911 resultados para Team Evaluation Models
Resumo:
Los sistemas transaccionales tales como los programas informáticos para la planificación de recursos empresariales (ERP software) se han implementado ampliamente mientras que los sistemas analíticos para la gestión de la cadena de suministro (SCM software) no han tenido el éxito deseado por la industria de tecnología de información (TI). Aunque se documentan beneficios importantes derivados de las implantaciones de SCM software, las empresas industriales son reacias a invertir en este tipo de sistemas. Por una parte esto es debido a la falta de métodos que son capaces de detectar los beneficios por emplear esos sistemas, y por otra parte porque el coste asociado no está identificado, detallado y cuantificado suficientemente. Los esquemas de coordinación basados únicamente en sistemas ERP son alternativas válidas en la práctica industrial siempre que la relación coste-beneficio esta favorable. Por lo tanto, la evaluación de formas organizativas teniendo en cuenta explícitamente el coste debido a procesos administrativos, en particular por ciclos iterativos, es de gran interés para la toma de decisiones en el ámbito de inversiones en TI. Con el fin de cerrar la brecha, el propósito de esta investigación es proporcionar métodos de evaluación que permitan la comparación de diferentes formas de organización y niveles de soporte por sistemas informáticos. La tesis proporciona una amplia introducción, analizando los retos a los que se enfrenta la industria. Concluye con las necesidades de la industria de SCM software: unas herramientas que facilitan la evaluación integral de diferentes propuestas de organización. A continuación, la terminología clave se detalla centrándose en la teoría de la organización, las peculiaridades de inversión en TI y la tipología de software de gestión de la cadena de suministro. La revisión de la literatura clasifica las contribuciones recientes sobre la gestión de la cadena de suministro, tratando ambos conceptos, el diseño de la organización y su soporte por las TI. La clasificación incluye criterios relacionados con la metodología de la investigación y su contenido. Los estudios empíricos en el ámbito de la administración de empresas se centran en tipologías de redes industriales. Nuevos algoritmos de planificación y esquemas de coordinación innovadoras se desarrollan principalmente en el campo de la investigación de operaciones con el fin de proponer nuevas funciones de software. Artículos procedentes del área de la gestión de la producción se centran en el análisis de coste y beneficio de las implantaciones de sistemas. La revisión de la literatura revela que el éxito de las TI para la coordinación de redes industriales depende en gran medida de características de tres dimensiones: la configuración de la red industrial, los esquemas de coordinación y las funcionalidades del software. La literatura disponible está enfocada sobre todo en los beneficios de las implantaciones de SCM software. Sin embargo, la coordinación de la cadena de suministro, basándose en el sistema ERP, sigue siendo la práctica industrial generalizada, pero el coste de coordinación asociado no ha sido abordado por los investigadores. Los fundamentos de diseño organizativo eficiente se explican en detalle en la medida necesaria para la comprensión de la síntesis de las diferentes formas de organización. Se han generado varios esquemas de coordinación variando los siguientes parámetros de diseño: la estructura organizativa, los mecanismos de coordinación y el soporte por TI. Las diferentes propuestas de organización desarrolladas son evaluadas por un método heurístico y otro basado en la simulación por eventos discretos. Para ambos métodos, se tienen en cuenta los principios de la teoría de la organización. La falta de rendimiento empresarial se debe a las dependencias entre actividades que no se gestionan adecuadamente. Dentro del método heurístico, se clasifican las dependencias y se mide su intensidad basándose en factores contextuales. A continuación, se valora la idoneidad de cada elemento de diseño organizativo para cada dependencia específica. Por último, cada forma de organización se evalúa basándose en la contribución de los elementos de diseño tanto al beneficio como al coste. El beneficio de coordinación se refiere a la mejora en el rendimiento logístico - este concepto es el objeto central en la mayoría de modelos de evaluación de la gestión de la cadena de suministro. Por el contrario, el coste de coordinación que se debe incurrir para lograr beneficios no se suele considerar en detalle. Procesos iterativos son costosos si se ejecutan manualmente. Este es el caso cuando SCM software no está implementada y el sistema ERP es el único instrumento de coordinación disponible. El modelo heurístico proporciona un procedimiento simplificado para la clasificación sistemática de las dependencias, la cuantificación de los factores de influencia y la identificación de configuraciones que indican el uso de formas organizativas y de soporte de TI más o menos complejas. La simulación de eventos discretos se aplica en el segundo modelo de evaluación utilizando el paquete de software ‘Plant Simulation’. Con respecto al rendimiento logístico, por un lado se mide el coste de fabricación, de inventario y de transporte y las penalizaciones por pérdida de ventas. Por otro lado, se cuantifica explícitamente el coste de la coordinación teniendo en cuenta los ciclos de coordinación iterativos. El método se aplica a una configuración de cadena de suministro ejemplar considerando diversos parámetros. Los resultados de la simulación confirman que, en la mayoría de los casos, el beneficio aumenta cuando se intensifica la coordinación. Sin embargo, en ciertas situaciones en las que se aplican ciclos de planificación manuales e iterativos el coste de coordinación adicional no siempre conduce a mejor rendimiento logístico. Estos resultados inesperados no se pueden atribuir a ningún parámetro particular. La investigación confirma la gran importancia de nuevas dimensiones hasta ahora ignoradas en la evaluación de propuestas organizativas y herramientas de TI. A través del método heurístico se puede comparar de forma rápida, pero sólo aproximada, la eficiencia de diferentes formas de organización. Por el contrario, el método de simulación es más complejo pero da resultados más detallados, teniendo en cuenta parámetros específicos del contexto del caso concreto y del diseño organizativo. ABSTRACT Transactional systems such as Enterprise Resource Planning (ERP) systems have been implemented widely while analytical software like Supply Chain Management (SCM) add-ons are adopted less by manufacturing companies. Although significant benefits are reported stemming from SCM software implementations, companies are reluctant to invest in such systems. On the one hand this is due to the lack of methods that are able to detect benefits from the use of SCM software and on the other hand associated costs are not identified, detailed and quantified sufficiently. Coordination schemes based only on ERP systems are valid alternatives in industrial practice because significant investment in IT can be avoided. Therefore, the evaluation of these coordination procedures, in particular the cost due to iterations, is of high managerial interest and corresponding methods are comprehensive tools for strategic IT decision making. The purpose of this research is to provide evaluation methods that allow the comparison of different organizational forms and software support levels. The research begins with a comprehensive introduction dealing with the business environment that industrial networks are facing and concludes highlighting the challenges for the supply chain software industry. Afterwards, the central terminology is addressed, focusing on organization theory, IT investment peculiarities and supply chain management software typology. The literature review classifies recent supply chain management research referring to organizational design and its software support. The classification encompasses criteria related to research methodology and content. Empirical studies from management science focus on network types and organizational fit. Novel planning algorithms and innovative coordination schemes are developed mostly in the field of operations research in order to propose new software features. Operations and production management researchers realize cost-benefit analysis of IT software implementations. The literature review reveals that the success of software solutions for network coordination depends strongly on the fit of three dimensions: network configuration, coordination scheme and software functionality. Reviewed literature is mostly centered on the benefits of SCM software implementations. However, ERP system based supply chain coordination is still widespread industrial practice but the associated coordination cost has not been addressed by researchers. Fundamentals of efficient organizational design are explained in detail as far as required for the understanding of the synthesis of different organizational forms. Several coordination schemes have been shaped through the variation of the following design parameters: organizational structuring, coordination mechanisms and software support. The different organizational proposals are evaluated using a heuristic approach and a simulation-based method. For both cases, the principles of organization theory are respected. A lack of performance is due to dependencies between activities which are not managed properly. Therefore, within the heuristic method, dependencies are classified and their intensity is measured based on contextual factors. Afterwards the suitability of each organizational design element for the management of a specific dependency is determined. Finally, each organizational form is evaluated based on the contribution of the sum of design elements to coordination benefit and to coordination cost. Coordination benefit refers to improvement in logistic performance – this is the core concept of most supply chain evaluation models. Unfortunately, coordination cost which must be incurred to achieve benefits is usually not considered in detail. Iterative processes are costly when manually executed. This is the case when SCM software is not implemented and the ERP system is the only available coordination instrument. The heuristic model provides a simplified procedure for the classification of dependencies, quantification of influence factors and systematic search for adequate organizational forms and IT support. Discrete event simulation is applied in the second evaluation model using the software package ‘Plant Simulation’. On the one hand logistic performance is measured by manufacturing, inventory and transportation cost and penalties for lost sales. On the other hand coordination cost is explicitly considered taking into account iterative coordination cycles. The method is applied to an exemplary supply chain configuration considering various parameter settings. The simulation results confirm that, in most cases, benefit increases when coordination is intensified. However, in some situations when manual, iterative planning cycles are applied, additional coordination cost does not always lead to improved logistic performance. These unexpected results cannot be attributed to any particular parameter. The research confirms the great importance of up to now disregarded dimensions when evaluating SCM concepts and IT tools. The heuristic method provides a quick, but only approximate comparison of coordination efficiency for different organizational forms. In contrast, the more complex simulation method delivers detailed results taking into consideration specific parameter settings of network context and organizational design.
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In a context of mass higher education, it is necessary to ensure not only quality but also the relevance of engineering master's programs, namely the appropriateness of the objectives and outcomes to the needs and interests of the program beneficiaries. After a literature review we analyzed the evaluation models of three organizations in Peru: the Board of Evaluation, Accreditation and Certification of the University Education Quality CONEAU, the Institute of Quality and Accreditation of Computing, Engineering and Technology - ICACIT and the Pontificia Universidad Catolica del Peru. The result of this study is a model for relevance evaluation for an engineering master¿s program in Peru.
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Since the establishment of the evaluation system in 1975, the junior colleges in the Republic of China (Taiwan), have gone through six formal evaluations. We know that evaluation in schooling, like quality control in businesses, should be a systematic, formal, and a continual process. It can doubtless serve as a strategy to refine the quality of education. The purpose of this research is to explore the current practice of junior college evaluation in Taiwan. This provides insight into the development of and quality of the current evaluation system. Moreover, this study also identified the source of problems with the current evaluation system and provided suggestion for improvements.^ In order to attain the above purposes, this research was undertaken in both theoretical and practical ways. First, theoretically, on the basis of a literature review, the theories of educational evaluation and, according to the course and principles of development, a view of the current practice in Taiwan. Secondly, in practice, by means of questionnaires, an analysis of the views of evaluation committeemen, junior college presidents, and administrators were obtained on evaluation models, methods, contents, organization, functions, criteria, grades reports, and others with suggestions for improvement. The summary of findings concludes that most evaluators and evaluatees think the purpose of evaluation can help the colleges explore their difficulties and problems. In addition, it was found that there is significant difference between the two groups regarding the evaluation methods, contents, organization, functions, criteria, grades reports and others, while analyzing these objective data forms the basis for an improved method of evaluation for Junior Colleges in Taiwan. ^
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Recently, researchers have begun to investigate the benefits of cross-training teams. It has been hypothesized that cross-training should help improve team processes and team performance (Cannon-Bowers, Salas, Blickensderfer, & Bowers, 1998; Travillian, Volpe, Cannon-Bowers, & Salas, 1993). The current study extends previous research by examining different methods of cross-training (positional clarification and positional modeling) and the impact they have on team process and performance in both more complex and less complex environments. One hundred and thirty-five psychology undergraduates were placed in 45 three-person teams. Participants were randomly assigned to roles within teams. Teams were asked to “fly” a series of missions on a PC-based helicopter flight simulation. ^ Results suggest that cross-training improves team mental model accuracy and similarity. Accuracy of team mental models was found to be a predictor of coordination quality, but similarity of team mental models was not. Neither similarity nor accuracy of team mental models was found to be a predictor of backup behavior (quality and quantity). As expected, both team coordination (quality) and backup behaviors (quantity and quality) were significant predictors of overall team performance. Contrary to expectations, there was no interaction between cross-training and environmental complexity. Results from this study further cross-training research by establishing positional clarification and positional modeling as training strategies for improving team performance. ^
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Voice communication systems such as Voice-over IP (VoIP), Public Switched Telephone Networks, and Mobile Telephone Networks, are an integral means of human tele-interaction. These systems pose distinctive challenges due to their unique characteristics such as low volume, burstiness and stringent delay/loss requirements across heterogeneous underlying network technologies. Effective quality evaluation methodologies are important for system development and refinement, particularly by adopting user feedback based measurement. Presently, most of the evaluation models are system-centric (Quality of Service or QoS-based), which questioned us to explore a user-centric (Quality of Experience or QoE-based) approach as a step towards the human-centric paradigm of system design. We research an affect-based QoE evaluation framework which attempts to capture users' perception while they are engaged in voice communication. Our modular approach consists of feature extraction from multiple information sources including various affective cues and different classification procedures such as Support Vector Machines (SVM) and k-Nearest Neighbor (kNN). The experimental study is illustrated in depth with detailed analysis of results. The evidences collected provide the potential feasibility of our approach for QoE evaluation and suggest the consideration of human affective attributes in modeling user experience.
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Previous research has highlighted the importance of positive physical activity (PA) behaviors during childhood to promote sustained active lifestyles throughout the lifespan (Telama et al. 2005; 2014). It is in this context that the role of schools and teachers in facilitating PA education is promoted. Research suggests that teachers play an important role in the attitudes of children towards PA (Figley 1985) and schools may be an efficient vehicle for PA provision and promotion (McGinnis, Kanner and DeGraw, 1991; Wechsler, Deveraux, Davis and Collins, 2000). Yet despite consensus that schools represent an ideal setting from which to ‘reach’ young people (Department of Health and Human Services, UK, 2012) there remains conceptual (e.g. multi-component intervention) and methodological (e.g. duration, intensity, family involvement) ambiguity regarding the mechanisms of change claimed by PA intervention programmes. This may, in part, contribute to research findings that suggest that PA interventions have had limited impact on children’s overall activity levels and thereby limited impact in reducing children’s metabolic health (Metcalf, Henley & Wilkin, 2012). A marked criticism of the health promotion field has been the focus on behavioural change while failing to acknowledge the impact of context in influencing health outcomes (Golden & Earp, 2011). For years, the trans-theoretical model of behaviour change has been ‘the dominant model for health behaviour change’ (Armitage, 2009); this model focusses primarily on the individual and the psychology of the change process. Arguably, this model is limited by the individual’s decision-making ability and degree of self-efficacy in order to achieve sustained behavioural change and does not take account of external factors that may hinder their ability to realise change. Similar to the trans-theoretical model, socio-ecological models identify the individual at the focal point of change but also emphasises the importance of connecting multiple impacting variables, in particular, the connections between the social environment, the physical environment and public policy in facilitating behavioural change (REF). In this research, a social-ecological framework was used to connect the ways a PA intervention programme had an impact (or not) on participants, and to make explicit the foundational features of the programme that facilitated positive change. In this study, we examined the evaluation of a multi-agency approach to a PA intervention programme which aimed to increase physical activity, and awareness of the importance of physical activity to key stage 2 (age 7-12) pupils in three UK primary schools. The agencies involved were the local health authority, a community based charitable organisation, a local health administrative agency, and the city school district. In examining the impact of the intervention, we adopted a process evaluation model in order to better understand the mechanisms and context that facilitated change. Therefore, the aim of this evaluation was to describe the provision, process and impact of the intervention by 1) assessing changes in physical activity levels 2) assessing changes in the student’s attitudes towards physical activity, 3) examining student’s perceptions of the child size fitness equipment in school and their likelihood of using the equipment outside of school and 4) exploring staff perceptions, specifically the challenges and benefits, of facilitating equipment based exercise sessions in the school environment. Methodology, Methods, Research Instruments or Sources Used Evaluation of the intervention was designed as a matched-control study and was undertaken over a seven-month period. The school-based intervention involved 3 intervention schools (n =436; 224 boys) and one control school (n=123; 70 boys) in a low socioeconomic and multicultural urban setting. The PA intervention was separated into two phases: a motivation DVD and 10 days of circuit based exercise sessions (Phase 1) followed by a maintenance phase (Phase 2) that incorporated a PA reward program and the use of specialist kid’s gym equipment located at each school for a period of 4 wk. Outcome measures were measured at baseline (January) and endpoint (July; end of academic school year) using reliable and valid self-report measures. The children’s attitudes towards PA were assessed using the Children’s Attitudes towards Physical Activity (CATPA) questionnaire. The Physical Activity Questionnaire for Children (PAQ-C), a 7-day recall questionnaire, was used to assess PA levels over a school week. A standardised test battery (Fitnessgram®) was used to assess cardiovascular fitness, body composition, muscular strength and endurance, and flexibility. After the 4 wk period, similar kid’s equipment was available for general access at local community facilities. The control school did not receive any of the interventions. All physical fitness tests and PA questionnaires were administered and collected prior to the start of the intervention (January) and following the intervention period (July) by an independent evaluation team. Evaluation testing took place at the individual schools over 2-3 consecutive days (depending on the number of children to be tested at the school). Staff (n=19) and student perceptions (n = 436) of the child sized fitness equipment were assessed via questionnaires post-intervention. Students completed a questionnaire to assess enjoyment, usage, ease of use and equipment assess and usage in the community. A questionnaire assessed staff perceptions on the delivery of the exercise sessions, classroom engagement and student perceptions. Conclusions, Expected Outcomes or Findings Findings showed that both the intervention (16.4%) and control groups increased their PAQ-C score by post-intervention (p < 0.05); with the intervention (17.8%) and control (21.3%) boys showing the greatest increase in physical activity levels. At post-intervention, there was a 5.5% decline in the intervention girls’ attitudes toward PA in the aesthetic subdomains (p = 0.009); whereas the control boys had an increase in positive attitudes in the health domain (p = 0.003). No significant differences in attitudes towards physical activity were observed in any other domain for either group at post-intervention (p > 0.05). The results of the equipment questionnaire, 96% of the children stated they enjoyed using the equipment and would like to use the equipment again in the future; however at post-intervention only 27% reported using the equipment outside of school in the last 7 days. Students identified the ski walker (34%) and cycle (32%) as their favorite pieces of equipment; with the single joint exercises such as leg extension and bicep/tricep machine (<3%) as their least favorite. Key themes from staff were that the equipment sessions were enjoyable, a novel activity, children felt very grown-up, and the activity was linked to a real fitness experience. They also expressed the need for more support to deliver the sessions and more time required for each session. Findings from this study suggest that a more integrated approach within the various agencies is required, particularly more support to increase teachers pedagogical content knowledge in physical activity instruction which is age appropriate. Future recommendations for successful implementation include sufficient time period for all students to access and engage with the equipment; increased access and marketing of facilities to parents within the local community, and professional teacher support strategies to facilitate the exercise sessions.
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O trabalho versa sobre as metodologias de avalia????o de programas e projetos sociais, enfatizando modalidades avalistas espec??ficas, as an??lises de resultados e impacto. Ap??s o exame de conceitos b??sicos e tipologias de avalia????o consagradas pela literatura, faz-se alguns coment??rios sobre os modelos tradicionais de avalia????o.
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Abstract — The analytical methods based on evaluation models of interactive systems were proposed as an alternative to user testing in the last stages of the software development due to its costs. However, the use of isolated behavioral models of the system limits the results of the analytical methods. An example of these limitations relates to the fact that they are unable to identify implementation issues that will impact on usability. With the introduction of model-based testing we are enable to test if the implemented software meets the specified model. This paper presents an model-based approach for test cases generation from the static analysis of source code.
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This paper analyses the performance and investment styles of internationally oriented Socially Responsible Investment (SRI)funds, domiciled in eight European markets, in comparison with characteristics-matched conventional funds. To the best of our knowledge, this is the first multi-country study, focused on international SRI funds (investing in Global and in European equities), to combine the matched-pairs approach with the use of robust conditional multi-factor performance evaluation models, which allow for both time-varying alphas and betas and also control for home biases and spurious regression biases.In general, the results show that differences in the performance of international SRI funds and their conventional peers are not statistically significant. Regarding investment styles, SRI and conventional funds exhibit similar factor exposures in most cases. In addition,conventional benchmarks present a higher explaining power of SRI fund returns than SRI benchmarks. Our results also show significant differences in the investment styles of SRI funds according to whether they use “best-in-class” screening strategies or not. When compared to SRI funds that employ simple negative and/or positive screens, SRI “best-in-class” funds present significantly lower exposures to small caps and momentum strategies and significantly higher exposures to local stocks.
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O catálogo é um produto de comunicação com presença forte no mundo da moda, reflexo por excelência de cada coleção e imagem de marca. Verifica-se que os critérios objectivos de avaliação dos catálogos não foram ainda alvo de uma análise estruturada e aprofundada, apesar da importância que possuem para as empresas do sector do Vestuário. Assim, decidiuse estudar os elementos que definem o nível de qualidade estética e gráfica dos catálogos de vestuário. Analisaram-se catálogos de marcas portuguesas e internacionais da indústria da moda cuja qualidade é reconhecida pelos profissionais de design. Como resultado desse estudo foi criada a Matriz AQC - Matriz de Avaliação da Qualidade dos Catálogos Produto e a Matriz AQC – Matriz de avaliação da Qualidade dos Catálogos Imagem.
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Desde o seu aparecimento, a Internet teve um desenvolvimento e uma taxa de crescimento quase exponencial. Os mercados de comércio electrónico têm vindo a acompanhar esta tendência de crescimento, tornando-se cada vez mais comuns e populares entre comerciantes ou compradores/vendedores de ocasião. A par deste crescimento também foi aumentando a complexidade e sofisticação dos sistemas responsáveis por promover os diferentes mercados. No seguimento desta evolução surgiram os Agentes Inteligentes devido à sua capacidade de encontrar e escolher, de uma forma relativamente eficiente, o melhor negócio, tendo por base as propostas e restrições existentes. Desde a primeira aplicação dos Agentes Inteligentes aos mercados de comércio electrónico que os investigadores desta área, têm tentado sempre auto-superar-se arranjando modelos de Agentes Inteligentes melhores e mais eficientes. Uma das técnicas usadas, para a tentativa de obtenção deste objectivo, é a transferência dos comportamentos Humanos, no que toca a negociação e decisão, para estes mesmos Agentes Inteligentes. O objectivo desta dissertação é averiguar se os Modelos de Avaliação de Credibilidade e Reputação são uma adição útil ao processo de negociação dos Agente Inteligentes. O objectivo geral dos modelos deste tipo é minimizar as situações de fraude ou incumprimento sistemático dos acordos realizados aquando do processo de negociação. Neste contexto, foi proposto um Modelo de Avaliação de Credibilidade e Reputação aplicável aos mercados de comércio electrónico actuais e que consigam dar uma resposta adequada o seu elevado nível de exigência. Além deste modelo proposto também foi desenvolvido um simulador Multi-Agente com a capacidade de simular vários cenários e permitir, desta forma, comprovar a aplicabilidade do modelo proposto. Por último, foram realizadas várias experiências sobre o simulador desenvolvido, de forma a ser possível retirar algumas conclusões para o presente trabalho. Sendo a conclusão mais importante a verificação/validação de que a utilização de mecanismos de credibilidade e reputação são uma mais-valia para os mercado de comércio electrónico.
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Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Educação Especial, domínio Cognição e Multideficiência
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A avaliação de empresas sempre constituiu um tema de elevada reflexão, sendo que vários especialistas tentam encontrar os modelos que melhor se adaptam a situações específicas e para as quais precisam de determinar um valor. No contexto empresarial português começa a ganhar significância a prática da gestão orientada para a criação de valor (Value-Based Management). O conceito de Value-Based Management assistiu a um particular desenvolvimento nos últimos 20 anos como resultado da globalização e desregulamentação dos mercados financeiros, dos avanços nas tecnologias de informação e do aumento da importância dos investidores institucionais. Vários analistas apresentaram evidência de que as empresas que adotam sistemas VBM melhoram o seu desempenho económico em relação a outras de dimensão semelhante no mesmo setor. É neste contexto que o EVA (Economic Value Added) se apresenta como uma métrica de desempenho privilegiada nos processos de controlo das decisões estratégicas tomadas. No presente trabalho pretendemos abordar o conceito da gestão baseada na criação de valor e a sua importância para o acionista, o que implica rever outros modelos de avaliação tradicionais baseados no valor contabilístico. Como métrica de avaliação do desempenho passado da empresa ao nível da criação de valor vamos dar particular importância ao estudo do EVA, fazendo referência à possível correlação entre esta métrica e o MVA (Market Value Added). O objetivo principal é analisar empiricamente a relação do EVA como medida de desempenho associada à criação de valor para os acionistas com a performance da empresa. Com efeito, vamos efetuar um estudo de caso, que vai incidir sobre um grupo empresarial português, referência no seu setor de atividade, o Grupo Galp Energia, cotado na Euronext Lisbon. Pensamos que a crescente prática da gestão baseada na criação de valor nas empresas cotadas em Portugal e a necessidade de aferir os resultados desta, tornam esta investigação pertinente, para além do facto de serem poucos os estudos empíricos à questão da criação de valor e a sua correlação com o valor acrescentado de mercado e com o valor de mercado dos capitais próprios das empresas cotadas em Portugal.
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RESUMO:A depressão clínica é uma patologia do humor, dimensional e de natureza crónica, evoluindo por episódios heterogéneos remitentes e recorrentes, de gravidade variável, correspondendo a categorias nosológicas porventura artificiais mas clinicamente úteis, de elevada prevalência e responsável por morbilidade importante e custos sociais crescentes, calculando-se que em 2020 os episódios de depressão major constituirão, em todo o mundo, a segunda causa de anos de vida com saúde perdidos. Como desejável, na maioria dos países os cuidados de saúde primários são a porta de entrada para o acesso à recepção de cuidados de saúde. Cerca de 50% de todas as pessoas sofrendo de depressão acedem aos cuidados de saúde primários mas apenas uma pequena proporção é correctamente diagnosticada e tratada pelos médicos prestadores de cuidados primários apesar dos tratamentos disponíveis serem muito efectivos e de fácil aplicabilidade. A existência de dificuldades e barreiras a vários níveis – doença, doentes, médicos, organizações de saúde, cultura e sociedade – contribuem para esta generalizada ineficiência de que resulta uma manutenção do peso da depressão que não tem sido possível reduzir através das estratégias tradicionais de organização de serviços. A equipa comunitária de saúde mental e a psiquiatria de ligação são duas estratégias de intervenção com desenvolvimento conceptual e organizacional respectivamente na Psiquiatria Social e na Psicossomática. A primeira tem demonstrado sucesso na abordagem clínica das doenças mentais graves na comunidade e a segunda na abordagem das patologias não psicóticas no hospital geral. Todavia, a efectividade destas estratégias não se tem revelado transferível para o tratamento das perturbações depressivas e outras patologias mentais comuns nos cuidados de saúde primários. Novos modelos de ligação e de trabalho em equipa multidisciplinar têm sido demonstrados como mais eficazes e custo-efectivos na redução do peso da depressão, ao nível da prestação dos cuidados de saúde primários, quando são atinentes com os seguintes princípios estratégicos e organizacionais: detecção sistemática e abordagem da depressão segundo o modelo médico, gestão integrada de doença crónica incluindo a continuidade de cuidados mediante colaboração e partilha de responsabilidades intersectorial, e a aposta na melhoria contínua da qualidade. Em Portugal, não existem dados fiáveis sobre a frequência da depressão, seu reconhecimento e a adequação do tratamento ao nível dos cuidados de saúde primários nem se encontra validada uma metodologia de diagnóstico simples e fiável passível de implementação generalizada. Foi realizado um estudo descritivo transversal com os objectivos de estabelecer a prevalência pontual de depressão entre os utentes dos cuidados de saúde primários e as taxas de reconhecimento e tratamento pelos médicos de família e testar metodologias de despiste, com base num questionário de preenchimento rápido – o WHO-5 – associado a uma breve entrevista estruturada – o IED. Foram seleccionados aleatoriamente 31 médicos de família e avaliados 544 utentes consecutivos, dos 16 aos 90 anos, em quatro regiões de saúde e oito centros de saúde dotados com 219 clínicos gerais. Os doentes foram entrevistados por psiquiatras, utilizando um método padronizado, o SCAN, para diagnóstico de perturbação depressiva segundo os critérios da 10ª edição da Classificação Internacional de Doenças. Apurou-se que 24.8% dos utentes apresentava depressão. No melhor dos cenários, menos de metade destes doentes, 43%, foi correctamente identificada como deprimida pelo seu médico de família e menos de 13% dos doentes com depressão estavam bem medicados com antidepressivo em dose adequada. A aplicação seriada dos dois instrumentos não revelou dificuldades tendo permitido a identificação de pelo menos 8 em cada 10 doentes deprimidos e a exclusão de 9 em cada 10 doentes não deprimidos. Confirma-se a elevada prevalência da patologia depressiva ao nível dos cuidados primários em Portugal e a necessidade de melhorar a capacidade diagnóstica e terapêutica dos médicos de família. A intervenção de despiste, que foi validada, parece adequada para ser aplicada de modo sistemático em Centros de Saúde que disponham de recursos técnicos e organizacionais para o tratamento efectivo dos doentes com depressão. A obtenção da linha de base de indicadores de prevalência, reconhecimento e tratamento das perturbações depressivas nos cuidados de saúde primários, bem como a validação de instrumentos de uso clínico, viabiliza a capacitação do sistema para a produção de uma campanha nacional de educação de grande amplitude como a proposta no Plano Nacional de Saúde 2004-2010.------- ABSTRACT: Clinical depression is a dimensional and chronic affective disorder, evolving through remitting and recurring heterogeneous episodes with variable severity corresponding to clinically useful artificial diagnostic categories, highly prevalent and producing vast morbidity and growing social costs, being estimated that in 2020 unipolar major depression will be the second cause of healthy life years lost all over the world. In most countries, primary care are the entry point for access to health care. About 50% of all individuals suffering from depression within the community reach primary health care but a smaller proportion is correctly diagnosed and treated by primary care physicians though available treatments are effective and easily manageable. Barriers at various levels – pertaining to the illness itself, to patients, doctors, health care organizations, culture and society – contribute to the inefficiency of depression management and pervasiveness of depression burden, which has not been possible to reduce through classical service strategies. Community mental health teams and consultation-liaison psychiatry, two conceptual and organizational intervention strategies originating respectively within social psychiatry and psychosomatics, have succeeded in treating severe mental illness in community and managing non-psychotic disorders in the general hospital. However, these strategies effectiveness has not been replicated and transferable for the primary health care setting treatment of depressive disorders and other common mental pathology. New modified liaison and multidisciplinary team work models have been shown as more efficacious and cost-effective reducing depression burden at the primary care level namely when in agreement with principles such as: systematic detection of depression and approach accordingly to the medical model, chronic llness comprehensive management including continuity of care through collaboration and shared responsibilities between primary and specialized care, and continuous quality improvement. There are no well-founded data available in Portugal for depression prevalence, recognition and treatment adequacy in the primary care setting neither is validated a simple, teachable and implementable recognition and diagnostic methodology for primary care. With these objectives in mind, a cross-sectional descriptive study was performed involving 544 consecutive patients, aged 16-90 years, recruited from the ambulatory of 31 family doctors randomized within the 219 physicians working in eight health centres from four health regions. Screening strategies were tested based on the WHO-5 questionnaire in association with a short structured interview based on ICD-10 criteria. Depression ICD-10 diagnosis was reached according to the gold standard SCAN interview performed by trained psychiatrists. Any depressive disorder ICD-10 diagnosis was present in 24.8% of patients. Through the use of favourable recognition criteria, 43% of the patients were correctly identified as depressed by their family doctor and about 13% of the depressed patients were prescribed antidepressants at an adequate dosage. The serial administration of both instruments – WHO-5 and short structured interview – was feasible, allowing the detection of eight in ten positive cases and the exclusion of nine in ten non-cases. In Portugal, at the primary care level, high depressive disorder prevalence is confirmed as well as the need to improve depression diagnostic and treatment competencies of family doctors. A two-stage screening strategy has been validated and seems adequate for systematic use in health centres where technical and organizational resources for the effective management of depression are made available. These results can be viewed as primary care depressive disorders baseline indicators of prevalence, detection and treatment and, along with clinical useful instruments, the health system is more capacitated for the establishment of a national level large education campaign on depression such as proposed in the National Health Plan 2004-2010.