Balanced scorecard como ferramenta de gestão aplicada a unidade hospitalar privada

In this study the objective is to implant Balanced Scorecard administration for the development of a Strategic Map, for the support of the electric outlet of decisions in the administration of operations of an unit of attendance doctor-hospitalar. The present work presents a case study developed at a private hospital in the State of Rio Grande do Norte. The collection of data was developed after the analysis of the revision of the literature, and he/she had as critical judgement of evaluation used by the following Unit. The work is concluded in the proposition of a strategic map that elevates the return on investment (financial perspective), in the item profitability and growth. In the search of the customer's satisfaction (customer's perspective), that is nothing else than it already exists inside of the Unit in study, just needing to be organized and aligned with the executive picture and the other collaborators. The requirements competitiveness, information, innovation and technology (perspective of the internal processes), they were indispensable to eliminate the re-work, waste and to improve the automation. It is finally, the investment and development of innovation mechanisms, they enlarge important competitive advantage in the processes for creation of value, through the ability, attitude and knowledge (perspective of the learning and growth). As one of the results of this study a strategic map was developed, looked for in Balanced Scorecard, for support in the electric outlet of decisions of the administration of operations of an Unit Doctor- Healthcare

Desenvolvimento, pobreza e meio ambiente no seridó potiguar: um estudo centrado nas micro-regiões do seridó oriental e ocidental

This research work intends to carry out a study focused on the dynamic between development, poverty reduction and conservation of natural resources. To consider this relationship to the region chosen was the micro-region of Eastern and Western Seridó in the state of Rio Grande do Norte. In recent years, several studies (Araújo, 2011; BASTOS, 2009) have pointed out that after a period of economic crisis in its tripodproductive, formed by the activities of farming, cotton farming, mining and faced in the eighties, this region of the State of Rio Grande do Norte, has not only shown signs of economic recovery but also improve their social indicators. On the other hand, studies of desertification as the view of the state of RN (produced in cooperation between the Government of RN and research institutions) and the Sustainable Development Plan of Seridó (ADES, 2000), indicate that there is an ongoing French process of degradation of natural resources that is capable of compromising the ability of sustaining such a system. To verify this reality and likely finding this relationship, this work is adopted for this study, the analysis of evolution of secondary data from official bodies such as the IBGE on HDI, per capita income and other social indicators between 2000 and 2009. Here is another time of the survey analysis of qualitative data collected from interviews with institutions of academic intervention in nature, researchers at the Federal University of Rio Grande do Norte (UFRN) State agencies that address the issue of the Middle Environment in Seridó: Institute for Sustainable Development of the NB (IDEMA) and the Brazilian Institute of Environment and the Amazon (IBAMA) and institutions of direct intervention in the region, as the Agency's Sustainable Development Seridó (adhesive) and the Joint Semi-Arid (ASA). After crossing data from quantitative and qualitative, it was found that the dynamics of the region's economic Seridó Potiguar partially answers the improvement of social indicators of poverty. Contribution by the State in this shared stock transfer income. Regarding the influence of productive restructuring in the region on issues of environment, it is noted that the ceramic tile industry, responsible for the absorption percentage of the population with limited ingress into the urban economy, given the low education, accounts for the increase of susceptibility to the ongoing process of desertification in North Seridó Rio Grande. We conclude finally that the guarantee of increased income, freedom and conservation of natural resources ensures primarily by changing the beliefs and values, especially on the part of the business sector, which use natural resources so predatory, aimed at maintaining their rates of return on investment. And concomitantly, the synchronization between technological change, through the use of new energy sources, and institutional change.

Integração da simulação termoenergética com o processo de projeto: a análise de 6 casos

This work consists of the integrated design process analyses with thermal energetic simulation during the early design stages, based on six practical cases. It aims to schematize the integration process, identifying the thermal energetic analyses contributions at each design phase and identifying the highest impact parameters on building performance. The simulations were run in the DesignBuilder energy tool, which has the same EnergyPlus engine, validated. This tool was chosen due to the flexible and user friendly graphic interface for modeling and output assessment, including the parametric simulation to compare design alternatives. The six case studies energy tools are three architectural and three retrofit projects, and the author the simulations as a consultant or as a designer. The case studies were selected based on the commitment of the designers in order to achieve performance goals, and their availability to share the process since the early pre-design analyses, allowing schematizing the whole process, and supporting the design decisions with quantifications, including energy targets. The thermoenergetic performance analyses integration is feasible since the early stages, except when only a short time is available to run the simulations. The simulation contributions are more important during the sketch and detail phases. The predesign phase can be assisted by means of reliable bioclimatic guidelines. It was verified that every case study had two dominant design variables on the general performance. These variables differ according the building characteristics and always coincide with the local bioclimatic strategies. The adaptation of alternatives to the design increases as earlier it occurs. The use of simulation is very useful: to prove and convince the architects; to quantify the cost benefits and payback period to the retrofit designer; and to the simulator confirm the desirable result and report the performance to the client

Análise de confiabilidade de uma bomba centrífuga: aplicação na injeção de água para recuperação de petróleo

The oil industry`s need to produce with maximum efficiency, not to mention the safety and the environment aspects, encourages the optimization of processes. It makes them look for a level of excellence in acquisition of equipment, ensuring the quality without prejudice security of facilities and peoples. Knowing the reliability of equipment and that this stands for a system is fundamental to the production strategy to seeks the maximum return on investment. The reliability analysis techniques have been increasingly applied in the industry as strategy for predicting failures likelihood ensuring the integrity of processes. Some reliability theories underlie the decisions to use stochastic calculations to estimate equipment failure. This dissertation proposes two techniques associating qualitative (through expertise opinion) and quantitative data (European North Sea oil companies fault database, Ored) applied on centrifugal pump to water injection system for secondary oil recovery on two scenarios. The data were processed in reliability commercial software. As a result of hybridization, it was possible to determine the pump life cycle and what impact on production if it fails. The technique guides the best maintenance policy - important tool for strategic decisions on asset management.

Desmame em recém-nascidos de muito baixo peso ao nascer no primeiro retorno ambulatorial após a alta hospitalar

Investigate intrahospital and neonatal determinants associated to the weaning of very low birth weight (VLBW) infants. Methods: 119 VLBW (<1500g) infants 81 were monitored from July 2005 through August 2006, from birth to the first ambulatory visit after maternity discharge. This maternity unit uses the Kangaroo Method and the Baby Friendly Hospital Initiative. Results: Out of 119 VLBW infants monitored until discharge, 88 (75%) returned to the facility, 22 (25%) were on exclusive breastfeeding (EB) and 66 (75%) were weaned (partial breastfeeding or formula feeding). Univariate analysis found an association between weaning and lower birth weight, longer stays in the NICU and longer hospitalization times, in addition to more prolonged enteral feeding and birth weight recovery period. Logistic regression showed length of NICU stay as being the main determinant of weaning. Conclusion: The negative repercussion on EB of an extended stay in the NICU is a significant challenge for health professionals to provide more adequate nutrition to VLBW infants

Histórias e relatos sobre Pipa: a praia internacional do Rio Grande do Norte

The overwhelming gear that boosted tourism as the main economic activity of Pipa a district formerly agricultural and fishery, that belongs to the municipality of Tibau do Sul/RN produced significant changes in the social, economic and cultural rights of the native population of the place where social relations were narrow and justified in some cases, the line of kinship in an environment where all residents knew each other. However, we can not observe the emergence of this activity just as voracious disarticulator of old local forms of sociability that in a linear process, destroys the old, replacing it with the new. New compositions are generated by merging elements of past and present. Overcoming opposition to simplistic positive or negative impacts of tourism sought especially in this dissertation, review the history of Pipa (told in narrative form), showing how slowly this district has become a major international tourist destination and how its residents were being swallowed by the "whirlwind" that led to this reality. The research used qualitative methodology and was based on photographic, literature and survey, observation, experience, oral and written reports acquired in the field. We conducted in-depth interviews (oral history) with subjects that are the living memory of the place local residents (mostly natives). We found that before the process of "modernization" resulting from the pressure of globalization itself and the capital investment in tourism resulting from the native population is not passive. On the contrary, natives resist, creating mechanisms of material and symbolic reformulations. The present moment is always dynamic. Because of that, the identity of a place is not the crystallization of its past. Many landscapes still reveal materialities of yesteryear, such as registration of social practices in the construction of the place

Modelo de covariância bayesiana para seleção de protfólios de investimentos

The portfolio theory is a field of study devoted to investigate the decision-making by investors of resources. The purpose of this process is to reduce risk through diversification and thus guarantee a return. Nevertheless, the classical Mean-Variance has been criticized regarding its parameters and it is observed that the use of variance and covariance has sensitivity to the market and parameter estimation. In order to reduce the estimation errors, the Bayesian models have more flexibility in modeling, capable of insert quantitative and qualitative parameters about the behavior of the market as a way of reducing errors. Observing this, the present study aimed to formulate a new matrix model using Bayesian inference as a way to replace the covariance in the MV model, called MCB - Covariance Bayesian model. To evaluate the model, some hypotheses were analyzed using the method ex post facto and sensitivity analysis. The benchmarks used as reference were: (1) the classical Mean Variance, (2) the Bovespa index's market, and (3) in addition 94 investment funds. The returns earned during the period May 2002 to December 2009 demonstrated the superiority of MCB in relation to the classical model MV and the Bovespa Index, but taking a little more diversifiable risk that the MV. The robust analysis of the model, considering the time horizon, found returns near the Bovespa index, taking less risk than the market. Finally, in relation to the index of Mao, the model showed satisfactory, return and risk, especially in longer maturities. Some considerations were made, as well as suggestions for further work

Gestão ambiental na saúde pública: um estudo sobre a percepção ambiental em laboratórios de análises clínicas

This objective of this work was to investigate the enviromental perception of technician of clinical laboratories, in the city of the Natal/RN, focusing the generated environmental aspects and impacts in the activities, the strategical importance of the environmental management for the activity, as well as the knowledge about environmental norms and resolutions applied to the sector. A type survey exploratory and descriptive was carried through, using a questionnaire applied in 82 clinical laboratory, getting a return tax of 53,65%, or either, 44 laboratories. The results of the descriptive analyses point with respect to environmental conscience of the interviewed, therefore the majority (75%) described the activities of clinical analyses as great imapact on the environment. Although the interviewed present certain knowledge on the advantages of practical of envivonmental protection and the risks that the activities of clinical analyses offer, some important practical of environmental protection arer not develped by the majority of the iterviewed. The carried through statistical analyses had allowed to investigate the level of environmental knowledge of the professionals of the sector, being consisted themselves that they present little knowledge on practical ISO 14001 and of environmental protection in the health public sector. It can be conclude that, a program of environmental qualification for the sector becomes necessary, in order to improve the knowledge of the professionals of the area, and that the majority of the professionals would have a good recptivity therefore recognize the benefits of the practicadl of environmental protection for the competitiveness of the clinical analyses laboratories

Estratégias para ajuste do ciclo vigília-sono de adolescentes aos horários escolares matutinos: a educação sobre o sono e a exposição a luz solar

In adolescents, who tend to sleep and wake-up later, the school schedule in the morning is associated with sleep advancement and shortening besides bedtime and wake-up time irregularity between week and weekend days. As a result, there is an increase in daytime sleepiness and a drop in cognitive performance that interfer in students performance in classroom. These consequences reinforce the need to evaluate alternatives that help the adolescent to adapt their sleep needs to the time of start of classes in the morning. Accordingly, the general aim of this study was to evaluate the effects of a sleep program education and sunlight exposure in early morning on sleep-wake cycle (SWC) and daytime sleepiness of adolescents. The students chronotype were evaluated by the Horne-Ostberg questionnaire and the health and usual sleep habits by "the health and the sleep questionnaire. The SWC patterns were assessed by sleep log, the daytime sleepiness by Karolinska Sleepiness Scale (KSS) and the alertness by the Psychomotor Vigilance Test (PVT). These parameters were compared before and after a sleep education program and before and during the sunlight exposure. The sleep program was effective in increasing sleep knowledge of adolescents, in promoting a reduction of bedtime and wake-up time irregularity and increasing the sleep duration in school days. The sunlight exposure effect was evaluated in the return to classes after vacation due to the difference in sleep patterns between school and vacation days. During the intervention week it was observed an advance of sleep schedules, an increase on sleep duration and alertness at the end of the morning. Assessed separately, sleep education and sunlight exposure should contribute to minimize adolescents partial sleep deprivation, but daytime sleepiness effect must be better investigated. These strategies should be used jointly by school members to improve health and performance of their students

O papel das rotas e da obtenção de informações sobre a eficiência no forrageio de dinoponera quadriceps em ambiente natural

In this study, we investigated the role of routes and information attainment for the queenless ant species Dinoponera quadriceps foraging efficiency. Two queenless ant colonies were observed in an area of Atlantic secondary Forest at the FLONA-ICMBio of Nisia Floresta, in the state of Rio Grande do Norte, northeastern Brazil, at least once a week. In the first stage of the study, we observed the workers, from leaving until returning to the colony. In the second stage, we introduced a acrylic plate (100 x 30 x 0,8 cm) on a selected entrance of the nest early in the morning before the ants left the nest. All behavioral recordings were done through focal time and all occurence samplings. The recording windows were of 15 minutes with 1 minute interval, and 5 minute intervals between each observation window. Foraging was the main activity when the workers were outside the nest. There was a positive correlation between time outside the nest and distance travelled by the ants. These variables influenced the proportion of resource that was taken to the nest, that is, the bigger its proportion, the longer the time outside and distance travelled during the search. That proportion also influenced the time the worker remained in the nest before a new trip, the bigger the proportion of the item, the shorter was the time in the nest. During all the study, workers showed fidelity to the route and to the sectors in the home range, even when the screen was in the ant´s way, once they deviated and kept the route. The features of foraging concerning time, distance, route and flexibility to go astray by the workers indicate that decisions are made by each individual and are optimal in terms of a cost-benefit relation. The strategy chosen by queenless ants fits the central place foraging and marginal value theorem theories and demonstrate its flexibility to new informations. This indicates that the workers can learn new environmental landmarks to guide their routes

Análise comparativa na influência da técnica de moldagem funcional em arcos parcialmente edêntulos sobre os pontos de contato oclusais, a integridade da fibromucosa e a extensão da base da prótese

There is a lack of clinical studies evaluating techniques of functional impression for partially edentulous arches. The aim of this double-blind non-randomized controlled clinical trial was to compare the efficacy of altered cast impression (ACI) and direct functional impression (DFI) techniques. The efficacy was evaluated regarding the number of occlusal units on denture teeth, mucosa integrity at 24-hour follow-up and denture base extension. The sample included 51 patients (female and male) with mean age of 58.96 years treated at Dental Department of UFRN. The patients, exhibiting edentulous maxilla and mandibular Kennedy class I, were divided into two groups (group ACI, n=29; group DFI, n=22). Clinical evaluation was based on the number of occlusal units on natural and/or artificial teeth, mucosa integrity at 24-hour follow-up, and denture base extension. Statistical analysis was conducted using the software SPSS 17.0® (SPSS Inc., Chicago, Illinois). Student T-test was used to reveal association between number of occlusal units and impression technique while chi-square test showed association between mucosa integrity and impression technique. Fischer s exact test was applied for association between denture base extension and impression technique at 95% level of significance. No significant difference was observed between the groups regarding number of occlusal units, mucosa integrity and denture base extension. The altered cast technique did not provide significant improvement in comparison to the direct technique when the number of occlusal units, mucosa integrity and denture base extension

Influencia do turismo sobre a atividade pesqueira do município de Tibal do Sul-RN

A área da pesquisa localiza-se no município de Tibau do Sul, situado na costa leste do Estado do Rio Grande do Norte, a 80 km ao Sul da capital Natal. O turismo, a pesca esportiva e instalação de empreendimentos vêm aumentando nessa área litorânea, disputando espaços com pescadores artesanais. A dissertação teve como objetivo identificar e analisar os conflitos socioeconômicos e ambientais entre a atividade pesqueira e a atividade turística no Município de Tibau do Sul, para subsidiar órgãos governamentais e entidades ligadas ao setor pesqueiro, com futuras políticas de incentivo e desenvolvimento sustentável local. O presente trabalho está dividido em introdução e dois capítulos. A introdução apresenta proposta e justificativa da pesquisa, com fundamentação teórica, em seguida são apresentados os procedimentos metodológicos. O primeiro capítulo apresenta a caracterização da pesca artesanal e o perfil socioeconômico dos pescadores de Tibau do Sul, identificando os conflitos entre a atividade pesqueira e o turismo. Para alcançar esse propósito, foram realizados levantamentos qualitativos e quantitativos, através da efetivação de 100 entrevistas com questionários semiestruturados, os quais foram aplicados a quatro comunidades pesqueiras. Os resultados constataram a real situação da pesca artesanal local e foram identificados vários conflitos, dentre eles: a falta de investimento no setor, baixo desenvolvimento tecnológico e de infraestrutura, além da ocupação desordenada em área de desembarque da produção. Todos esses fatores têm contribuído para o declínio da atividade pesqueira nesse município. O segundo capítulo apresenta uma análise territorial a partir da elaboração do mapa de ocupação do solo utilizando a metodologia de geoprocessamento. Constatou-se que a ocupação desordenada ocorreu principalmente depois da chegada dos turistas em Tibau do Sul e está concentrada principalmente na praia de Pipa, observou-se também que os empreendimentos construídos na área de estudo interferem no acesso público as praias e área de desembarque da produção dos pescadores. Espera-se que este estudo contribua para elaboração do plano de manejo nas comunidades pesqueiras e possa subsidiar os gestores na implementação de políticas públicas voltadas para o desenvolvimento sustentável local

Elaboração de pós de ferrita de cobalto, CoFe2O4, nanoestruturados e hierarquizados: influência da morfologia sobre a detecção e oxidação catalítica de gases poluentes

This thesis is part of research on new materials for catalysis and gas sensors more active, sensitive, selective. The aim of this thesis was to develop and characterize cobalt ferrite in different morphologies, in order to study their influence on the electrical response and the catalytic activity, and to hierarchize these grains for greater diffusivity of gas in the material. The powders were produced via hydrothermal and solvothermal, and were characterized by thermogravimetric analysis, X-ray diffraction, scanning electron microscopy, transmission electron microscopy (electron diffraction, highresolution simulations), and energy dispersive spectroscopy. The catalytic and electrical properties were tested in the presence of CO and NO2 gases, the latter in different concentrations (1-100 ppm) and at different temperatures (room temperature to 350 ° C). Nanooctahedra with an average size of 20 nm were obtained by hydrothermal route. It has been determined that the shape of the grains is mainly linked to the nature of the precipitating agent and the presence of OH ions in the reaction medium. By solvothermal method CoFe2O4 spherical powders were prepared with grain size of 8 and 20 nm. CoFe2O4 powders exhibit a strong response to small amounts of NO2 (10 ppm to 200 ° C). The nanooctahedra have greater sensitivity than the spherical grains of the same size, and have smaller response time and shorter recovery times. These results were confirmed by modeling the kinetics of response and recovery of the sensor. Initial tests of catalytic activity in the oxidation of CO between temperatures of 100 °C and 350 °C show that the size effect is predominant in relation the effect of the form with respect to the conversion of the reaction. The morphology of the grains influence the rate of reaction. A higher reaction rate is obtained in the presence of nanooctahedra. In order to improve the detection and catalytic properties of the material, we have developed a methodology for hierarchizing grains which involves the use of carbonbased templates.

A produção científica de psicologia e o debate sobre política social

Postgraduate studies in Psychology have passed through intense process of growth and consolidation, attested by current high levels of scientific production. It is questionable, however, the return that psychological science has given to a society that has made large investments. Considering the increasing integration of Psychology in the social welfare area, a form of possible and necessary contribution is by the expansion of social policy debate. This work aimed to discuss how Psychology postgraduate studies can contribute to understand the issue of social policy. The object were academic theses defended in the 2007/2009 triennium related to one of the five thematic criteria, which resulted in 105 theses of 824 defended in the period. The main results point to the existence of the issue in Psychology programs in a sprayed way, predominantly, albeit for a limited set of researchers and programs, "social policy" appears as a priority object of research, indicating incipient systematization of these studies. Moreover, it was found that while the majority of theses can be characterized by fragility of the theoretical frameworks in relation to the subject, with most research in a strictly technical perspective, some proportion of the studies reveals concern about putting the social policy debate into a broader social context, which represents the essential condition to construct a reasoned and robust theoretical critic. In conclusion, this thesis defends that psychological science can only contribute effectively to the society development if academic community promotes a structured articulation around the theme, deepens the theoretical debate and transforms the knowledge built into organized political practice

Conhecimento de si e unidade: considerações sobre a alma em Plotino

L'obiettivo di questa tesi è quello di sviluppare una analisi dell'idea dell'immortalità dell'anima dalle Enneadi di Plotino attraverso la comprensione del discorso dell'anima come eterno, e unità-pluralità ricerca di semplicità con la Uno sulla temporalità del corpo multiple. Per fare ciò, abbiamo iniziato cercando di analizzare brevemente le plotinianas ipostasi (l'Uno, lo spirito e l'anima) per stabilire meglio le basi del pensiero di Plotino quando si discute l'idea dell'anima e la sua immortalità. Cerchiamo di esaminare il pensiero epistéme di Plotino e la sua dialettica, al fine di sviluppare una comprensione del rapporto tra materia e forma sensibile e intelligibile. In questo modo, si sviluppa nelle Enneadi di Plotino il ruolo fondamentale del Logos e il Logoi nella formazione dell'anima. Analizziamo anche la processione (Proódos) e ritorno (Epistrophé) le implicazioni degli aspetti dell'eternità sulla purificazione dell'anima nella temporalità del corpo. Cerchiamo in ultima analisi, l'idea dell'immortalità dell'anima dalla conoscenza stessa immortalità sulla semplicità di Colui, cioè, l'ultima volta che la ricerca della conoscenza di sé dalla dimenticanza di sé per è solo con l'Uno: il "Elimina ogni cosa" (Aphele pánta).