The Design of Effective Maintenance Outsourcing Contracts

Recent developments in maintenance planning and management demonstrate that the establishment of optimized maintenance policies may drastically improve the performance and reduce the operating cost of facilities. However maintenance activities are typically outside of the core business of production facilities, hence enterprises often fail to catch the opportunities that may originate by properly optimized management strategies. A strategic maintenance management should hence encompass the possibility of outsourcing maintenance activities to ensure the necessary perfomance of production systems, while allowing enterprises to concentrate their resources on their core activities. In order to be effectively undertaken an outsourcing strategy must be supported by a proper performance oriented contract. The present paper aims to provide an adequate methodology to address such issues and to define a framework for the definition of the relevant contract variables such as availability levels, penalty policies, rewards and service cost. The methodology here proposed is based upon the evaluation of the expected profit function of both the outsourcer and the provider, by performing a trade-off analysis on the basis of the transaction costs

Avaliação e recomendações adicionais para a preparação de material sangüíneo integral para controles

OBJECTIVE: The assessment of an easy to prepare and low cost control material for Hematology, available for manual and automated methods. MATERIAL AND METHOD: Aliquots of stabilized whole blood were prepared by partial fixation with aldehydes; the stability at different temperatures (4. 20 and 37 °C) during periods of up to 8-9 weeks and aliquot variability with both methods were controlled. RESULTS: Aliquot variability with automated methods at day 1, expressed as CV% (coefficient of variation) was: white blood cells (WBC) 2.7, red blood cells (RBC) 0.7, hemoglobin (Hb) 0.6, hematocrit (Hct) 0.7, mean cell volume (MCV) 0.3, mean cell hemoglobin (MCH) 0.6, mean cell hemoglobin concentration (MCHC) 0.7, and platelets (PLT) 4.6. The CV (coefficient of variation) percentages obtained with manual methods in one of the batches were: WBC 23, Hct 2.8, Hb 4.5, MCHC 5.9, PLT 41. Samples stored at 4ºC and 20ºC showed good stability, only a very low initial hemolysis being observed, whereas those stored at 37ºC deteriobed a rapidly (metahemoglobin formation, aggregation of WBC and platelets, as well as alteration of erythrocyte indexes). CONCLUSIONS: It was confirmed that, as long as there is no exposure to high temperatures during distribution, this material is stable, allowing assessment, both esternal and internal, for control purposes, with acceptable reproductivity, both for manual and auttomatic methods.OBJETIVO: Avaliar material de controle para hematologia, de fácil preparação e baixo custo, que poderá ser usado por métodos manuais e automatizados. MATERIAL E MÉTODO: Alíquotas de sangue estabilizado foram preparadas por fixação parcial com aldeídos. Foram estudadas a estabilidade a diferentes temperaturas (4, 20, 37ºC) durante períodos de até 8-9 semanas e a variabilidade das alíquotas para ambos os métodos. RESULTADOS: A variabilidade entre alíquotas, expressada em CV% (coeficiente de variação) com métodos automatizados no primero dia, foi: glóbulos blancos (WBC) 2,7, glóbulos vermelhos (RBC) 0,7, hemoglobina (Hb) 0,6, hematócrito (Hct) 0,7, volume corpuscular médio (MCV) 0,3, Hb corpuscular médio (MCH) 0,3, concentração de Hb corpuscular médio (MCHC) 0,7 e plaquetas (Plt) 4,6. O CV% obtido com métodos manuais para um dos grupos foi: WBC 23, Hct 2,8, Hb 4,5, MCHC 5,9, Plt 41. As amostras conservadas a 4 e 20ºC foram estáveis, observando-se leve hemólise inicial, enquanto que as amostras conservadas a 37ºC mostraram uma rápida decomposição (formação de metaemoglobina, agregação de glóbulos brancos e plaquetas e alteração de índices). CONCLUSÕES: Confirmou-se que, se não houver exposição a altas temperaturas durante a distribuição, este material é estável, permitindo avaliação, tanto externa como interna para controle e com reprodutividade aceitável, tanto para métodos manuais como automáticos

Evaluation and additional recommendations for preparing a whole blood control material

Objective: The assessment of an easy to prepare and low cost control material for Hematology, available for manual and automated methods. Material and Method: Aliquots of stabilized whole blood were prepared by partial fixation with aldehydes; the stability at different temperatures (4. 20 and 37 °C) during periods of up to 8-9 weeks and aliquot variability with both methods were controlled. Results: Aliquot variability with automated methods at day 1, expressed as CV% (coefficient of variation) was: white blood cells (WBC) 2.7, red blood cells (RBC) 0.7, hemoglobin (Hb) 0.6, hematocrit (Hct) 0.7, mean cell volume (MCV) 0.3, mean cell hemoglobin (MCH) 0.6, mean cell hemoglobin concentration (MCHC) 0.7, and platelets (PLT) 4.6. The CV (coefficient of variation) percentages obtained with manual methods in one of the batches were: WBC 23, Hct 2.8, Hb 4.5, MCHC 5.9, PLT 41. Samples stored at 4ºC and 20ºC showed good stability, only a very low initial hemolysis being observed, whereas those stored at 37ºC deteriobed a rapidly (metahemoglobin formation, aggregation of WBC and platelets, as well as alteration of erythrocyte indexes). Conclusions: It was confirmed that, as long as there is no exposure to high temperatures during distribution, this material is stable, allowing assessment, both esternal and internal, for control purposes, with acceptable reproductivity, both for manual and auttomatic methods.Objetivo: Avaliar material de controle para hematologia, de fácil preparação e baixo custo, que poderá ser usado por métodos manuais e automatizados. Material e Método: Alíquotas de sangue estabilizado foram preparadas por fixação parcial com aldeídos. Foram estudadas a estabilidade a diferentes temperaturas (4, 20, 37ºC) durante períodos de até 8-9 semanas e a variabilidade das alíquotas para ambos os métodos. Resultados: A variabilidade entre alíquotas, expressada em CV% (coeficiente de variação) com métodos automatizados no primero dia, foi: glóbulos blancos (WBC) 2,7, glóbulos vermelhos (RBC) 0,7, hemoglobina (Hb) 0,6, hematócrito (Hct) 0,7, volume corpuscular médio (MCV) 0,3, Hb corpuscular médio (MCH) 0,3, concentração de Hb corpuscular médio (MCHC) 0,7 e plaquetas (Plt) 4,6. O CV% obtido com métodos manuais para um dos grupos foi: WBC 23, Hct 2,8, Hb 4,5, MCHC 5,9, Plt 41. As amostras conservadas a 4 e 20ºC foram estáveis, observando-se leve hemólise inicial, enquanto que as amostras conservadas a 37ºC mostraram uma rápida decomposição (formação de metaemoglobina, agregação de glóbulos brancos e plaquetas e alteração de índices). Conclusões: Confirmou-se que, se não houver exposição a altas temperaturas durante a distribuição, este material é estável, permitindo avaliação, tanto externa como interna para controle e com reprodutividade aceitável, tanto para métodos manuais como automáticos. Sangue. Controle de qualidade. Laboratórios.observed, whereas those stored at 37ºC deteriobed a rapidly (metahemoglobin formation, aggregation of WBC and platelets, as well as alteration of erythrocyte indexes). Conclusions It was confirmed that, as long as there is no exposure to high temperatures during distribution, this material is stable, allowing assessment, both esternal and internal, for control purposes, with acceptable reproductivity, both for manual and auttomatic methods.Facultad de Ciencias Exacta

Outpatient parents' views on shared-decision-making at an Italian children's hospital

Information is lacking on what parents in southern European countries know and how they view clinical shared-decision-making (SDM) for their children. This survey assesses general parental views on SDM and patient-physician SDM relationships in an Italian paediatric outpatients' clinic. In a 3-month cross-sectional survey, we enrolled 458 consecutive native and foreign Italian-speaking parents bringing their children to our public hospital for various reasons. Parents completed an anonymous questionnaire exploring their general views on SDM, including what doctor-patient relationship predominates today, and what approach reassures them most. Multivariate logistic regression analysed outcome data from parental questionnaire answers. Results are reported as percentages, odds ratios (OR) and 95% confidence intervals (CI). Multivariate logistic regression showed that 440 parents (96.1%) appreciated SDM, 245 (53.5%) preferred SDM for choosing children's treatment, 126 (27.5%) answered that SDM is the predominant relationship today, and most parents 275 (60.0%) felt reassured by SDM. More native than foreign Italian-speaking parents preferred SDM (97.0 vs 89.7%, OR = 3.8; 95% CI = 1.4-10.8). Highly-educated parents preferred SDM for choosing their child's therapy (57.9 vs 34.1%, OR = 2.7; 95% CI = 1.6-4.4) and this approach reassured them (64.3 vs 41.2%, OR = 2.5; 95% CI = 1.6-4.1). In conclusion, parents bringing children to an Italian outpatient clinic, especially highly-educated parents, wish to be offered SDM and find it reassuring. These findings should encourage paediatricians working in a challenging multicultural environment to change their physician-centred approach and engage parents in tailored SDM strategies

Evaluation and additional recommendations for preparing a whole blood control material

Objective: The assessment of an easy to prepare and low cost control material for Hematology, available for manual and automated methods. Material and Method: Aliquots of stabilized whole blood were prepared by partial fixation with aldehydes; the stability at different temperatures (4. 20 and 37 °C) during periods of up to 8-9 weeks and aliquot variability with both methods were controlled. Results: Aliquot variability with automated methods at day 1, expressed as CV% (coefficient of variation) was: white blood cells (WBC) 2.7, red blood cells (RBC) 0.7, hemoglobin (Hb) 0.6, hematocrit (Hct) 0.7, mean cell volume (MCV) 0.3, mean cell hemoglobin (MCH) 0.6, mean cell hemoglobin concentration (MCHC) 0.7, and platelets (PLT) 4.6. The CV (coefficient of variation) percentages obtained with manual methods in one of the batches were: WBC 23, Hct 2.8, Hb 4.5, MCHC 5.9, PLT 41. Samples stored at 4ºC and 20ºC showed good stability, only a very low initial hemolysis being observed, whereas those stored at 37ºC deteriobed a rapidly (metahemoglobin formation, aggregation of WBC and platelets, as well as alteration of erythrocyte indexes). Conclusions: It was confirmed that, as long as there is no exposure to high temperatures during distribution, this material is stable, allowing assessment, both esternal and internal, for control purposes, with acceptable reproductivity, both for manual and auttomatic methods.Objetivo: Avaliar material de controle para hematologia, de fácil preparação e baixo custo, que poderá ser usado por métodos manuais e automatizados. Material e Método: Alíquotas de sangue estabilizado foram preparadas por fixação parcial com aldeídos. Foram estudadas a estabilidade a diferentes temperaturas (4, 20, 37ºC) durante períodos de até 8-9 semanas e a variabilidade das alíquotas para ambos os métodos. Resultados: A variabilidade entre alíquotas, expressada em CV% (coeficiente de variação) com métodos automatizados no primero dia, foi: glóbulos blancos (WBC) 2,7, glóbulos vermelhos (RBC) 0,7, hemoglobina (Hb) 0,6, hematócrito (Hct) 0,7, volume corpuscular médio (MCV) 0,3, Hb corpuscular médio (MCH) 0,3, concentração de Hb corpuscular médio (MCHC) 0,7 e plaquetas (Plt) 4,6. O CV% obtido com métodos manuais para um dos grupos foi: WBC 23, Hct 2,8, Hb 4,5, MCHC 5,9, Plt 41. As amostras conservadas a 4 e 20ºC foram estáveis, observando-se leve hemólise inicial, enquanto que as amostras conservadas a 37ºC mostraram uma rápida decomposição (formação de metaemoglobina, agregação de glóbulos brancos e plaquetas e alteração de índices). Conclusões: Confirmou-se que, se não houver exposição a altas temperaturas durante a distribuição, este material é estável, permitindo avaliação, tanto externa como interna para controle e com reprodutividade aceitável, tanto para métodos manuais como automáticos. Sangue. Controle de qualidade. Laboratórios.observed, whereas those stored at 37ºC deteriobed a rapidly (metahemoglobin formation, aggregation of WBC and platelets, as well as alteration of erythrocyte indexes). Conclusions It was confirmed that, as long as there is no exposure to high temperatures during distribution, this material is stable, allowing assessment, both esternal and internal, for control purposes, with acceptable reproductivity, both for manual and auttomatic methods.Facultad de Ciencias Exacta

Identification of particles with Lorentz factor up to 10410^{4} with Transition Radiation Detectors based on micro-strip silicon detectors

This work is dedicated to the study of a technique for hadron identification in the TeV momentum range, based on the simultaneous measurement of the energies and of the emission angles of the Transition Radiation (TR) X-rays with respect to the radiating particles. A detector setup has been built and tested with particles in a wide range of Lorentz factors (from about $10^3$ to about $4 \times 10^4$ crossing different types of radiators. The measured double-differential (in energy and angle) spectra of the TR photons are in a reasonably good agreement with TR simulation predictions.Comment: 31 pages, 12 figures, paper published on Nuclear Instruments & Methods

Internal alignment and position resolution of the silicon tracker of DAMPE determined with orbit data

The DArk Matter Particle Explorer (DAMPE) is a space-borne particle detector designed to probe electrons and gamma-rays in the few GeV to 10 TeV energy range, as well as cosmic-ray proton and nuclei components between 10 GeV and 100 TeV. The silicon-tungsten tracker-converter is a crucial component of DAMPE. It allows the direction of incoming photons converting into electron-positron pairs to be estimated, and the trajectory and charge (Z) of cosmic-ray particles to be identified. It consists of 768 silicon micro-strip sensors assembled in 6 double layers with a total active area of 6.6 m$^2$. Silicon planes are interleaved with three layers of tungsten plates, resulting in about one radiation length of material in the tracker. Internal alignment parameters of the tracker have been determined on orbit, with non-showering protons and helium nuclei. We describe the alignment procedure and present the position resolution and alignment stability measurements

Test beam studies of possibilities to separate particles with gamma factors above 10\u3csup\u3e3\u3c/sup\u3e with straw based Transition Radiation Detector

Measurements of hadron production in the TeV energy range are one of the tasks of the future studies at the Large Hadron Collider (LHC). The main goal of these experiments is a study of the fundamental QCD processes at this energy range, which is very important not only for probing of the Standard Model but also for ultrahigh-energy cosmic particle physics. One of the key elements of these experiments measurements are hadron identification. The only detector technology which has a potential ability to separate hadrons in this energy range is Transition Radiation Detector (TRD) technology. TRD prototype based on straw proportional chambers combined with a specially assembled radiator has been tested at the CERN SPS accelerator beam. The test beam results and comparison with detailed Monte Carlo simulations are presented here

The Observation of Up-going Charged Particles Produced by High Energy Muons in Underground Detectors

An experimental study of the production of up-going charged particles in inelastic interactions of down-going underground muons is reported, using data obtained from the MACRO detector at the Gran Sasso Laboratory. In a sample of 12.2 10^6 single muons, corresponding to a detector livetime of 1.55 y, 243 events are observed having an up-going particle associated with a down-going muon. These events are analysed to determine the range and emission angle distributions of the up-going particle, corrected for detection and reconstruction efficiency. Measurements of the muon neutrino flux by underground detectors are often based on the observation of through-going and stopping muons produced in $\nu_\mu$ interactions in the rock below the detector. Up-going particles produced by an undetected down-going muon are a potential background source in these measurements. The implications of this background for neutrino studies using MACRO are discussed.Comment: 18 pages, 9 figures. Accepted by Astrop. Physic