O problema de programação de operações em ambiente no-wait flow shop tem sido abordado desde a década de 60. Por se tratar de um ambiente em que as tarefas devem ser processadas continuamente e sem interrupções entre uma máquina e outra, um tempo de espera entre o início da tarefa anterior e o início da tarefa atual deve ser determinado na primeira máquina. Neste sentido, uma vez que a tarefa inicia seu processamento, as máquinas devem estar disponíveis para que atendam a restrição de no-wait. Portanto, operações de manutenção preventiva são necessárias para que a programação seja atendida sem maiores problemas. Este trabalho aborda dois problemas: no-wait flow shop e no-wait flow shop com operações de manutenção preventiva. O critério de desempenho adotado foi a duração total da programação (makespan). Por meio de uma revisão de literatura, mecanismos de construção de soluções foram identificadas e classificadas e, baseando-se em tais, novos métodos heurísticos construtivos simples e compostos foram propostos para o problema no-wait flow shop e uma heurística composta foi desenvolvida considerando as operações de manutenção preventiva. Experimentações computacionais para os dois problemas foram realizadas para fins de comparação e avaliação dos métodos propostos com os métodos heurísticos construtivos da literatura. Para o problema Fm|no - wait|Cmax resultados evidenciaram que as heurísticas propostas H4GPSLLS e MH4GPSLLS superaram as heurísticas da literatura em qualidade de solução, com diferença estatisticamente significativa no nível de 5% de significância. Para o problema Fm|no - wait, m(k)|Cmax, pode-se constatar que a heurística BIHLS e as heurísticas H4GPSLLS e MH4GPSLLS apresentaram desempenho superior com diferença estatística significativa no nível de 5% de significância em comparação as heurísticas da literatura. / The no-wait flow shop scheduling problem has been studied since 60\'s. In this environment, jobs must be processed continuously without interruption between one machine and another, and because of this, a delay between the start time of the previous job and the start time of the current job must be determined in the first machine. In this sense, since a job starts its processing, the machines must be available to respect the no-wait constraint. Therefore, preventive maintenance operations are needed. This work adresses two problems: the m machine no-wait flow shop and the m machine no-wait flow shop with preventive maintenance operations. The performance measure adopted was the makespan. By means of a literature review, mechanisms of solution construction were identified and classified. New simple and composite constructive heuristics were proposed to the no-wait flow shop problem and a new composite constructive heuristic was developed considering the preventive maintenance operations. Computational experiments and their respective analyses for both problems were carried out to compare and evaluate the performance between the proposed methods and the constructive heuristics of the literature. Regarding Fm|no - wait|Cmax problem, results show that the proposed heuristics H4GPSLLS and MH4GPSLLS outperformed the heuristics of the literature in quality of the solution and is statistically significative to 5% of significance level. To the Fm|no - wait, m(k)|Cmax problem it can be seen that the proposed heuristic BIHLS and H4GPSLLS and MH4GPSLLS outperformed the heuristics of the literature and is statistically better to 5% of significance level.

Este trabalho aborda o problema de no-wait flowshop em um ambiente com custos de setup apartados dos tempos de processamento, são investigados os casos de setups dependentes e independentes da seqüência para makespan e total flowtime. Diversas aplicações práticas podem ser modeladas sob estas suposições, dentre elas destacamos a indústria química e alimentícia. É proposta uma metaheurística evolutiva baseada em algoritmo genético e clustering search e seus resultados são comparados com os métodos de Brown et al (2004), França et al (2006) e Ruiz e Allahverdi (2007) através dos bancos de dados de Ruiz e Stützle (2008) e Ruiz e Allahverdi (2007). Os métodos são avaliados segundo o percentual de sucesso e desvio relativo médio. Os resultados obtidos demonstram a superioridade do método proposto para problemas de grande porte. / This work intends to research the no-wait flowshop scheduling problem with setup times separated from the processing costs; the both cases where the sequence is dependent and independent are targeted for makespan and total flowtime. There are numerous practical situations that can be modeled under these assumptions, such as, chemical industry, food processing, etc. A hybrid metaheuristic method based on a genetic algorithm and clustering search is proposed and its results are compared to the methods of Brown et al (2004), França et al (2006) e Ruiz e Allahverdi (2007) using the data base from Ruiz e Stützle (2008) and Ruiz e Allahverdi (2007). The methods are evaluated as regarding the success rate and average relative deviation. The results show that the proposed method delivers better solutions for problems with higher complexity.

Evaluer le vécu des examens complémentaires en terme d'utilité est pertinent car cela permet de prendre en compte cette donnée dans l'évaluation médico-économique des examens. Le Standard gamble n'a jamais été utilisé pour mesurer l'utilité des examens ; son application dans ce cas pose des problèmes méthodologiques liés à la nature temporaire de l'état évalué. Nous proposons une adaptation du Standard gamble chaîné (SGc) pour mesurer l'utilité des examens. Nous avons mené une étude transversale pour évaluer le vécu des examens du dépistage et du diagnostic initial du cancer du sein en pratique clinique courante. Le vécu a été mesuré en terme (1) d'utilité avec le SGc et une méthode dérivée du Time trade-off, le Wait trade-off (WTO) et (2) de qualité de vie avec un questionnaire standardisé (index TMI). Dans 5 services de radiologie de Montpellier et sa région, 185 patientes ayant eu une mammographie +/- échographie mammaire (68), une IRM mammaire (60) ou une biopsie du sein (57) avec un résultat négatif ont été interrogées après l'annonce du résultat. Les scénarios du SGc ont été bien compris par les patientes (temps d'entretien : 20-30 minutes). Dans les repères (e0, e1) et (décès, e1), 61.0% et 84.0% des patientes avaient une utilité égale à 1. L'utilité du SGc dans le repère (e0, e1) variait avec le type d'examen (p=0.12) et était associé à certaines variables de la qualité de vie (p=0.11 et p=0.036). La mesure n'était pas corrélée avec le WTO. Dans le repère (décès, pleine santé), la désutilité moyenne de l'examen obtenue par le SGc et par le WTO était : 0.0004 (et=0.0015) et 0.0010 (et=0.0031) pour la mammographie, 0.0004 (et=0.0027) et 0.0011 (et=0.0027) pour l'IRM mammaire et 0.0014 (et=0.0073) et 0.0036 (et=0.0083) pour la biopsie du sein. En conclusion, le SGc était compréhensible par les patients mais montrait un effet plafond important quand la mesure était rapportée dans le repère (décès, e1) ; cet effet devra être pris en compte dans les utilisations ultérieures de la mesure. / To evaluate the health impact of diagnostic testing in terms of utility is relevant because introducing this data in the economic evaluation of tests. The Standard gamble has never been used to measure the utility of diagnostic tests; there is methodological problems related to the temporary nature of the condition evaluated. We propose an adaptation of the chained Standard gamble (SGc) to measure the utility of diagnostic tests. A cross-sectional study was conducted to evaluate the health impact of the screening and diagnostic tests of breast cancer in clinical practice. The health impact was measured in terms of (1) utility with the SGc and an adapted version of the Time trade-off, the Wait trade-off (WTO) and (2) quality of life with a standardized questionnaire (index TMI). In 5 departments of radiology in Montpellier area, 185 patients who had a mammography +/- breast echography (68) or a breast MRI (60) or a breast biopsy (57) with a negative result were interviewed after the announcement of the results. The patients understood well the SGc scenarios (interview time : 20-30 minutes). In (e0, e1) and (death, e1), 61.0% and 84.0% of patients had utility equal to 1. The utility of the SGc in (e0, e1) varied with the type of test (P=0.12) and was associated with some variables of quality of life (P=0.11 and P=0.036). The measure was not correlated with the WTO. In (death, perfect health), the average disutility of the test measured by the SGc and the WTO was: 0.0004 (SD=0.0015) and 0.0010 (SD=0.0031) for the mammography, 0.0004 (SD=0.0027) and 0.0011 (SD=0.0027) for the breast MRI and 0.0014 (SD=0.0073) and 0.0036 (SD=0.0083) for the breast biopsy. In conclusion, the SGc was understandable by patients but showed a significant ceiling effect in (death, e1); this effect should be taken into account in subsequent uses of the measure.

O problema de programação de operações em ambiente no-wait flow shop tem sido abordado desde a década de 60. Por se tratar de um ambiente em que as tarefas devem ser processadas continuamente e sem interrupções entre uma máquina e outra, um tempo de espera entre o início da tarefa anterior e o início da tarefa atual deve ser determinado na primeira máquina. Neste sentido, uma vez que a tarefa inicia seu processamento, as máquinas devem estar disponíveis para que atendam a restrição de no-wait. Portanto, operações de manutenção preventiva são necessárias para que a programação seja atendida sem maiores problemas. Este trabalho aborda dois problemas: no-wait flow shop e no-wait flow shop com operações de manutenção preventiva. O critério de desempenho adotado foi a duração total da programação (makespan). Por meio de uma revisão de literatura, mecanismos de construção de soluções foram identificadas e classificadas e, baseando-se em tais, novos métodos heurísticos construtivos simples e compostos foram propostos para o problema no-wait flow shop e uma heurística composta foi desenvolvida considerando as operações de manutenção preventiva. Experimentações computacionais para os dois problemas foram realizadas para fins de comparação e avaliação dos métodos propostos com os métodos heurísticos construtivos da literatura. Para o problema Fm|no - wait|Cmax resultados evidenciaram que as heurísticas propostas H4GPSLLS e MH4GPSLLS superaram as heurísticas da literatura em qualidade de solução, com diferença estatisticamente significativa no nível de 5% de significância. Para o problema Fm|no - wait, m(k)|Cmax, pode-se constatar que a heurística BIHLS e as heurísticas H4GPSLLS e MH4GPSLLS apresentaram desempenho superior com diferença estatística significativa no nível de 5% de significância em comparação as heurísticas da literatura. / The no-wait flow shop scheduling problem has been studied since 60\'s. In this environment, jobs must be processed continuously without interruption between one machine and another, and because of this, a delay between the start time of the previous job and the start time of the current job must be determined in the first machine. In this sense, since a job starts its processing, the machines must be available to respect the no-wait constraint. Therefore, preventive maintenance operations are needed. This work adresses two problems: the m machine no-wait flow shop and the m machine no-wait flow shop with preventive maintenance operations. The performance measure adopted was the makespan. By means of a literature review, mechanisms of solution construction were identified and classified. New simple and composite constructive heuristics were proposed to the no-wait flow shop problem and a new composite constructive heuristic was developed considering the preventive maintenance operations. Computational experiments and their respective analyses for both problems were carried out to compare and evaluate the performance between the proposed methods and the constructive heuristics of the literature. Regarding Fm|no - wait|Cmax problem, results show that the proposed heuristics H4GPSLLS and MH4GPSLLS outperformed the heuristics of the literature in quality of the solution and is statistically significative to 5% of significance level. To the Fm|no - wait, m(k)|Cmax problem it can be seen that the proposed heuristic BIHLS and H4GPSLLS and MH4GPSLLS outperformed the heuristics of the literature and is statistically better to 5% of significance level.

Este trabalho aborda o problema de no-wait flowshop em um ambiente com custos de setup apartados dos tempos de processamento, são investigados os casos de setups dependentes e independentes da seqüência para makespan e total flowtime. Diversas aplicações práticas podem ser modeladas sob estas suposições, dentre elas destacamos a indústria química e alimentícia. É proposta uma metaheurística evolutiva baseada em algoritmo genético e clustering search e seus resultados são comparados com os métodos de Brown et al (2004), França et al (2006) e Ruiz e Allahverdi (2007) através dos bancos de dados de Ruiz e Stützle (2008) e Ruiz e Allahverdi (2007). Os métodos são avaliados segundo o percentual de sucesso e desvio relativo médio. Os resultados obtidos demonstram a superioridade do método proposto para problemas de grande porte. / This work intends to research the no-wait flowshop scheduling problem with setup times separated from the processing costs; the both cases where the sequence is dependent and independent are targeted for makespan and total flowtime. There are numerous practical situations that can be modeled under these assumptions, such as, chemical industry, food processing, etc. A hybrid metaheuristic method based on a genetic algorithm and clustering search is proposed and its results are compared to the methods of Brown et al (2004), França et al (2006) e Ruiz e Allahverdi (2007) using the data base from Ruiz e Stützle (2008) and Ruiz e Allahverdi (2007). The methods are evaluated as regarding the success rate and average relative deviation. The results show that the proposed method delivers better solutions for problems with higher complexity.

Les communications par satellites sont l’aboutissement de recherches menées dans les domaines de télécommunications et des technologies spatiales depuis plus de 50 ans. Les premiers satellites souffraient d’un coût exorbitant pour des performances très limitées. Les avancées technologiques apparues dans ces domaines ont permis de rendre ce rapport satisfaisant et commercialement viable ce qui a permis de multiplier leurs lancements et ainsi de mettre en place de véritables réseaux de satellites. À ce jour, il existe de nombreuses constellations de satellites géostationnaires et d’orbites basses utilisées à des fins civiles ou militaires. De manière générale, le routage au sein de ces constellations s’effectue suivant un pré-calcul des routes existantes qui est alors utilisé sur une période donnée et rafraîchi si besoin. Ce type de routage n’étant optimal que sur des topologies déterministes, nous sommes donc amenés à considérer d’autres solutions si l’on relaxe cette hypothèse. L’objectif de cette thèse est d’explorer les alternatives possibles au routage pré-calculé. En tant que piste potentielle, nous proposons de vérifier l’adéquation des protocoles de routage à réplication issus du monde des réseaux tolérants au délai, DTN, aux constellations de satellites. Afin de nous offrir un cadre d’étude pertinent à la vue de cet objectif, nous nous focalisons sur une constellation particulière à caractère quasi-déterministe n’offrant pas une connectivité directe entre tous les nœuds du système. Dans une deuxième partie nous nous intéressons à la modélisation du protocole de routage Binary Spray and Wait. Nous développons un modèle capable de déterminer théoriquement la distribution du délai d’acheminement pour tout type de réseau, homogène et hétérogène. / Satellite communication is the achievement of more than 50 years of research in the fields of telecommunications and space technologies.First satellites had exorbitant costs for very limited performances. Technological advances occurred in these areas have helped them to become commercially feasible and satisfying. This enable the increase of satellite launches and thus, building complete satellite networks.Today, there are many GEO or LEO satellite constellations used for civilian or military applications. In general, routing in these constellations is done by pre-computing existing routes. These routes are then used for a given period and refreshed if needed. This type of routing is optimal only on deterministic topologies as a consequence we need to consider other solutions if we relax this assumption. The objective of this thesis is to explore alternatives to pre-computed routing. As a potential solution, we propose to assess the suitability of replication based routing protocols issued from the world of delay tolerant networks, DTN. To provide a relevant framework to study this topic, we focus on a particular constellation that present a quasi-deterministic nature and do not provide direct connectivity between all nodes of the system. In a second part, we focus on the modeling of the Binary Spray and Wait, routing protocol. We develop a model that can theoretically determine the distribution of end-to-end delay for any type of network, homogeneous and heterogeneous. Finally, we present a possible use of this model to conduct more in-depth theoretical analysis.

Emergency surgeries are serviced by three main forms of capacity: dedicated operating room time reserved for emergency surgeries, alternative (on call) capacity, and lastly, canceling of elective surgeries. The objective of this research is to model capacity implications of meeting wait time targets for multiple priority levels in the context of emergency surgeries. Initial attempts to solve the capacity evaluation problem were made using a non-linear optimisation model, however, this model was intractable. A simulation model was then used to examine the trade-off between additional dedicated operating room capacity (and consequent idle capacity) versus increased re-scheduling of elective surgeries while keeping reserved time for emergency surgeries low. Considered performance measures include utilization of operating room time, elective re-scheduling, and wait times by priority class. Finally, the instantaneous utilization of different types of downstream beds is determined to aid in capacity planning. The greatest number of patients seen within their respective wait time targets is achieved by a combination of additional on call capacity and a variation of the rule allowing low priority patients to utilize on call capacity. This also maintains lower cancelations of elective surgeries than the current situation. Although simulation does not provide an optimum solution it enables a comparison of different scenarios. This simulation model can determine appropriate capacity levels for servicing emergency patients of different priorities with different wait time targets.

The purpose of this essay is to understand meeting between hidden refugees and health professionals through interviews with refugee in hiding and health professionals. The implantation of the essay has been made by social science research methods which I have used as a qualitative survey. The material that I have used in this paper is to interview with hidden refugee and health care workers. I have used the different sources such as literature, internet and different laws which relates to the topic of this easy. I am using the power of theories to analyze the work. The work highlights relation between healthcare professionals and hidden refugees. The work is based on a new law that called SFS and that is health care for some foreigners who reside in Sweden without the necessary of permeation which according to the Social Board (2010) gives the hidden and undocumented person entitled to care that cannot be deferred. The result of my investigation was that hidden refugee’s right to emergency cares is not always met in practice although they are legally entitled to it. Another result was that the hidden meeting with health care professionals is not problem in itself but being refused to care is problematic . Controlled documents from health professionals page allows hidden may feel at a disadvantage. In this case crated anxiety and fear among the hidden people seeking care .This means that they seek care at nonprofit organizations instead. Conclusions about my essay is that a more clear legislation should be enacted and that healthcare professionals should be payable after care needs and not by legal status and ability to pay.

Årligen sker över 1,5 miljoner operationer i Sverige och idag väntar många på operationen som ska genomföras. Inom vården är väntan inför ett kirurgiskt ingrepp något många patienter får uppleva och kölistan för operationer kan vara lång. Erfarenheterna av väntan på ett kirurgiskt ingrepp och strategierna för att hantera väntan skiljer sig mellan individer. Litteraturstudiens syfte var att beskriva patienters erfarenheter av väntan på kirurgiskt ingrepp som resulterade i nio kvalitativa vetenskapliga artiklar. Resultatet påvisar att patienters erfarenheter av väntetiden och vänteprocessen inför kirurgiskt ingrepp genererade både positiva och negativa känslor. Artiklarnas underkategorier skapade huvudkategorierna som var att leva i standby och känsla av hopp. De negativa känslorna som upplevdes var bland annat frustration och smärta. De positiva erfarenheterna av väntan var bland annat stöd och bättre hälsa. För att hantera väntan användes olika strategier där stöd var ett återkommande och viktigt begrepp. Patienterna letade efter stöd i form av information och närhet från både anhöriga och vårdpersonal. Mer forskning kring patienters erfarenheter av väntan inför kirurgiskt ingrepp är önskvärt där information och kommunikation spelar en central roll i omvårdnadsarbetet. / There are performed 1,5 million operations on a yearly basis in Sweden and still today are a lot of people waiting for their scheduled surgery. Waiting for surgery is something many patients will be experiencing and waitinglists for surgery can be long. The experience of waiting for surgery and strategies for manage the waiting time was different between the individuals. The aim of the study is to describe patients’ experience of waiting for surgery. The study was conducted by reviewing nine qualitative research articles. The results demonstrates patients' experience of waiting and the waiting process before surgery generated both positive and negative feelings. Articles subcategories created the main categories that were living in standby and sense of hope. Some of the negative feelings that were experienced were frustration and pain. The positive experience of waiting included support and health. To manage the wait, different stratergies were used and supporting was important. Patients were looking for support in terms of information from both families and healthcare professionals. Wait is a concept that with more research could provide a more clear picture of what waiting is and what it means for the patients who are in the middle of the waiting process for a surgical procedure.

Thesis advisor: Diana C. Pullin / The introduction of the No Child Left Behind Act (NCLB) in 2002 and the reauthorization of the Individuals With Disabilities Education Act (IDEA) in 2004, resulted in numerous changes in the American education system. In particular, the IDEA reauthorization introduced an initiative entitled Response to Intervention (RTI) that has impacted both regular and special education practices and policies. RTI is a regular education initiative that involves a multi-tiered approach to service delivery and is based on student outcomes. The purpose of this qualitative, single case study is to examine and report teachers' perceptions of the RTI implementation process for reading in grades K-3 in a suburban elementary school. Additionally, this research seeks to identify themes that have influenced the success of the RTI model, and to provide a framework for key components for a successful reading RTI implementation process according to teachers. The data sources used in this qualitative study included: focus groups, individual semi-structured interviews, and artifacts. This data was analyzed and compared using constant comparison analysis. According to the teachers and principal, seven themes emerged from the analysis, including: communication, success, professional development, support/materials, challenges, implementation, and leadership. Every participant reported that communication among all members of the school community is essential within an RTI model. Most importantly, teachers expressed the significance of creating a shared vision among staff. Teachers defined successful RTI implementation and their perceptions of reading success in grades K-3. Teachers reported the need for authentic, purposeful, RTI professional development and support/materials to support each tier. The participants reported the challenges that are inherent in RTI implementation and how the model has changed since inception. Participants discussed the role of leadership and the qualities of a leader that promote success. Lastly, recommendations are made for teachers and school leaders who are beginning the RTI implementation process and for public policy officials who create and monitor regulations regarding reading RTI policies and procedures. / Thesis (PhD) — Boston College, 2012. / Submitted to: Boston College. Lynch School of Education. / Discipline: Educational Administration and Higher Education.