Induction methods used in low temperature physics

A study has been made of induction bridges used in low temperature physics.\ud \ud In Part 1 the design of a mutual inductance bridge of the Hartshorn type is discussed. This design is based on a critical analysis of impurity effects of the different parts of the Hartshorn bridge. With this equipment frequencies up to 0.5 MHz can be used. Two methods have been developed to examine the secondary signal. In one of these use has been made of AD conversion techniques. In the other one, the secondary signal, produced by a superconducting sample, which is generally distorted, is analysed by using a Fourier expansion.\ud \ud In Part 2 equipment is described which enables us to measure the phase and amplitude of the harmonics of the output signal of the bridge. For synchronous detection a reference signal of the same frequency of the harmonic of interest is required. This reference signal is generated from the input signal of the bridge by means of a digital frequency multiplier with programmable multiplication factor N.\ud \ud In Part 3 some experimental results, showing the possibilities of the equipment, on some superconductors are presented

Telecommunication carrier selection under volume discounts: a case study.

During 2001 many of the European mobile phone markets have reached saturation, and hence mobile phone operators have shifted their attention from growth and market share to cutting costs. One way of doing so is to reduce spending on international calls which are routed via network operating companies (carriers). These carriers charge per call-minute for each destination and may use a joint business volume discount to price their services. We developed a software system that supports the decision of allocating destinations to carriers. The core of this system is a min-cost flow routine that is embedded in a branch-and-bound framework. Our system not only solves the operational problem to optimality, it is also capable of performing what-if analyses and sensitivity analysis. It has been implemented at a major telecommunication services provider. The main benefits realized are twofold: the business process of allocating carriers to destinations has been structured and the costs arising from routing international calls have significantly decreased.Selection; Case studies; Studies; Markets; Market; Costs; International; Companies; Software; Decision; Framework; Sensitivity; Processes;

Trapezoidal ac magnetic fields:a powerful technique for the investigation of type 11 superconductors

In ac losses in type II superconductors three contributing factors may be distinguished. These are connected with the three parameters in the Critical State Model: the critical current density Jc, surface screening currents denoted by Ben(Ba) and Bex (Ba), and the flux conductivity σff. In this paper the authors present an inductive technique which makes it possible to determine these three parameters separately. For this purpose, ac magnetic fields of trapzoidal waveform are applied. The theoretical background of the technique will be discussed together with the experimental equipment designed for these experiments. The technique has been verified by means of numerical model calculations. Finally, some experimental results are given to illustrate the possibilities of the technique

Models, algorithms and performance analysis for adaptive operating room scheduling

The complex optimisation problems arising in the scheduling of operating rooms have received considerable attention in recent scientific literature because of their impact on costs, revenues and patient health. For an important part, the complexity stems from the stochastic nature of the problem. In practice, this stochastic nature often leads to schedule adaptations on the day of schedule execution. While operating room performance is thus importantly affected by such adaptations, decision-making on adaptations is hardly addressed in scientific literature. Building on previous literature on adaptive scheduling, we develop adaptive operating room scheduling models and problems, and analyse the performance of corresponding adaptive scheduling policies. As previously proposed (fully) adaptive scheduling models and policies are infeasible in operating room scheduling practice, we extend adaptive scheduling theory by introducing the novel concept of committing. Moreover, the core of the proposed adaptive policies with committing is formed by a new, exact, pseudo-polynomial algorithm to solve a general class of stochastic knapsack problems. Using these theoretica

The effect of human resource management on performance in hospitals in Sub-Saharan Africa: A systematic literature review

Hospitals in Sub-Saharan Africa (SSA) face major workforce challenges while having to deal with extraordinary high burdens of disease. The effectiveness of human resource management (HRM) is therefore of particular interest for these SSA hospitals. While, in general, the relationship between HRM and hospital performance is extensively investigated, most of the underlying empirical evidence is from western countries and may have limited validity in SSA. Evidence on this relationship for SSA hospitals is scarce and scattered. We present a systematic review of empirical studies investigating the relationship between HRM and performance in SSA hospitals. Following the PRISMA protocol, searching in seven databases (i.e., Embase, MEDLINE, Web of Science, Cochrane, PubMed, CINAHL, Google Scholar) yielded 2252 hits and a total of 111 included studies that represent 19 out of 48 SSA countries. From a HRM perspective, most studies researched HRM bundles that combined practices from motivation-enhancing, skills-enhancing, and empowerment-enhancing domains. Motivation-enhancing practices were most frequently researched, followed by skills-enhancing practices and empowerment-enhancing practices. Few studies focused on single HRM practices (instead of bundles). Training and education were the most researched single practices, followed by task shifting. From a performance perspective, our review reveals that employee outcomes and organizational outcomes are frequently researched, whereas team outcomes and patient outcomes are significantly less researched. Most studies report HRM interventions to have positively impacted performance in one way or another. As researchers have studied a wide variety of (bundled) interventions and outcomes, our analysis does not allow to present a structured set of effective one-to-one relationships between specific HRM interventions and performance measures. Instead, we find that specific outcome improvements can be accomplished by different HRM interventions and conversely that similar HRM interventions are reported to affect different outcome measures. In view of the high burden of disease, our review identified remarkable little evidence on the relationship between HRM and patient outcomes. Moreover, the presented evidence often fails to provide contextual characteristics which are likely to induce variety in the performance effects of HRM interventions. Coordinated resea

Modeling Patient Journeys for Demand Segments in Chronic Care, With an Illustration to Type 2 Diabetes

Chronic care is an important area for cost-effective and efficient health service delivery. Matching demand and services for chronic care is not easy as patients may have different needs in different stages of the disease. More insight is needed into the complete patient journey to do justice to the services required in each stage of the disease, to the different experiences of patients in each part of the journey, and to outcomes in each stage. With patient journey we refer to the “journey” of the patient along the services received within a demand segment of chronic care. We developed a generic framework for describing patient journeys and provider networks, based on an extension of the well-known model of Donabedian, to relate demand, services, resources, behavior, and outcomes. We also developed a generic operational model for the detailed modeling of services and resources, allowing for insight into costs. The generic operational model can be tailored to the specific characteristics of patient groups. We applied this modeling approach to type 2 diabetes (T2D) patients. Diabetes care is a form of chronic care for patients suffering diabetes mellitus. We studied the performance of T2D networks, using a descriptive model template. To identify and describe demand we made use of the following demand segments within the diabetes type 2 population: patients targeted for prevention; patients with stage 1 diabetes treated by their GP with lifestyle advice; patients with diabetes stage 2 treated by their GP with lifestyle advice and oral medication; patients with stage 3 diabetes treated by their GP with lifestyle advice, oral medication, and insulin injections; patients with stage 4 diabetes with complications (treated by internal medicine specialists). We used a Markov model to describe the transitions between the different health states. The model enables the patient journey through the health care system for cohorts of newly diagnosed T2D patients to be described, and to make a projection of the resource requirements of the different demand segments over the years. We illustrate our approach with a case study on a T2D care network in The Netherlands and reflect on the role of demand segmentation to analyse the case study results, with the objective of improving the T2D service delivery

Intention to use Medical Apps Among Older Adults in the Netherlands: Cross-Sectional Study

BACKGROUND: The increasing health service demand driven by the aging of the global population calls for the development of modes of health service delivery that are less human resource-intensive. Electronic health (eHealth) and medical apps are expected to play an important role in this development. Although evidence shows mobile medical apps might be effective in improving the care, self-management, self-efficacy, health-related behavior, and medication adherence of older adults, little is known about older adults' intention to use these technologies when needed, or the factors influencing this intention. OBJECTIVE: The objective of this study was to investigate the relationship of technology acceptance factors and intention to use mobile medical apps among community-dwelling older adults. METHODS: Data was collected using questionnaires. The factors selected from the literature have been validated using Cronbach α and tested for significance using logistic regressions. RESULTS: Almost half (49.7%) of the included older adults reported no intention to use medical apps. Adjusted logistic regression analysis per factor showed that the factors Attitude toward use (odds ratio [OR] 8.50), Perceived usefulness (OR 5.25), Perceived ease of use (OR 4.22), Service availability (OR 3.46), Sense of control (OR 3.40), Self-perceived effectiveness (OR 2.69), Facilities (OR 2.45), Personal innovativeness (OR 2.08), Social relationships (OR 1.79), Subjective norm (OR 1.48), and Feelings of anxiety (OR 0.62) significantly influenced the intention to use mobile medical apps among older adults, whereas the factor Finance (OR 0.98) did not. When considered together, a controlled multivariate logistic regression yielded high explained variances of 0.542 (Cox-Snell R2) and 0.728 (Nagelkerke R2). CONCLUSIONS: The high odds ratios and explained variance indicate that the factors associated with the intention to use medical apps are largely understood and the most important factors have been identified. To advance the evidence base, experimental controlled research should investigate the causality between the factors, intention to use, and actual use. For this purpose, our evidence suggests that policies designed to improve Attitude toward use appear most effective, followed by policies addressing Perceived usefulness, Perceived ease of use, Service availability, and Sense of control