e de consolidação de um Estado nacional. Ao longo de usa trajetória histórica passou por situações distintas, no que se refere ao seu papel no Sistema de Saúde, articuladas a determinantes de natureza técnica e política. Enquanto fenômeno burocrático, esta organização sobreviveu às diversas conjunturas históricas interpondo resistências, que se manifestaram, principalmente, pela lentidão com que eram processadas as mudanças internas propostas. / The Health Centers in the city of Rio de Janeiro are analyzed as organizations that have been structured to execute parto of the bureaucratic duties petaining to the brazilian State, as far as health care is concerned. Their role, as institutions, is related to the solution of new problems, in their sanitary aspects, that are emerging in a society in processo f increasing urbanization and inside a process of organizing a National State. Along the course of their history, these organization have overcome various distinctive situations, dependind on technical and political determinants. As bureaucratic phenomena, this organization have survived many historical conjuntures, presenting itself as resistant to the proposed changes, mainly by slow ways of implementing these propositions.

Foi descrita e analisada a implantação de um processo de gestão da qualidade total na Divisão de Laboratório Central entre 1996 e 97. O sistema de garantia da qualidade com descrição e análise efetuadas, apoiou-se na Norma ISO 9002. Seu desempenho foi monitorizado por indicadores, tendo as suas repercussões discutidas. Os resultados indicaram que processos similares são viáveis em laboratórios clínicos públicos. Demonstrando-se um envolvimento dos funcionários, com diminuição do absenteísmo e do número de licenças do trabalho. A produtividade e o faturamento aumentaram, mantendo-se o custo médio por exame. As pesquisas de opinião apontaram mudanças no conceito dos médicos sobre o laboratório e mais satisfaçào dos pacientes com os serviços prestados. Este sistema obteve reconhecimento externo em 1997 / The implementing process of a total quality management system in the DLC was described and analyzed from 1996-97. A quality assurance system was established base don the rules of the ISO 9002. The steps of the establishing process were described, analyzed and a set of the indicators were used in order to monitor the performance of the introduced system, through the analysis of its follow-up. The results demonstrated that employees´ commitment resulted in a decrease in absenteeism, leave of absence and accidents related to work. There was an increase in productivity and billing with the upkeep of the cost per exam. Public opinion polls disclosed a better concept of the laboratory by the clinical staff and the patients. This system got external certification in 1997