Linking customer satisfaction, quality, and strategic planning

By acknowledging and dissecting the interconnected roles of customer satisfaction, quality, and strategic planning, this paper provides an analytical framework for creating a customer-driven organization and culture. It shows how quality starts and ends with the customer. Companies that are achieving long-term continuous improvement in quality tailored to customer satisfaction possess lasting characteristics such as customer orientation, customer consciousness, and customer responsiveness. In doing so, they liberate the quality concept from the narrow product or service focus to encompass total conformance to customer requirements in spite of the existing functionalization and departmentalization of modern complex structures. In addition to these key components, a customer-driven organization demands building and nurturing a customer satisfaction culture and value system that makes quality improvement and heightened concern for customer satisfaction a permanent aspect of organizational life.

Competências relevantes para a efetividade do processo decisório em defesa aérea

Este artigo investiga o impacto das competências consideradas essenciais para o desempenho das atividades de defesa aérea sobre a efetividade do processo decisório. Como principais referenciais teóricos, foram utilizados os estudos de Simon (1970; 1987) sobre o processo decisório e o modelo de competências por setor de Gramigna (2002). Na pesquisa de campo, utilizou-se a triangulação de dados: entrevistas, análise documental, observações e questionário, por meio do qual levantou-se a percepção dos profissionais que desempenham as funções em estudo. Os dados foram analisados através de análise fatorial exploratória e análise de regressão linear múltipla. Os resultados da pesquisa realizada para este artigo contribuem para o estabelecimento de programas voltados ao desenvolvimento de competências individuais específicas, com impacto direto nas competências essenciais da organização. Os achados deste artigo servem também aos gestores militares como subsídio para decisões relativas à alocação de pessoal e formação de equipes, visando distribuir de forma mais racional os indivíduos, aliando suas competências aos interesses organizacionais, tal seja, alinhando as práticas de gestão de pessoas à estratégia organizacional.

Higher education of tourism in Spain and its adaptation to the European higher education area

The international tourism system has deeply undergone structural changes in the last decades which not remain outside the subsystem higher education in tourism, especially in the European case. This article has two objectives: firstly, describes the European higher education area and the objectives, skills and subjects taught in the main Spanish universities that offer higher education in tourism. On the other hand, in the light of knowledge that researchers' descriptive models, provide experience of the implementation of European credit and thorough a deeply review of the literature on the topic higher education in tourism, to propose strategies that will enable other tourism higher education systems approach to the European reality. These policy proposals are aimed at agents and elements from higher education in tourism subsystem and they specifically include: the institutions providing education in tourism, the curriculum, the teaching methods, teachers and students.

Enterprise Resource Planning governamental: a percepção dos servidores atuantes no Projeto Ciclo do Ministério da Justiça quanto à implementação

Indubitavelmente, a implementação de sistemas de gestão integrada é fator consolidado em empresas privadas; no entanto, em empresas públicas é relativamente recente e inovadora. Em 2009, o Ministério da Justiça (MJ) foi um dos pioneiros ao firmar parceria com a Universidade Federal do Rio Grande do Norte (UFRN) para a implantação de sistemas de gestão integrada. Com o decorrer dos processos de implementação surge a necessidade de identificar se o acordo surtiu os efeitos a que se destinou, bem como é pertinente a análise da implementação de um Enterprise Resource Planning (ERP) governamental em uma empresa pública, haja vista que existe uma tendência de que se repita em outras instituições governamentais. Assim, o principal objetivo deste artigo é identificar a percepção dos usuários quanto ao processo de implementação de sistemas integrados de gestão vinculados ao Projeto Ciclo, no âmbito da Secretaria Executiva do MJ, destacando suas principais dificuldades e benefícios. A fim de atingir o objetivo da pesquisa foi realizada uma pesquisa quali-quantitativa, cujo procedimento técnico foi o estudo de caso. Verificou-se que os usuários do sistema reconhecem sua importância como apoio à tomada de decisão, que estão cientes do papel que desempenham no processo de implementação e que a tecnologia da informação (TI) é fundamental para se obter melhoria nos processos executados. Ademais, percebe-se os avanços que um ERP governamental pode proporcionar a empresas públicas, destacando-se o planejamento e a confiabilidade das informações.

An appraisal of the health planning method proposed by the Pan-American Health Organization for Latin America

A brief description of the main features of the health planning technique developed by the "Centro de Estudios del Desarrollo" (CENDES) in Venezuela, and proposed by the Pan-American Health Organization for use in Latin America, is presented. This presentation is followed by an appraisal of the planning method which includes comments both upon its positive aspects and upon its negative points. Comments are also made referring to other recent publications of the WHO/PAHO on health planning. In conclusion, the CENDES technique is considered a health planning method of great potential for use especially in underdeveloped areas, the success of its application depending upon the hability of the health planners to introduce the necessary modifications to adapt to the local circunstamces.

Notes on health care planning in Latin America and the Caribbean

Attention is called to the fact that the efforts to improve health of populations in Latin America have generally failed. The inequality in the distribution of ill-health is great. The authors accept the fact that the lack of resources available to the health sector may be a restriction towards the improvement of the situation, but they argue that a much more important issue is the misuse of such resources and their maldistribution within the health sector. The lack of integration and coordination between the health services, the conflict of public and private health systems, the under-utilization of existing services and the gap between planning and real implementation are discussed.

Health education: the role and functions of the specialist and the generalist

Education for health is a process in which all public health and medical care personnel are involved. People learn both formally (planned learning experiences) and informally (unplanned learning experiences). Since the patient, the client, the consummer and the community expect public health and medical care personnel to assist them with health and disease issues and problems, the response of the professional "educates" the customer whether the professional intends to educate or not. Therefore, it is incumbent on all public health and medical care professionals to understand their educational functions and their role in health education. It is also important that the role of the specialist in education be clear. The specialist, as to all other specialists, has an in-depth knowledge of his area of expertise, i.e., the teaching/learning process; s/he may function as a consultant to others to enhance the educational potential of their role or s/he may work with a team or with communities or groups of patients. Specific competencies and knowledge are required of the health education specialist; and there is a body of learning and social change theory which provides a frame of reference for planning, implementing and evaluating educational programs. Working with others to enhance their potential to learn and to make informed decisions about health/disease issues is the hallmark of the health education specialist.

Chagas' disease and social security: a case-control study in an urban area, Goiás, Brazil

One hundred and twenty subjects with Chagas' cardiopathy and 120 non-infected subjects were randomly selected from first time claimants of sickness benefits in the National Institute of Social Security (INPS) in Goiás. Cases of Chagas' cardiopathy were defined based on serological test, history of residence in an endemic area and, clinical and/or electrocardiogram (ECG) alterations suggestive of Chagas' cardiomyopathy. Controls were defined as subjects with at least two negative serological tests. Case and controls were compared in the analysis for age, sex, place of birth, migration history, socio-economic level, occupation, physical exertion at work, age at affiliation and years of contribution to the social security scheme, clinical course of their disease and ECG abnormalities. Chagas' disease patients were younger than other subjects and predominantly of rural origin. Non-infected subjects presented a better socio-economic level, were performing more skilled activities and had less changes of job than cases. No important difference was observed in relation to age at affiliation to INPS. About 60% of cases have claimed for benefits within the first four years of contribution while among controls this proportion was 38.5%. Cases were involved, proportionally more than controls, in "heavy" activities. A risk of 2.3 (95%CL 1.5 - 4.6) and 1.8 (95%CL 1.2- 3.5) was obtained comparing respectively "heavy" and "moderate" physical activity against "light". A relative risk of 8.5 (95%CL 4.9 - 14.8) associated with the presence of cardiopathy was estimated comparing the initial sample of seropositive subjects and controls. A high relative risk was observed in relation to right bundle branch block (RR = 37.1 95%CL = 8.8 - 155.6) and left anterior hemiblock (RR = 4.4, 95%CL = 2.1 - 9.1).

An investigation into support for restrictions on HIV carriers in the Chicago metropolitan area

An investigation into support for restrictions on people testing seropositive for HIV is reported on. Data were collected during telephone interviews with two-hundred adults aged eighteen to sixty-five in the Chicago metropolitan area. Using the analytic technique of LISREL, six models which attempt to explain support for restrictions were tested. It was found that the model best supported by the data indicates that two groups contribute to support for restrictions on HIV carriers - one due to intolerance of homosexuality and one to mistrust of public health officials regarding their control and management of the AIDS epidemic. The relevance of these findings for public health policy makers is discussed.

Populations of larvae of Anopheles spp. in natural breeding sites in Western Venezuela, an area of refractory malaria

Studies have been un dertaken into on the diversity and relative abundance of larvae of Anopheles (Nyssorhynchus) spp. in 22 permanent or temporary pools in an area of 70 km² in the eastern piedmont of the Venezuela Andes, between the mountains and the plains, an area in which malaria is refractory and A. nuñeztovari is present. Twelve species were identified, the most frequent, abundant and sympatric being A. triannulatus, A. albitarsis, A. nuñeztovari, A. oswaldoi and A. strodei. The samples from the permanent pools showed greater diversity of species and greater numbers of larvae than the samples from the temporary pools. The existence of the same larval associations in pools of other localities in the eastern piedmont of the Venezuelan Andes suggests the possibility of the making an ecological map of the breeding sites of A. nuñeztovari and for these anophelines in a region extending for 430 km.

Physiological age in Lutzomyia youngi (Diptera: Psychodidae) populations from an endemic area for cutaneous leishmaniasis, Venezuela

Batches of sylvatic females of Lutzomyia youngi (Phlebotominae) captured in a Shannon trap on twelve occasions over one year in a locality where subcutaneous leishmaniasis is endemic, near the city of Trujillo, Venezuela, were used to study: 1) the percentages of parous females according to previously established criteria and 2) the average number of eggs laid spontaneously by isolated females during 7 days after feeding on hamsters. The data on the batches of females captured on nights previous to the rainy period (prepluvial) were compared with those on females captured after the rains (postpluvial) . Significant differences were detected by variation analysis for two variables and different number of N, as also were consistent groupings by Duncan's Test for pre-and postpluvial lots of females. The females captured on nights prior to the rainy periods (January-March and August-September) presented higher rates of nulliparity (86-72%) and contained or laid a greater number of eggs (71-67) than those captured after the rains (March-June and November-December) which presented lower rates of nulliparity (60-24%) and a smaller number of eggs (50-30). The rainfall peaks occurred in April and September-October, respectively. It is considered that these differences can be used by epidemiological studies as a means of estimating the physiological age of female populations of L. youngy.

Staphylococcal food poisoning from cream-filled cake in a metropolitan area of South-Eastern Brazil

Twelve people became ill with vomiting and diarrhoea approximately four hours after eating cake with a cream filling at a birthday party and on the day following. The cake had been prepared by a food handler who had long experience in preparing foods for such functions. Staphylococcus aureus that produced enterotoxin A was isolated from the nose, the fingernails, and a healed infection on the neck of the food handler, and from the cake. Enterotoxin A was detected in the remaining portion of the cake. The cake, while still warm, had been refrigerated for one hour after it was prepared before it was removed for the party; it was refrigerated after the party. The cake was large (6 kg) and hence it was not adequately cooled in the hour during wich it was refrigerated before the party. The conclusion is that the cake was accidentally contaminated by the food handler and inadequately cooled before it was eaten.

Mortality among patients with non-affective functional psychoses in a metropolitan area of South-Eastern Brazil

High mortality rates among those suffering from schizophrenia and related psychoses have been consistently described in developed societies. However, to date there is a lack of data on this matter in Brazil. In order to examine this issue, a prospective 2-year follow-up study was carried out in S. Paulo. The sample consisted of 120 consecutive admissions to psychiatric hospitals in a defined catchment area, aged 18 to 44 years old, with clinical diagnoses of non-affective functional psychoses according to the ICD-9. After 2 years, 116 (96.7%) subjects were traced. During the study period there were 7 deaths (6.0% of those traced), 5 (4.3%) due to suicide. All but one of the suicides occurred in the first year after discharge from hospital. Age and sex Standardised Mortality Ratios (relative to rates for the population of the city of Sao Paulo) were 8.4 for overall mortality (95% confidence interval: 4.0-15.9) and 317.9 for deaths due to suicide (95% confidence interval: 125.2-668.3). These results are in agreement with previous studies, and show that in Brazil non-affective functional psychoses are life-threatening illnesses, which need adequate care, particularly when patients go back to live in the community after hospital discharge.

Demographic profile and health conditions of the elderly in a community in an urban area of Southeastern Brazil

Some specific characteristics of the aging of the Brazilian population in different areas, states and communities all over the country, have shown significant variations. Historical series of demographic and health indicators for the population in their sixties and over in Brazil, state of S. Paulo and in the municipal district of Araraquara are listed as follows: level of education and urban population growth rate, income distribution, mortality rates and main causes of death. In 1991 the aged constituled were 7,8% of the Brazilian population and 9,7% in Araraquara community. The elderly population (of 70 years of aged and above) as a proportion of the whole, has increased and already stands for 40%. The same trend holds good for both the proportion of aged within the urban population and their level of education wich increased to 90% in 1991. The main causes of death are chronic degenerative diseases which have replaced the infectious illness: firts, the diseases of the circulatory sistem (which account for more than 40% of all deaths) and the neoplasms (which let to 15% of the deaths). On the basis of these health and demographic data relating to people of 60 years of age and over, this study suggests some procedures for the improvement of the quality of the assistance given to the target population: a) the assistance give to the aged should be improved by providing gerontological training for general physicians and nurses, both of public and private clinics; b) the already exixting educational activities for the aged, for health workers and for teachers of secundary education should be further developed; c) the number of day-hospitals should be increased for the purpose of avoiding unnecessary confinement so as maintain the low rate of institutionalization in homes for the elderly (0,7% in Araraquara). It is reported that at least 35% of the aged population in this area is entitled to private health assistance, wich brings out the importance of including such services in the local health programs for this group.