O desempenho da Maternidade da Santa Casa de Angra dos Reis face aos critérios de qualidade do Programa Nacional de Avaliação dos Serviços de Saúde - PNASS.

A Santa Casa de Angra dos Reis é uma Instituição Filantrópica inaugurada em 06 de janeiro de 1839. A Unidade passa por Intervenção Municipal, recomendada pelo Ministério Público, no intuito de garantir o restabelecimento adequado de seus serviços, a eficiência desejável e para resgatar a credibilidade e sustentabilidade do Hospital. Da motivação pelos projetos da nova gestão emergiu a necessidade de conhecer a situação do desempenho desta unidade hospitalar, em especial a Maternidade, ponto de partida do projeto. Este estudo é relevante para a institucionalização da avaliação da qualidade nesta Unidade Hospitalar, bem como condição primária para construção de planos de trabalho. O Programa Nacional de Avaliação dos Serviços de Saúde PNASS é uma proposta do Ministério da Saúde, e é visto como uma ferramenta de gestão para monitoramento e avaliação. O programa pode apontar diversas oportunidades de melhorias e auxiliar a tomada de decisão tornando-se adequado seu emprego no levantamento das informações necessárias para o conhecimento do cenário da Maternidade, como base para um futuro plano de ação. Este estudo tem por objetivo aplicar o programa de avaliação normativa proposto pelo PNASS na Maternidade da Santa Casa, a fim de identificar seu desempenho, como primeiro passo para a construção do plano estratégico de ação em busca do aprimoramento da qualidade em saúde neste setor. Como metodologia, é uma pesquisa quantitativa onde foram utilizados padrões de conformidade, questionários fechados direcionados aos usuários e trabalhadores da Maternidade, e análise de indicadores. Resultados: foram entrevistadas 35 mulheres e 47 profissionais de saúde, num total de 85% da amostra desejada; ficou evidente a necessidade de intervenção e implementação de mudanças na área de Gerenciamento de Risco; e melhorias quanto às condições de trabalho relacionadas à infraestrutura e equipamentos. Os indicadores de internação apontam a necessidade de revisão do número de leitos disponíveis; a taxa de parto cesáreo, 59%, é extremamente alta e muito acima do preconizados pela Organização Mundial de Saúde. Este estudo mostrou um resultado positivo quanto à satisfação das parturientes com o serviço prestado, embora existam áreas carentes de melhorias. Melhorias também são necessárias para o dimensionamento efetivo do quadro de profissionais para atendimento à demanda. A interrupção do lançamento de relatórios sobre atuais avaliações feitas pelo PNASS e a pouca divulgação do mesmo são questões levantadas por este estudo. Considera-se que a aplicação do PNASS na Maternidade da Santa Casa de Angra dos Reis proporcionou embasamento para a elaboração de uma oportuna matriz de intervenção.

Using strong sustainability to optimize electricity generation fuel mixes

This work represents a contribution to the field of sustainable electricity system design by using an optimization tool to specify the final mix composition, subject to the constraints of: emissions that are within the biocapacity of the region; a diverse and robust electricity supply system; and supply that at least meets current demand. The 25-country European Union (EU-25) is used as a case study. All the goals, save diversity, can be met by re-structuring the current fuel mix, thus maintaining current consumption levels. The diversity target is only met when consumption is reduced by 10-15% and the constraint on maximum material throughput is relaxed. Re-structuring the mix and reducing consumption is insufficient to achieve a sustainable EU carbon footprint. However, the solution proposed singlehandedly allows the EU to meet its Kyoto emissions target as well as its 2007 policy of a reduction of 20% in greenhouse gas emissions by 2020. © 2007 Elsevier Ltd. All rights reserved.

Tailored sustainability assessment for urban masterplanning

Tailored sustainability assessment represents one approach to addressing sustainability issues on large-scale urban projects with varying geographical, social and political constraints and diverse incentives among stakeholders. This paper examines the value and limitations of this approach. Three case studies of tailored systems developed by the authors for three unique masterplanning projects are discussed in terms of: contextual sustainability drivers; nature and evolution of systems developed; outcomes of implementation; and overall value delivered. Analysis Leads to conclusions on the key features of effective tailored assessment, the value of tailored sustainability assessment from various perspectives (including client, designer, end-users and the environment), and the limitations of tailored assessment as a tool for comparative analysis between projects. Although systems considered here are specific to individual projects and developed commercially, the challenges and lessons learned are relevant to a range of sustainability assessment approaches developed under different conditions.

Modular risk modeling and management of water infrastructure disaster incidents

Water supply and wastewater control are critical elements of society's infrastructure. The objective of this study will be to provide a generic risk assessment tool to provide municipalities and the nation as a whole with a quantifiable assessment of their vulnerability to water infrastructure threats. The approach will prioritize countermeasures and identify where research and development is required to further minimize risk. This paper outlines the current context, primary concerns and state-of-the art in critical infrastructure risk management for the water sector and proposes a novel approach to resolve existing questions in the field. The proposed approach is based on a modular framework that derives a quantitative risk index for varied domains of interest. The approach methodology is scaleable and based on formal definitions of event probability and severity. The framework is equally applicable to natural and human-induced hazard types and can be used for analysis of compound risk events.

Engineering as a tool for improving human habitat

The conventional approaches to poverty alleviation in the slums entail a cocktail of interventions in health, education, governance and physical improvements, often stretching the scarce resources far and thin. Driven by the 'poverty' mindset, physical measures such as minimal paving, public water posts and community latrines actually brand the slums apart instead of assimilating them into the urban infrastructure fabric. The concept of Slum Networking proposes comprehensive water and environmental sanitation infrastructure as the central and catalytic leverage for holistic development. At costs less than the conventional 'slum' solutions, it tries to penetrate a high quality urban infrastructure net deeply into the slums to assimilate them into the city rather than lock them in as disadvantaged islands. Further, it transcends resource barriers and 'aid' through innovative partnerships and the latent resource mobilisation potential of the so-called 'poor'. This paper examines Slum Networking as implemented in Sanjaynagar in Ahmedabad, India and compares it with a similar settlement with no interventions in Ahmedabad. It assesses the knock-on impact of physical infrastructure on health, education and poverty. Finally, it evaluates the multiplier effect of physical infrastructure and the partnerships on the subsequent investments by the community in its own shelter and habitat. Copyright © 2009 Inderscience Enterprises Ltd.

Embodied energy and gas emission of geotechnical infrastructure

Construction of geotechnical structures produces various environmental impacts. These include depletion of limited natural resources, generation of wastes and harmful substances during material productions and construction, ineffective usage of energy during processing of raw materials into construction materials, and emissions of unwanted gasses during transportation of materials and usage of equipments. With increasing interests in sustainability at the global scale, there is a need to develop a methodology that can assess environmental impacts at such scale for geotechnical construction. Using embodied energy and gas emission, quantitative measures of environmental impact are evaluated using a case study of a new high speed railway line construction in the UK. Based on the results, the keys to energy savings are (a) to optimise the usage of materials with high embodied energy intensity value (b) to optimise the transportation network and logistics for processes using primarily low embodied energy intensity materials and (c) to reuse as much materials on-site as possible to minimise the quantity of spoils or distance to disposal sites. The evaluated embodied energy and embodied carbon values are compared to those of other types of structures and of other activities and carbon tax values. Such comparisons can be used to discuss among various interested parties (clients, contractors, consultants, policy makers, etc) to make the construction industry more energy efficient. © Springer Science+Business Media B.V. 2011.

Risk-based approaches to sustainability in civil engineering

Infrastructure project sustainability assessment typically entails the use of specialised assessment tools to measure and rate project performance against a set of criteria. This paper looks beyond the prevailing approaches to sustainability assessments and explores sustainability principles in terms of project risks and opportunities. Taking a risk management approach to applying sustainability concepts to projects has the potential to reconceptualise decision structures for sustainability from bespoke assessments to becoming a standard part of the project decisionmaking process. By integrating issues of sustainability into project risk management for project planning, design and construction, sustainability is considered within a more traditional business and engineering language. Currently, there is no widely practised approach for objectively considering the environmental and social context of projects alongside the more traditional project risk assessments of time, cost and quality. A risk-based approach would not solve all the issues associated with existing sustainability assessments but it would place sustainability concerns alongside other key risks and opportunities, integrating sustainability with other project decisions.

A value mapping tool for sustainable business modelling

Purpose: Although business models that deliver sustainability are increasingly popular in the literature, few tools that assist in sustainable business modelling have been identified. This paper investigates how businesses might create balanced social, environmental and economic value through integrating sustainability more fully into the core of their business. A value mapping tool is developed to help firms create value propositions better suited for sustainability. Design/methodology/approach: In addition to a literature review, six sustainable companies were interviewed to understand their approaches to business modelling, using a case study approach. Building on the literature and practice, a tool was developed which was pilot tested through use in a workshop. The resulting improved tool and process was subsequently refined through use in 13 workshops. Findings: A novel value mapping tool was developed to support sustainable business modelling, which introduces three forms of value (value captured, missed/destroyed or wasted, and opportunity) and four major stakeholder groups (environment, society, customer, and network actors). Practical implications: This tool intends to support business modelling for sustainability by assisting firms in better understanding their overall value proposition, both positive and negative, for all relevant stakeholders in the value network. Originality/value: The tool adopts a multiple stakeholder view of value, a network rather than firm centric perspective, and introduces a novel way of conceptualising value that specifically introduces value destroyed or wasted/ missed, in addition to the current value proposition and new opportunities for value creation. © Emerald Group Publishing Limited.

The Sustainability Balanced Scorecard. Linking Sustainability Management to Business Strategy.

The Balanced Scorecard of Kaplan and Norton is a management tool that supports the successful implementation of corporate strategies. It has been discussed and considered widely in both practice and research. By linking operational and non-financial corporate activities with causal chains to the firm's long-term strategy, the Balanced Scorecard supports the alignment and management of all corporate activities according to their strategic relevance. The Balanced Scorecard makes it possible to take into account non-monetary strategic success factors that significantly impact the economic success of a business. The Balanced Scorecard is thus a promising starting-point to also incorporate environmental and social aspects into the main management system of a firm. Sustainability management with the Balanced Scorecard helps to overcome the shortcomings of conventional approaches to environmental and social management systems by integrating the three pillars of sustainability into a single and overarching strategic management tool. After a brief discussion of the different possible forms of a Sustainability Balanced Scorecard the article takes a closer look at the process and steps of formulating a Sustainability Balanced Scorecard for a business unit. Before doing so, the basic conventional approach of the Balanced Scorecard and its suitability for sustainability management will be outlined in brief.

The Paralax Infrastructure: Automatic Parallelization With a Helping Hand

Speeding up sequential programs on multicores is a challenging problem that is in urgent need of a solution. Automatic parallelization of irregular pointer-intensive codes, exempli?ed by the SPECint codes, is a very hard problem. This paper shows that, with a helping hand, such auto-parallelization is possible and fruitful. This paper makes the following contributions: (i) A compiler framework for extracting pipeline-like parallelism from outer program loops is presented. (ii) Using a light-weight programming model based on annotations, the programmer helps the compiler to ?nd thread-level parallelism. Each of the annotations speci?es only a small piece of semantic information that compiler analysis misses, e.g. stating that a variable is dead at a certain program point. The annotations are designed such that correctness is easily veri?ed. Furthermore, we present a tool for suggesting annotations to the programmer. (iii) The methodology is applied to autoparallelize several SPECint benchmarks. For the benchmark with most parallelism (hmmer), we obtain a scalable 7-fold speedup on an AMD quad-core dual processor. The annotations constitute a parallel programming model that relies extensively on a sequential program representation. Hereby, the complexity of debugging is not increased and it does not obscure the source code. These properties could prove valuable to increase the ef?ciency of parallel programming.

A bridge-monitoring tool based on bridge and vehicle accelerations

Previous research on damage detection based on the response of a structure to a moving load has reported decay in accuracy with increasing load speed. Using a 3D vehicle – bridge interaction model, this paper shows that the area under the filtered acceleration response of the bridge increases with increasing damage, even at highway load speeds. Once a datum reading is established, the area under subsequent readings can be monitored and compared with the baseline reading, if an increase is observed it may indicate the presence of damage. The sensitivity of the proposed approach to road roughness and noise is tested in several damage scenarios. The possibility of identifying damage in the bridge by analysing the acceleration response of the vehicle traversing it is also investigated. While vehicle acceleration is shown to be more sensitive to road roughness and noise and therefore less reliable than direct bridge measurements, damage is successfully identified in favourable scenarios.

IRIDE:Interdisciplinary research infrastructure based on dual electron linacs and lasers

This paper describes the scientific aims and potentials as well as the preliminary technical design of IRIDE, an innovative tool for multi-disciplinary investigations in a wide field of scientific, technological and industrial applications. IRIDE will be a high intensity "particles factory", based on a combination of high duty cycle radio-frequency superconducting electron linacs and of high energy lasers. Conceived to provide unique research possibilities for particle physics, for condensed matter physics, chemistry and material science, for structural biology and industrial applications, IRIDE will open completely new research possibilities and advance our knowledge in many branches of science and technology. IRIDE is also supposed to be realized in subsequent stages of development depending on the assigned priorities. © 2013 Elsevier B.V.

Predictive Maintenance for Improved Sustainability - An Ion Beam Etch Endpoint Detection System Use Case

In modern semiconductor manufacturing facilities maintenance strategies are increasingly shifting from traditional preventive maintenance (PM) based approaches to more efficient and sustainable predictive maintenance (PdM) approaches. This paper describes the development of such an online PdM module for the endpoint detection system of an ion beam etch tool in semiconductor manufacturing. The developed system uses optical emission spectroscopy (OES) data from the endpoint detection system to estimate the RUL of lenses, a key detector component that degrades over time. Simulation studies for historical data for the use case demonstrate the effectiveness of the proposed PdM solution and the potential for improved sustainability that it affords.

A Lightweight Tool for Anomaly Detection in Cloud Data Centres

Cloud data centres are critical business infrastructures and the fastest growing service providers. Detecting anomalies in Cloud data centre operation is vital. Given the vast complexity of the data centre system software stack, applications and workloads, anomaly detection is a challenging endeavour. Current tools for detecting anomalies often use machine learning techniques, application instance behaviours or system metrics distribu- tion, which are complex to implement in Cloud computing environments as they require training, access to application-level data and complex processing. This paper presents LADT, a lightweight anomaly detection tool for Cloud data centres that uses rigorous correlation of system metrics, implemented by an efficient corre- lation algorithm without need for training or complex infrastructure set up. LADT is based on the hypothesis that, in an anomaly-free system, metrics from data centre host nodes and virtual machines (VMs) are strongly correlated. An anomaly is detected whenever correlation drops below a threshold value. We demonstrate and evaluate LADT using a Cloud environment, where it shows that the hosting node I/O operations per second (IOPS) are strongly correlated with the aggregated virtual machine IOPS, but this correlation vanishes when an application stresses the disk, indicating a node-level anomaly.