Training needs in TQM: the Portuguese perspective

A survey to assess training needs in TQM was developed in several European countries, within the framework of a Leonardo���s project named IMVOCED. Beyond a comparison of the results in each country, a global analysis was performed to design a TQM programme to be delivered by WBL (Work Based Learning). Differences were found between countries, and the Portuguese results also revealed that different approaches to TQM training should be adopted according to the organisation���s dimension. Based on this evidence, two different strategies for TQM training by WBL are proposed and discussed.

An integrated approach for TQM implementation in SMEs

This paper tackles the broad issue of TQM implementation in SMEs. It includes a review of two models aimed at improving organisational performance, the EFQM Excellence Model and the Balanced Scorecard, which have been widely used in large organisations. Both models are examined as to their suitability and applicability to small and medium sized enterprises. The findings indicate that SMEs can benefit from the adoption of an integrated approach that combines both models if some critical factors are considered in the implementation process. A theoretical framework is proposed, which considers such integration and leads to a gradual implementation of TQM principles and methods in SMEs.

Democratic dialogue and collective learning in the context of self-managed teams

This paper provides a longitudinal, empirical view of the multifaceted and reciprocal processes of organizational learning in a context of self-managed teams. Organizational learning is seen as a social construction between people and actions in a work setting. The notion of learning as situated (Brown & Duguid 1989, Lave& Wenger 1991, Gherardi & al. 1998, Easterby-Smith & Araujo 1999, Abma 2003) opens up the possibility for placing the focus of research on learning in the community rather than in individual learning processes. Further, in studying processes in their social context, we cannot avoid taking power relations into consideration (Contu & Willmott 2003). The study is based on an action research with a methodology close to the ���democratic dialogue��� presented by Gustavsen (2001). This gives a ground for research into how the learning discourse developed in the case study organization over a period of 5 years, during which time the company abandoned a middle management level of hierarchy and the teams had to figure out how to work as self-managed units. This paper discusses the (re)construction of power relations and its role in organizational learning. Power relations are discussed both in vertical and horizontal work relations. A special emphasis is placed on the dialectic between managerial aims and the space for reflection on the side of employees. I argue that learning is crucial in the search for the limits for empowerment and that these limits are negotiated both in actions and speech. This study unfolds a purpose-oriented learning process, constructing an open dialogue, and describes a favourable context for creative, knowledge building communities.

Mobile and web tools for participative learning

Disserta����o apresentada na Faculdade de Ci��ncias e Tecnologia da Universidade Nova de Lisboa, para a obten����o do grau de Mestre em Engenharia Inform��tica

Designing market-based instruments for biodiversity conservation: learning with the Australian experience and evaluating Portugal's potential

Disserta����o apresentada na Faculdade de Ci��ncias e Tecnologia da Universidade Nova de Lisboa para a obten����o do grau de Mestre em Engenharia do Ambiente, perfil Gest��o de Sistemas Ambientais

A learning approach to swarm-based path detection and tracking

Disserta����o para obten����o do Grau de Mestre em Engenharia Electrot��cnica e de Computadores

Integrated study by NMR and X-ray Crystallography on the analysis of the molecular interactions in heme-binding proteins

Disserta����o para obten����o do Grau de Doutor em Bioqu��mica, Especialidade Bioqu��mica Estrutural

Molecular determinants of ligand specificity in carbohydrate-binding modules: an NMR and X-ray crystallography integrated study

Disserta����o para obten����o do Grau de Doutor em Bioqu��mica ��� Ramo Bioqu��mica Estrutural

Learning networks and moodle use in online courses: a social network analysis study

Disserta����o para obten����o do Grau de Doutor em Ci��ncias da Educa����o Especialidade em Tecnologias, Redes e Multim��dia na Educa����o e Forma����o

An RF LC Q-enhanced CMOS iter using integrated inductors with layout optimization

Disserta����o apresentada para obten����o do Grau de Mestre em Engenharia Electrot��cnica e de Computadores, pela Universidade Nova de Lisboa, Faculdade de Ci��ncias e Tecnologia

Adapter module for self-learning production systems

Disserta����o para obten����o do Grau de Mestre em Engenharia Electrot��cnica, Sistemas e Computadores

The national physics and chemistry exams and the learning of sciences

Disserta����o apresentada para obten����o do Grau de Doutor em Ci��ncias da Educa����o, pela Faculdade de Ci��ncias e Tecnologia da Universidade Nova de Lisboa

Sintomas somatoformes em Medicina Geral e Familiar

RESUMO: Os doentes que v��o �� consulta com sintomas f��sicos para os quais o m��dico n��o encontra uma causa org��nica, s��o frequentes na Medicina Geral e Familiar, embora n��o sejam espec��ficos, e s��o o objecto de estudo do presente trabalho. N��o deixar uma doen��a por diagnosticar (erro de tipo II) sem contudo rotular pessoas saud��veis como doentes (erro de tipo I) �� um dos mais dif��ceis problemas da pr��tica cl��nica di��ria e para o qual n��o existe uma orienta����o infal��vel e n��o �� previs��vel que alguma vez venha a existir. Mas se o diagn��stico de doen��a ou n��o-doen��a �� dif��cil, o tratamento dos que n��o tem doen��a, embora com sofrimento, tamb��m n��o �� mais f��cil, sobretudo, se estivermos conscientes do sofrimento que determina a medicaliza����o e a iatrogenia. O presente trabalho est�� estruturado em 3 partes. Na primeira parte descrevemos a nossa vis��o integrada do que apreendemos da leitura da literatura publicada e �� qual tivemos acesso. �� semelhan��a do que se verifica na maioria das ��reas da Medicina esta �� tamb��m uma em que o conhecimento cresce a ritmo exponencial. No entanto, �� falta de conceitos precisos e de defini����es consensuais sucede um conhecimento, por vezes, pouco consistente, tanto mais que estamos na fronteira entre a cultura leiga e a cultura erudita m��dica em que os significados devem, a todo o momento, ser validados. Fizemos uma revis��o sobre as defini����es do que est�� em quest��o, sobre o que se sabe sobre a frequ��ncia dos sintomas f��sicos na popula����o, quantos recorrem aos servi��os de sa��de e o que lhes �� feito. Pass��mos por uma revis��o da fisiologia destes sintomas e algumas explica����es fisiopatol��gicas para terminarmos sobre o que os doentes pensam sobre os seus sintomas e os cuidados que recebem e o que os profissionais pensam sobre estes doentes. Esta parte termina com uma revis��o das propostas de abordagem para este tipo de doentes. Na segunda parte, descrevemos os estudos emp��ricos focados no problema dos pacientes com sintomas f��sicos mas sem evid��ncia de doen��a org��nica. Come��a por uma apresenta����o dos aspectos processuais e metodol��gicos dos estudos realizados, mais especificamente, de dois estudos quantitativos e um qualitativo. No primeiro estudo pretendeu-se avaliar quais s��o os sintomas f��sicos e a sua frequ��ncia na popula����o em geral e a frequ��ncia de pacientes que procuram (ou n��o) os servi��os de sa��de tendo como motivo este tipo de sintomas. O objectivo deste estudo �� contribuir para a demonstra����o que este tipo de sintomas faz parte da vida do dia-a-dia e que, na maioria das vezes, s�� por si n��o significa doen��a, sem contudo negar que representa sofrimento, por vezes at�� maior do que quando h�� patologia org��nica. Se no primeiro estudo era demonstrar que os sintomas f��sicos s��o frequentes na popula����o, no segundo estudo o objectivo �� demonstrar que pacientes com este tipo de sintomas s��o igualmente frequentes e que o tipo de sintomas apresentados na consulta n��o difere dos referidos pela popula����o em geral. Pretendia-se ainda saber o que �� feito ou proposto pelo m��dico a estes doentes e se estes doentes traziam ou n��o, junto com os sintomas, ideias explicativas para os mesmos. Finalmente e n��o menos importante, �� avaliar o grau de fidedignidade do diagn��stico de sintoma somatoforme, chamando assim ao sintoma f��sico que foi ���levado��� �� consulta e que o m��dico diagnosticou como n��o tendo causa org��nica. O terceiro estudo parte do conhecimento adquirido que a Medicina tem muitas respostas para este problema, mas poucas que se possam considerar satisfat��rias se usadas isoladamente. Que a maioria das solu����es �� procurada entre a cultura m��dica e num paradigma reducionista de separa����o mente-corpo. Contudo, se o sintoma �� ���constru��do��� pelo doente, se o principal problema n��o est�� no sintoma mas na forma como o paciente o v��, ent��o pareceu-nos l��gico que a solu����o tamb��m tem que passar por integrarmos no plano de abordagem o que o doente entende ser melhor para si. Nesta sequ��ncia, entrevistaram-se alguns doentes cujo diagn��stico de sintomas somatoformes estava demonstrado pelo teste do tempo. Por isso, entrevistaram-se doentes que j�� tinham ido �� consulta de MGF h�� mais de 6 meses por sintomas somatoformes e, na data da entrevista, o diagn��stico se mantinha inalterado, independentemente da sua evolu����o. As entrevistas visaram conhecer as ideias dos doentes sobre o que as motivou a procurarem a consulta, o que pensavam da forma como foram cuidados e que ideias tinham sobre o que os profissionais de sa��de devem fazer para os ajudar a restabelecer o equil��brio com o seu ambiente evitando a medicaliza����o, a iatrogenia e a evolu����o para a cronicidade. Na terceira parte, discutem-se e integram-se os resultados encontrados no conhecimento previamente existente. Tenta-se teorizar, fazer doutrina sobre o tema e contribuir para abordagens terap��uticas mais personalizadas, abrangentes, variadas e multimodais, baseadas sempre no m��todo cl��nico centrado no paciente, ou de modo menos correcto mas enf��tico, baseadas no m��todo centrado na rela����o. Apresentam-se algumas hip��teses de trabalhos futuros sobre o tema e, sobretudo, esperamos ter contribu��do para o reconhecimento da necessidade de a comunica����o m��dico-doente ser uma aprendizagem transversal a todos os profissionais de sa��de e ao longo da vida, com a ideia que �� sempre poss��vel fazer melhor, caso contr��rio tenderemos, inexoravelmente, a fazer cada vez pior.-----------ABSTRACT: Patients who go to consultation with physical symptoms, for which the doctor does not find an organic cause, are the subject of the present study. They are common in family medicine, although not specific. Do not let an undiagnosed disease (type II error), but without labeling healthy people as patients with disease (type I error) is one of the most difficult problems in clinical practice and for which doesn���t exist an infallible guide and it is unlikely that any since coming into existence. But, if the diagnosis of disease or non-disease is difficult, the treatment of those who do not have the disease, though suffering, it is not easy, especially if we are aware of the suffering that medicalization and iatrogenic determines. This work is structured in three parts. In the first part we describe our integrated view of what we grasp from reading the published literature and to which we had access. Similar to that found in most areas of medicine, this is also one in which knowledge grows exponentially. However, the absence of precise concepts and consensual definitions determines an inconsistent knowledge, especially because we're on the border between secular culture and medical culture where, at all times, the meaning must be validated. We did a review on the definitions of what is at issue, what is known about the frequency of physical symptoms in the population, how many use the services of health and what they receive as care. We went through a review of the physiology of these symptoms and some pathophysiological explanations, to finish on what patients think about their symptoms and how they perceived the care they received and, finally, what professionals think about these patients. This part ends with a review of the approaches proposed for such patients. In the second part, we describe the empirical studies focused on the problem of patients with physical symptoms but no evidence of organic disease. Begins with a presentation of the procedural and methodological aspects of studies, more specifically, two quantitative and one qualitative. The first study sought to assess which are the physical symptoms, their incidence in the general population and the frequency they seek (or not) health services on behalf of those symptoms. The aim behind this study was to contribute to the demonstration that this type of symptoms is part of life's day-to-day and that, in most cases, does not represent disease by itself, without denying that they represent suffering, sometimes even greater than when there are organic disease. The first study endeavor to demonstrate that the physical symptoms are common in the population. The second study aspires to demonstrate that patients with such symptoms are also common and that the type of symptoms presented in the consultation does not differ from those in the general population. The aim was also to know what is done or proposed by the physician for these patients and if these patients brought or not, along with the symptoms, explanatory ideas for them. Finally and not least, it would try to assess the degree of reliability of diagnosis of somatoform symptoms, thus drawing the physical symptom that patient presents in the consultation and that the doctor diagnosed as having no organic cause. The third study starts from the acquired knowledge that medicine has many answers to this problem, but few can be considered satisfactory if used in isolation. The most solutions are sought in the medical culture and based on a reductionist paradigm of mind-body. However, if the symptom is "built" by the patient, if the main problem is not the symptom but the way the patient sees it, then it seemed logical to us that the solution must integrate the approaches that patients believes are best for them. Subsequently, a few patients, whose diagnosis of somatoform symptoms was demonstrated by the test of time, were interviewed. Therefore, patients who were interviewed had gone to the consultation of family medicine more than 6 months before for somatoform symptoms and. at the moment of the interview, the diagnosis remained unchanged, regardless of their evolution. The interviews aimed to ascertain the patients' ideas about what motivated them to seek consultation, what they thought about the care they got and which ideas they have about what health professionals should do to help these patients to re-establish equilibrium with its environment avoiding medicalization, iatrogenic effects and the evolution to chronicity. In the third section, we discuss and integrate the results found in previously existing knowledge. Attempts to theorize on the subject and contribute to more personalized treatment, comprehensive, varied and multi-modal approaches, always based on patient-centered clinical method, with emphasis on the relationship. We presents some hypotheses for future work on the subject and,above all, defend the recognition of the importance of lifelong learning communication skills for all health professionals, with the idea that we can always do better, otherwise we tend inexorably to do worse.

Robots and humans as co-workers? The human-centred perspective of work with autonomous systems

The design of work organisation systems with automated equipment is facing new challenges and the emergence of new concepts. The social aspects that are related with new concepts on the complex work environments (CWE) are becoming more relevant for that design. The work with autonomous systems implies options in the design of workplaces. Especially that happens in such complex environments. The concepts of ���agents���, ���co-working��� or ���human-centred technical systems��� reveal new dimensions related to human-computer interaction (HCI). With an increase in the number and complexity of those human-technology interfaces, the capacities of human intervention can become limited, originating further problems. The case of robotics is used to exemplify the issues related with automation in working environments and the emergence of new HCI approaches that would include social implications. We conclude that studies on technology assessment of industrial robotics and autonomous agents on manufacturing environment should also focus on the human involvement strategies in organisations. A needed participatory strategy implies a new approach to workplaces design. This means that the research focus must be on the relation between technology and social dimensions not as separate entities, but integrated in the design of an interaction system.