Análise da relação causal entre imagem de destinos, qualidade, satisfação e fidelidade: um estudo de acordo com a percepção do turista nacional no destino turístico Natal

This dissertation aims to analyze the causal relationship between the quality of tourist services, satisfaction with the attributes and globally, fidelity and image of tourist destinations. Therefore, it was conducted an exploratory, descriptive research with quantitative analytical approach. Data collection was performed by a questionnaire addressed to tourists at the Augusto Severo International Airport and Bus station of Natal, the main points of entry and exit of tourists. The composition was simple random sampling by reaching the final number of 400 tourists interviewed. Among the main results, is an assessment of the quality of the components of the destination. It was noted that nine are the dimensions of perceived quality of tourism products and services of ―Sun and Sand‖ segment, that is, Beaches and Facilities, Public Equipment, Catering Services, Transportation, Hotel Equipment, Hotel Services, Entertainment & Attractions, Access to the Hotel and Hospitality. Moreover, it was concluded that the Preview Tourism Destination Image has little direct influence in the Consumer Satisfaction, and only indirectly in the Post-Purchase Behavior. While the Complex Tourism Destination Image exerts strong and direct influence on both factors, in the Customer Satisfaction Process and Loyalty, the dimensions of quality also claimed to be strongly influences both factors

GESTÃO AMBIENTAL E COMPETITIVIDADE EM DESTINOS TURÍSTICOS: percepção dos gestores de pequenos meios de hospedagem de Natal/RN sobre o uso de práticas ambientais como fator de competitividade

The present work aimed at investigating the small hotel managers perceptions from Natal/RN concerning the environmental practice uses as a competitive factor. This study is characterized as a descriptive exploratory research that used an aleatory probabilistic sample followed by the application of collect data instrument (questionnaire). The small hotels located in Natal/RN were the study participants and the specific location where 35 questionnaires were answered. Based on the data and on the mangers point of view, it is possible to comprehend that, among the presented indicators, the development of environmental programs in the hotel enterprise is showed as the least important for the client s choice. As the main conclusion it is relevant to argue that, according to the small hotel managers, the guests do not still search for hotels that implement environmental practices. On the other side, the interviewed managers believe that the use of these practices can generate a great competitive advantage in relation to their competitors. The information obtained by this present research will be able to contribute to establish a contemporary panorama in relation to the importance attributed by the managers concerning the use of environmental practices in small hotel enterprises in Natal/RN. In addition the correct use of this information can generate possibilities of major competitiveness in this segment

Análise da relação entre apego ao lugar, satisfação e fidelidade dos visitantes em destinos turísticos ambientais: um estudo em Fernando de Noronha/PE

The competition among tourist destinations environmental generates the emergent need to find different strategies to close down if the purpose of delight and retain their visitants. A customer satisfaction, loyalty and the development of attachment to place form a solid compound in search of promotion a tourist destination. This study presents the general objective analysis of the relationship between attachment to place, satisfaction and loyalty of visitors, in the archipelago of Fernando de Noronha / PE. Therefore, a model will be used as reference, where they will be analyzed various constructs related to attachment to place, satisfaction and loyalty, as well as the relations between them. The methodology used in the study consists of an exploratory, descriptive, where the sample is random and consists of individuals who visited Fernando de Noronha on a pre-defined period of ten days. Based on a sample table, we defined a quantitative equivalent of 246 questionnaires, which will be applied when the visitor leaves the destination, the departure lounge of airport. A proposal focuses on the possibility to get results able to understand the subjective and intriguing relationship that involves the triad attachment to place, satisfaction and loyalty, trying to thus provide subsidies for optimizing environmental tourist destination

Estudo imuno-histoquímico da presença de miofibroblastos e da expressão do fator transformador de crescimento-beta1, interferon gama, metaloproteinase de matriz 13 e indutor de metaloproteinases de matriz em lesões odontogênicas epiteliais

Myofibroblasts are cells that exhibit a hybrid phenotype, sharing the morphological characteristics of fibroblasts and smooth muscle cells, which is acquired during a process called differentiation. These cells then start to express -SMA, a marker that can be used for their identification. Studies suggest that myofibroblasts are related to the aggressiveness of different tumors and that TGF-1 and IFN- play a role in myofibroblast differentiation, stimulating or inhibiting this differentiation, respectively. The objective of this study was to investigate the role of myofibroblasts in epithelial odontogenic tumors, correlating the presence of these cells with the aggressiveness of the tumor. Immunohistochemistry was used to evaluate the expression of TGF-1 and IFN- in myofibroblast differentiation, as well as the expression of MMP-13, which is activated by myofibroblasts, and of EMMPRIN (extracellular matrix metalloproteinase inducer) as a precursor of this MMP. The sample consisted of 20 solid ameloblastomas, 10 unicystic ameloblastomas, 20 odontogenic keratocysts, and 20 adenomatoid odontogenic tumors. For evaluation of myofibroblasts, anti- -SMA-immunoreactive cells were quantified in connective tissue close to the epithelium. Immunoexpression of TGF-1, IFN-, MMP-13 and EMMPRIN was evaluated in the epithelial and connective tissue components, attributing scores of 0 to 4. The results showed a higher concentration of myofibroblasts in solid ameloblastomas (mean of 30.55), followed by odontogenic keratocysts (22.50), unicystic ameloblastomas (20.80), and adenomatoid odontogenic tumors (19.15) (p=0.001). No significant correlation between TGF-1 and IFN- was observed during the process of myofibroblast differentiation. There was also no correlation between the quantity of myofibroblasts and MMP-13 expression. Significant correlations were found between MMP-13 and TGF-1 (r=0.087; p=0.011), between MMP- 13 and IFN- (r=0.348; p=0.003), as well as between EMMPRIN and MMP-13 (r=0.474; p<0.001) and between EMMPRIN and IFN- (r=0.393; p=0.001). The higher quantity of myofibroblasts observed in solid ameloblastomas, odontogenic keratocysts and unicystic ameloblastomas suggests that these cells are one of the factors responsible for the more aggressive biological behavior of these tumors, although the myofibroblast population was not correlated with TGF-1, IFN-, MMP-13 or EMMPRIN. The correlation between MMP- 13 and TGF-1 suggests that the latter induces the expression of this metalloproteinase. The present results also support the well-established role of EMMPRIN as an inducer of MMP-13. Furthermore, the relationship between EMMPRIN and IFN- and between MMP-13 and IFN- suggests synergism in the antifibrotic effect of these markers

Estudo comparativo de abordagens de inversão do fator de qualidade Q

Seismic wave dispersion and attenuation studies have become an important tool for lithology and fluid discrimination in hydrocarbon reservoirs. The processes associated to attenuation are complex and are encapsulated in a single quantitative description called quality factor (Q). The present dissertation has the objective of comparing different approaches of Q determination and is divided in two parts. Firstly, we made performance and robustness tests of three different approaches for Q determination in the frequency domain. They are: peak shift, centroid shift and spectral ratio. All these tests were performed in a three-layered model. In the suite of tests performed here, we varied the thickness, Q and inclination of the layers for propagation pulses with central frequency of 30, 40 and 60 Hz. We found that the centroid shift method is produces robust results for the entire suíte of tests. Secondly, we inverted for Q values using the peak and centroid shift methods using an sequential grid search algorithm. In this case, centroid shift method also produced more robust results than the peak shift method, despite being of slower convergence

Desenvolvimento territorial e a política nacional de água em Moçambique: o caso do distrito de Chibuto

The development has been a phenomenon in constant discussion today, whose fundamental importance should be to promote the welfare of humanity. Thus, the development becomes an element that adds political, economic, social and environmental values . In Mozambique the development model adopted by the State prioritizes the economic dimension, in this case favoring the growth of capitalist structure production. Thus , the basic conditions for human survival still leaves much to be desired and the Mozambican population in general and the district of Chibuto , in particular , continue to face several difficulties to have access to such conditions, and the lack of potable water is a that most of the problems afflicting this population . The water was always a factor related to the socio-economic development of the population, where great civilizations and major economic marks were always influenced by water availability, and today this feature is present in all sectors of production. In Mozambique, much effort has been made by the government, national and international organizations to enhance and guarantee the supply of potable and drinking water, and despite all this effort, most of the population does not have access to this precious resource. In this sense, this work presents an analysis of the effects of the National Water Policy in the study area, analyzes the shortage of potable water in the district of Chibuto, discusses the design and development contained in the official discourse of the state and, opposes the idea of human development. For such issues that help to understand the phenomenon under study, such as territory, public policy and criticism of hegemonic conception of development are addressed. To make the desired approach, we performed a characterization of the District of Chibuto, addressing the issue of poverty, with a brief discussion of this concept, from different approaches, and analyze the impact of the PARPA (Action Plan for the Reduction of Absolute Poverty) in fighting poverty in Mozambique, and became a description of the scenario of poverty and vulnerability in Chibuto district with the construction of Territorial Human Development Index. Research also brings up a discussion about territory and technicization which describes the senary of the water supply system in the District and territorial dynamics of Chibuto, from the analysis and description of existing structures and other technical objects that structure the territory under study. Thus, it was found that the development should be summarized in the satisfaction of human needs, and should be the cornerstone of the new type of development that is intended for the purpose of triggering urgently actions to overcome or combat bleak misery suffered by the majority of inhabitants of the District of Chibuto

A influência do conforto luminoso na satisfação dos profissionais que atuam no ginásio do Centro de Reabilitação Infantil, Natal-RN

This study addresses the environmental quality in therapeutic spaces for children's rehabilitation. The assumption that space is active and interfere in interpersonal relationships, highlights the importance of natural light to the hospital architecture, to foster the creation of environments that encourage and assist in the recovery of patients in the rehabilitation process. Therefore, interferes with health humanization through positive actions in the physiological and emotional effects of natural light, as facilitators of the health recovery process. In Brazil hospital openings systems projects are built exclusively to follow requirements of the local construction code which do not consider the landscape, but only ventilation and heat stroke; and the luminance levels are treated just as recommendations for artificial lighting. The National Policy for Healthcare Humanization presents the environmental comfort as a priority. However, it does not guidelines for achieving it. In this context this research aims to evaluate the lighting comfort in infant therapeutic areas from the professional satisfaction, in order to identify human preferences on the variables: technical and constructive aspects, relationship with the exterior, internal visual interface and quality elements. With this purpose it was adopted as research strategy the Post-Occupancy Evaluation (Technical Functional) through a multi method approach, which included a case study in the rehabilitation gym of Children Rehabilitation Center, at Natal, Rio Grande do Norte, and a reference study at SARAH Rehabilitation Center, Fortaleza Unit at Ceará, both in Brazil northeast. The results indicate that the definition of openings systems should consider external and internal factors to the building, as the natural landscape, the immediate surroundings and activities to be performed. The POE found out the preference of the professional visual privacy in detriment to other analyzed aspects. Thus, it is expected that this study can contribute to the discussion of luminous quality and generate inputs for future projects or renovations in the Children's Rehabilitation Centers, which should not be projected as hospitals

A simulação realística como estratégica de ensino-aprendizagem em enfermagem

The study aims to examine the methodology of realistic simulation as facilitator of the teaching-learning process in nursing, and is justified by the possibility to propose conditions that envisage improvements in the training process with a view to assess the impacts attributed to new teaching strategies and learning in the formative areas of health and nursing. Descriptive study with quantitative and qualitative approach, as action research, and focus on teaching from the realistic simulation of Nursing in Primary Care in an institution of public higher education. . The research was developed in the Comprehensive Care Health discipline II, this is offered in the third year of the course in order to prepare the nursing student to the stage of Primary Health Care The study population comprised 40 subjects: 37 students and 3 teachers of that discipline. Data collection was held from February to May 2014 and was performed by using questionnaires and semi structured interviews. To do so, we followed the following sequence: identification of the use of simulation in the discipline target of intervention; consultation with professors about the possibility of implementing the survey; investigation of the syllabus of discipline, objectives, skills and abilities; preparing the plan for the execution of the intervention; preparing the checklist for skills training; construction and execution of simulation scenarios and evaluation of scenarios. Quantitative data were analyzed using simple descriptive statistics, percentage, and qualitative data through collective subject discourse. A high fidelity simulation was inserted in the curriculum of the course of the research object, based on the use of standard patient. Three cases were created and executed. In the students’ view, the simulation contributed to the synthesis of the contents worked at Integral Health Care II discipline (100%), scoring between 8 and 10 (100%) to executed scenarios. In addition, the simulation has generated a considerable percentage of high expectations for the activities of the discipline (70.27%) and is also shown as a strategy for generating student satisfaction (97.30%). Of the 97.30% that claimed to be quite satisfied with the activities proposed by the academic discipline of Integral Health Care II, 94.59% of the sample indicated the simulation as a determinant factor for the allocation of such gratification. Regarding the students' perception about the strategy of simulation, the most prominent category was the possibility of prior experience of practice (23.91%). The nervousness was one of the most cited negative aspects from the experience in simulated scenarios (50.0%). The most representative positive point (63.89%) pervades the idea of approximation with the reality of Primary Care. In addition, professors of the discipline, totaling 3, were trained in the methodology of the simulation. The study highlighted the contribution of realistic simulation in the context of teaching and learning in nursing and highlighted this strategy while mechanism to generate expectation and satisfaction among undergraduate nursing students

Contribuições ao estudo de modelagem de equações estruturais na avaliação da satisfação do cliente de serviços de comunicações móveis

No mercado de telecomunicações as transformações tecnológicas das últimas décadas aliaram-se a um cenário formado por empresas de alta tecnologia que caracterizam o setor de comunicações móveis pessoais em todo mundo. Neste contexto, as empresas deste setor preocupam-se cada vez mais com a competitividade, oferta de serviços, área de atendimento, demanda reprimida e a lealdade do cliente. Estudos de comportamento do consumidor pesquisam a satisfação e lealdade de clientes como fatores básicos para relações bem sucedidas e duradouras com as empresas. A complexidade das relações entre variáveis na avaliação da satisfação do cliente em comunicações móveis pode ser adequadamente pesquisada com a utilização de métodos estatísticos multivariados. Essa tese analisou as relações causais envolvendo os antecedentes e consequentes associados à satisfação do cliente, no segmento de comunicações móveis, bem como desenvolveu e validou um modelo comportamental do cliente no uso deste serviço, buscando explicar as relações entre os construtos envolvidos: satisfação, qualidade dos serviços, valor percebido, imagem da marca, lealdade e reclamação. Foi estabelecida uma ampla base teórica para avaliar a importância estratégica do modelo que relaciona a influência na satisfação do serviço com as percepções dos clientes e avaliada a precisão deste modelo, por meio de uma análise comparativa a utilização de três métodos de estimação dos seus parâmetros, MLE, GLS, e ULS, com o emprego de modelagem de equações estruturais. Foram feitas aplicações em análises de dados, sendo testada e avaliada empiricamente, a influência do gênero na satisfação do cliente deste setor, além de uma segmentação de mercado utilizando mapas auto-organizáveis e a correspondente validação deste processo, com modelagem de equações estruturais.Os resultados do estudo empírico produziram uma boa qualidade de ajustamento para o modelo teórico proposto, com evidências do estabelecimento de uma adequada capacidade explicativa e preditiva, destacando-se a relevância da relação causal entre a satisfação e lealdade, em consonância com diversos estudos realizados para os mercados de comunicações móveis.

Avaliação da atenção humanizada ao abortamento em maternidade-escola, em Natal, Rio Grande do Norte

Unplanned pregnancy is experienced by millions of women worldwide. Such fact increases the risk of abortion-related morbimortality, which represents a serious public health problem. This study aims to evaluate the advances and challenges of the implementation of Humanized Abortion Care at the Maternity-School in Natal, state of Rio Grande do Norte. The research was evaluative, was preceded by an Evaluative Study, and resulted in a Case Study. The intentional sample totaled 102 subjects (60 users, 39 professionals and 3 managers). The collection techniques included documental analysis, semi-structured interview and observation with a field diary. The documental analysis was descriptive, while the Content Analysis by Bardin was used for semi-structured interviews and field diary. The Evaluative Study observed that Humanized Abortion Care is an evaluative program with preparation and pact of the logical model, of the matrix of indicators and evaluative questions. The Case Study showed that users were satisfied with the problem-solving capacity and access to the service; however, is also showed that they pointed out inadequacy in terms of environment, qualified hearing and reproductive planning. Professionals reported that the inefficiency of service consists of infrastructure and environment, which are considered inefficient and inadequate to humanized care, especially regarding patient accommodation, the lack of hospital beds, the reduced number of rooms in the surgical center and the lack of laboratory inside the maternity. Moreover, reproductive planning does not consist of an institutionalized practice in the service, and integrality with other services or partnership with the community is not in place. The Maternity Board emphasizes that the excessive demand of patients is one of the reasons that hinders the appropriate implementation of the technical standard. We then conclude that although satisfied regarding problem-solving capacity in terms of service and ease of access, there is room for improvement in qualified hearing systems, in the creation of a system to promote team work, implementation of ombudsman and satisfaction surveys. The right of shared choice did not prevail among users and health professionals with regard to the option of uterine evacuation procedure. Environment was the most mentioned category as that requiring more changes, seeing as a limited factor for the development of humanized and welcoming practices. Health professionals do not establish a periodic routine of planning practices, and such practices are not aligned with the Technical Standard. Incorporation of guidelines and availability of a plurality of methods and possibilities of choices for family planning are required. There is no institutionalization of reference and counter-reference, or partnerships with the community, which makes integrality of care not viable. The Standard needs to be included in the action plans of managers as one of the priorities in the construction of care strategies for women's health, in order to enable, allied to other initiatives, the real integration among safe conduct service, primary care network and social organizations. As a result, respect for human rights and adequate humanized care, as a way of attention and prevention of abortion, can be secured.

Satisfação e impacto da saúde oral na qualidade de vida em pacientes reabilitados com prótese total dupla

Introduction: The rehabilitation of edentulous patients is one of the main challenges of Dentistry. Objective: To assess the satisfaction and the impact of oral health on quality of life of patients rehabilitated with conventional complete dentures in both arcades. Method: A clinical trial with 25 patients rehabilitated with CCD was conducted. The impact of oral health in individuals quality of life was evaluated through the Brazilian version of the OHIP-Edent and the patient satisfaction was evaluated using a specific questionnaire. The instruments were applied before and 3 months after rehabilitation. Results: There was a statistically significant improvement (p <0.001) on the impact of the quality of life of the denture users after the new rehabilitation. The analysis of 4 OHIP domains also showed statistically significant improvement (p <0.001). The final overall satisfaction with the dentures was statistically superior to initial satisfaction (p <0.001). The analysis of the specific aspects of satisfaction with CCD after 3 months of rehabilitation also showed significant results in the improvement of every aspect. Conclusion: Patients disappointed with their dentures, have their quality of life improved after the new rehabilitation, reducing the negative impact of the prostheses on oral health, and improving their satisfaction with the rehabilitation.

Antecedentes do engajamento em boca a boca eletrônico positivo entre turistas

This study examined the influence of the tourism destination image as well as satisfaction and motivation in the intention of engaging in a positive electronic word of mouth (eWOM) by tourists through Facebook. In addition, it was also specifically expected to assess the sociodemographic profile and frequency of eWOM publications from those who answered the questions; it also assessed the adequacy of the manifested variables for composition of the following dimensions: Quality, Satisfaction, Image, Motivations and Positive Electronic Word of Mouth (eWOM). And finally, it analyzed a relational model where there are relationships between Quality, Satisfaction, Image and Motivations in the explanation of engagement in the Positive Electronic Word of Mouth (eWOM). With this aim it was conducted a study, based on a hypothetical-deductive logic, which was descriptive in relation to its goals. The analytical approach was quantitative (a survey). The sampling procedure was non-probabilistic, by the convenience method of sampling specifically, having the choice of the subject been made through the probabilistic systematic method, and using time as a factor of systematization in an attempt of making randomly the selection of the interviewed people. The study sample consisted of 355 tourists. The used instrument to collect information was the structured questionnaire whose answers were collected in the main points of entry, exit and rides of tourists on the Pipa’s Beach/RN. Data analysis was carried out using descriptive and multivariate statistics, mainly exploratory and confirmatory factor analysis and structural equation modeling. Among the main results, it was possible to confirm that the Motivations, Satisfaction and Image strongly affect the intention of engaging in positive electronic word of mouth (eWOM). Emphasis is given to the motivations, as they demonstrate bigger impact in explaining the dependent variable; they are followed by the satisfaction and the image. The latter, however, is inversely proportional. Among the motivations, the one with the highest percentage of variance were the social benefits sought by tourists; and presenting the same percentage appears the desire to help other tourists and to vent Positive Emotions. The manifested variables demonstrate to be fully acceptable to be taken as reflexes of their respective factors.

Análise estratégica das Instituições de Ensino Superior privadas da cidade do Natal

Private Higher Education Institutions are embedded in a market where competitiveness is a key factor. To remain competitive, HEIs needs to have proactive and innovative strategies, especially to understand their main customers, students, with regard to their expectations about the quality of HEI. This study is to evaluate the overall private institutions of higher education in the city of Natal / RN, as the strategies adopted to remain on the market , based on the perceived quality of students. For conduct this research, it has developed two private institutions in the city of Natal, through the application using exploratory research to guide the survey for data collection with questionnaire to apply the overview with students, being directed to senior students courses in Bussiness, Accounting and Law. This research tool addresses aspects relevant to map the dimensions: (1) teaching, perspectives related to methods and teaching tools; ( 2 ) teachers, specifies the quality attributes related to teachers; (3 ) Infrastructure, describes the environment of the HEI; ( 4 ) services , evaluates the quality processes that attach to the HEI; and ( 5 ) intangible relates aspects with student satisfaction. The results were analyzed using descriptive statistical techniques using the Statistical Package Tool for Social Sciences (SPSS). The first stage of results characterizes the descriptive analysis of the overall sample and by HEI and course, plus a build univariate analysis of the HEI and also bivariate analysis shows that correlation of the factors through Spearman correlation coefficient. The results were used to compose a matrix of importance versus performance that compare with the contents of the Ministry of Education and Culture (MEC). Finally, these comparisons allowed identification of the most important factors for the quality of the HEI and the level of performance from institutions in the development of each attributes of quality dimensions.

Um controlador dual subótimo com fator de peso variável no tempo

This work concerns a refinement of a suboptimal dual controller for discrete time systems with stochastic parameters. The dual property means that the control signal is chosen so that estimation of the model parameters and regulation of the output signals are optimally balanced. The control signal is computed in such a way so as to minimize the variance of output around a reference value one step further, with the addition of terms in the loss function. The idea is add simple terms depending on the covariance matrix of the parameter estimates two steps ahead. An algorithm is used for the adaptive adjustment of the adjustable parameter lambda, for each step of the way. The actual performance of the proposed controller is evaluated through a Monte Carlo simulations method.

Correlação da imunoexpressão do fator de choque térmico 1 (hsf1) com aspectos clinicopatológicos em carcinomas de células escamosas de língua oral

Squamous cell carcinoma of oral tongue shows high rates of morbidity and mortality in the population, therefore, great efforts are being made to classify morphological changes and identify biomarkers that have prognostic value and that are able to group patients in individualized therapeutic options. From this perspective, there is the heat shock factor 1 (HSF1), which is a heat shock factor transcription protein (HSPs) that allows the cancer to deal with stressors associated with malignancy, acting differently in tumor progression. This research aimed to perform a clinico-pathological analysis of 70 cases of oral tongue squamous cell carcinoma (OTSCC) and immunohistochemical study of the expression of HSF1 protein in OTSCC, comparing it with 30 specimens of normal oral mucosa (NOM), and correlating this immunostaining with clinico-pathological aspects of OTSCC. To analyze the association between immunoexpression of HSF1 and clinicophatoloical aspects, the cases were categorized in minor and major overexpression, based in the median immunostaining score. Regarding the cases of OTSCC, 57.1% showed clinical stage III or IV, 82.9% were graded as high grade according to Bryne (1998) and 47.1% as high risk of malignancy according to Brandwein-Gensler et al., (2005). A disease free survival rate of 47.84% and overall survival rate of 68.20% was observed in the analyzed cases, and the high degree of malignancy according to Bryne’s system (1998) (p=0.05), tumor size T3 or T4 (p=0.04), local recurrence (p=0.02), and perineural invasion (p=0.02) determined negative impacts in survival time. We observed also a statistically significant result (p<0.01) when comparing the immunoreactivity of HSF1 between NOM and OTSCC. This significantly increased expression of HSF1 in cases of OTSCC suggests that this protein acts, indeed, in the pathogenesis of this disease. However, there were no statistically significant associations between this overexpression and the clinico-pathological parameters analyzed. This finding may reflect the influence of epigenetic events on HSF1 gene or a possible stability of this protein expression throughout disease progression.