AVALIAÇÃO DE DESEMPENHO DOS SETORES PRODUTIVOS DE UM HOSPITAL ESCOLA VETERINÁRIO: USO DE UM MODELO HIERARQUICO MULTICRITERIAL.

O curso de Medicina Veterinária compõe-se essencialmente de aulas práticas e teóricas desenvolvidas pelas mais diversas disciplinas presentes em sua matriz curricular. Para que as aulas práticas, principalmente aquelas relacionadas às disciplinas profissionalizantes, possam ser ministradas, o curso deve apresentar um Hospital Escola. Este local tem como missões: o ensino (aulas práticas), a pesquisa (desenvolvimento de novas tecnologias e conhecimentos) e a extensão ou assistência (atendimento aos anseios e necessidades das comunidades onde está inserido). Apesar de estar inserido no contexto do curso, o hospital deve apresentar um controle, não só sob o ponto de vista financeiro, mas de acordo com suas premissas a fim de garantir tanto a satisfação das pessoas que ali trabalham e a continuidade de suas atividades, bem como permitir que seus clientes internos (os alunos) e externos (a comunidade) possam ser atendidos em suas necessidades. O termo controle predispõe um pensamento de comando, que tem como objetivo principal permitir que a organização cumpra com os seus objetivos. O processo de controle gerencial é o processo que os líderes encontram para assegurar que os outros membros da organização respeitem as estratégias determinadas. Instituições de saúde e ensino desenvolvem suas atividades através de seus centros de responsabilidades, que existem para cumprir suas finalidades. Como a organização é o conjunto de centro de responsabilidades, e se cada centro de responsabilidade cumpre com suas estratégias a própria organização atinge suas metas. Cabe ao gestor hospitalar decidir qual a estratégia a seguir congruindo com as premissas ou objetivos da organização. Esta decisão deve ser fundamentada em parâmetros e resultados que podem ser conseguidos através de ferramentas de decisão. Muitas organizações utilizam a avaliação do desempenho financeiro de seus centros de responsabilidade para tomar suas decisões. O presente trabalho é uma pesquisa ação, que propõe a apresentação de um modelo teórico, aqui representado por uma ferramenta de decisão que disponibilizará como indicadores de avaliação de desempenho as premissas de ensino, pesquisa e extensão, bem como as de cunho financeiro que permitirão ao gestor hospitalar decidir qual o foco ou caminho a seguir, auxiliando-o em situações de decisões administrativas. Foi realizada a comparação da classificação ou ranqueamento de cada um dos setores produtivos de acordo com o desempenho financeiro, neste caso, a margem de contribuição própria e seu ranqueamento após os cálculos apresentados pelo modelo proposto a fim de demonstrar que ocorreu mudança no ranqueamento dos setores. Este modelo baseou-se em uma ferramenta de hierarquização multicriterial. O fato mais importante foi de perceber que todos os setores produtivos tiveram seu ranqueamento modificado após os cálculos com a ferramenta apresentada. Assim, esta ferramenta torna-se uma forma de decisão mais abrangente, pois contempla outros critérios, ou neste caso, premissas importantes para a decisão, sendo muito útil também para identificar entre as premissas apresentadas quais foram as de pior desempenho em cada setor. Desta forma, o gestor pode determinar ações de melhorias, buscando metas que possam ser alcançadas e determinando aporte financeiro, sendo este o caso, para alcançá-las.(AU)

O DESAFIO DA GESTÃO POR COMPETÊNCIAS NO TERCEIRO SETOR: O CASO DO PROJETO MENINOS E MENINAS DE RUA

A ação reduzida do Estado brasileiro com relação ao atendimento das necessidades das crianças e adolescentes em situação de rua dá espaço para a atuação de novos atores sociais. Alguns destes têm como objetivo promover a cidadania do país, como os participantes do terceiro setor: ONGs que enfrentam diversos obstáculos para realizar suas missões. Dentre estes desafios encontra-se a gestão de pessoas. O presente trabalho propõe a análise da gestão de pessoas e a construção participativa de um modelo de competências em uma Organização Não Governamental Projeto Meninos e Meninas de Rua, a partir da combinação das metodologias qualitativas de estudo de caso único e pesquisa-ação, tendo como embasamento a Gestão Social. A pesquisa de campo foi desenvolvida por meio de diferentes fontes de evidências: entrevistas, questionários, observação, análise de documentos e registros e artefatos físicos, que permitiu a construção participativa de um modelo com cinco (5) competências essenciais/institucionais: Diagnóstico e Planejamento, Alinhamento Institucional, Comunicação, Resiliência e Defesa, Garantia e Promoção de Direitos, tendo como foco deste trabalho o olhar para os Educadores Sociais que atuam na instituição.

CONHECER PARA CONVERTER OU ALGO MAIS?: LEITURA CRÍTICA DAS ETNOGRAFIAS MISSIONÁRIAS DE HENRI-ALEXANDRE JUNOD E CARLOS ESTERMANN

Resumo: O colonialismo produziu diversos discursos sobre as culturas locais, sendo que o discurso dos missionários é uma de suas variantes e, por sua vez, neste discurso estão inclusas as etnografias missionárias. Apresentamos uma leitura crítica de duas etnografias missionárias produzidas nas até então colônias portuguesas, os territórios de Angola e Moçambique. A primeira, intitulada Usos e costumes dos bantos: a vida duma tribo sulafricana, cujo autor é o missionário Henri-Alexandre Junod (1863-1934); a segunda, intitulada Etnografia do sudoeste de Angola, cujo autor é o missionário Carlos Estermann (1896- 1976). Problematizamos a relação entre a ação missionária, o colonialismo português e as culturas locais dos territórios de Angola e Moçambique, através da análise destas etnografias missionárias. Destacamos que estas etnografias, além de apresentarem a riqueza das formas de vida das sociedades nativas, sinalizam como se efetivaram as negociações entre estes missionários em suas práticas de missionação e seus interlocutores nativos.

METODISMO NO NORDESTE DO BRASIL ANÁLISE CRÍTICA DA IMPLANTAÇÃO E CONFIGURAÇÃO DO METODISMO NA PERSPECTIVA DA PRÁXIS RELIGIOSA

A presente pesquisa objetiva analisar o processo de implantação e configuração do metodismo no Nordeste, a partir da trajetória histórica da Igreja Metodista no Brasil, após sua autonomia, cobrindo o período de 1946 a 2003. Como ferramentas de trabalho, foram utilizadas a pesquisa bibliográfica (documentos, livros, pesquisas, meios de comunicação impressos da Igreja Metodista, entre outros) e a coleta de dados por meio de entrevistas e observação in loco da realidade missionária do metodismo no Nordeste. Como método de abordagem dos conteúdos, utilizam-se o Método Histórico Crítico e a História Oral. O primeiro capítulo constitui o levantamento histórico da implantação e expansão do metodismo no nordeste do Brasil, apontando o contexto histórico, social, cultural e econômico em que ocorrem; as primeiras tentativas nas capitais nordestinas e seus principais missionários e missionárias e as perspectivas atuais do avanço missionário. O segundo capítulo procura analisar a struturação e organização do Nordeste como Região Missionária, infocando os movimentos que buscaram tal estrut uração, como as conferências missionárias e o Encomene. O processo de criação da Região Missionária é resgatado, considerando-se seus desafios de sustento e administração, bem como considerando os modelos administrativos em voga no período histórico analisado. No terceiro capítulo, são feitas considerações acerca dos desafios e oportunidades para a práxis missionária em vista dos documentos da Igreja; em especial, o Plano para a Vida e Missão (1982). São analisados os conceitos de missão neste documento e na obra de David Bosch, verificando similaridades e disparidades em relação à prática metodista no Nordeste. São avaliados três modelos de missão: modelo de auto-sustento; modelo de auto-proclamação/propagação e modelo social (em busca de uma missão libertadora). Não se pretende esgotar a análise do processo de implantação do Metodismo no Nordeste, senão abrir caminhos para a avaliação e revisão da práxis missionária metodista no contexto nordestino.(AU)

Managing people and performance:An evidence based framework applied to health service organizations

People and their performance are key to an organization's effectiveness. This review describes an evidence-based framework of the links between some key organizational influences and staff performance, health and well-being. This preliminary framework integrates management and psychological approaches, with the aim of assisting future explanation, prediction and organizational change. Health care is taken as the focus of this review, as there are concerns internationally about health care effectiveness. The framework considers empirical evidence for links between the following organizational levels: 1. Context (organizational culture and inter-group relations; resources, including staffing; physical environment) 2. People management (HRM practices and strategies; job design, workload and teamwork; employee involvement and control over work; leadership and support) 3. Psychological consequences for employees (health and stress; satisfaction and commitment; knowledge, skills and motivation) 4. Employee behaviour (absenteeism and turnover; task and contextual performance; errors and near misses) 5. Organizational performance; patient care. This review contributes to an evidence base for policies and practices of people management and performance management. Its usefulness will depend on future empirical research, using appropriate research designs, sufficient study power and measures that are reliable and valid.

Accountability, organisational learning and risks to patient safety in England: conflict or compromise?

This article examines the current risk regulation regime, within the English National Health Service (NHS), by investigating the two, sometimes conflicting, approaches to risk embodied within the field of policies towards patient safety. The first approach focuses on promoting accountability and is built on legal principles surrounding negligence and competence. The second approach focuses on promoting learning from previous mistakes and near-misses, and is built on the development of a ‘safety culture’. Previous work has drawn attention to problems associated with risk-based regulation when faced with the dual imperatives of accountability and organisational learning. The article develops this by considering whether the NHS patient safety regime demonstrates the coexistence of two different risk regulation regimes, or merely one regime with contradictory elements. It uses the heuristic device of ‘institutional logics’ to examine the coexistence of and interrelationship between ‘organisational learning’ and ‘accountability’ logics driving risk regulation in health care.

On-Line Real-Time Service-Oriented Task Scheduling Using TUF

We present our approach to real-time service-oriented scheduling problems with the objective of maximizing the total system utility. Different from the traditional utility accrual scheduling problems that each task is associated with only a single time utility function (TUF), we associate two different TUFs—a profit TUF and a penalty TUF—with each task, to model the real-time services that not only need to reward the early completions but also need to penalize the abortions or deadline misses. The scheduling heuristics we proposed in this paper judiciously accept, schedule, and abort real-time services when necessary to maximize the accrued utility. Our extensive experimental results show that our proposed algorithms can significantly outperform the traditional scheduling algorithms such as the Earliest Deadline First (EDF), the traditional utility accrual (UA) scheduling algorithms, and an earlier scheduling approach based on a similar model.

Análise wavelet e modelo de manchas em curvas de luz estelares dos telescópios espaciais Kepler e CoRoT

Analogous to sunspots and solar photospheric faculae, which visibility is modulated by stellar rotation, stellar active regions consist of cool spots and bright faculae caused by the magnetic field of the star. Such starspots are now well established as major tracers used to estimate the stellar rotation period, but their dynamic behavior may also be used to analyze other relevant phenomena such as the presence of magnetic activity and its cycles. To calculate the stellar rotation period, identify the presence of active regions and investigate if the star exhibits or not differential rotation, we apply two methods: a wavelet analysis and a spot model. The wavelet procedure is also applied here to study pulsation in order to identify specific signatures of this particular stellar variability for different types of pulsating variable stars. The wavelet transform has been used as a powerful tool for treating several problems in astrophysics. In this work, we show that the time-frequency analysis of stellar light curves using the wavelet transform is a practical tool for identifying rotation, magnetic activity, and pulsation signatures. We present the wavelet spectral composition and multiscale variations of the time series for four classes of stars: targets dominated by magnetic activity, stars with transiting planets, those with binary transits, and pulsating stars. We applied the Morlet wavelet (6th order), which offers high time and frequency resolution. By applying the wavelet transform to the signal, we obtain the wavelet local and global power spectra. The first is interpreted as energy distribution of the signal in time-frequency space, and the second is obtained by time integration of the local map. Since the wavelet transform is a useful mathematical tool for nonstationary signals, this technique applied to Kepler and CoRoT light curves allows us to clearly identify particular signatures for different phenomena. In particular, patterns were identified for the temporal evolution of the rotation period and other periodicity due to active regions affecting these light curves. In addition, a beat-pattern vii signature in the local wavelet map of pulsating stars over the entire time span was also detected. The second method is based on starspots detection during transits of an extrasolar planet orbiting its host star. As a planet eclipses its parent star, we can detect physical phenomena on the surface of the star. If a dark spot on the disk of the star is partially or totally eclipsed, the integrated stellar luminosity will increase slightly. By analyzing the transit light curve it is possible to infer the physical properties of starspots, such as size, intensity, position and temperature. By detecting the same spot on consecutive transits, it is possible to obtain additional information such as the stellar rotation period in the planetary transit latitude, differential rotation, and magnetic activity cycles. Transit observations of CoRoT-18 and Kepler-17 were used to implement this model.

"Porta do Céu": o processo de cristianização da Freguesia de Nossa Senhora da Apresentação (1681-1714)

This study aims to analyze the process of Christianization space in the different areas of the Parish of Our lady of Presentation between 1681 and 1714. To accomplish this goal, the main primary sources researched was the parish records of baptism. Thus, areas of the parish were designed based on two fundamental concepts: Christianization of the locations (and souls), based on the study of Claudia Damasceno, who worked with the notion of ecclesiastical circumscription, adapted for the case of Parish of Our lady of Presentation, and the concept of local experimentation, by Yi-Fu Tuan. Christianization the areas was the process of transformation of spatial logic, found previously by the Portuguese, by overlapping the ecclesiastical logic over Indigenous perception, through buildings construction, to initiate people to Catholicism. The experiment, in turn, would be made by the local residents studied and by religious themselves, making these areas, in places, in the sense of achieving new local meanings. It was verified, therefore, that Parish of Our lady of Presentation had at least three distinct places, the City of Natal, the villages around and the parish missions. Then, the focus of this thesis is to analyze how settlers used these different places as religious meanings.

Near miss materno e iniquidades em saúde: análise de determinantes contextuais no Rio Grande do Norte, Brasil

The scope of this study was to identify socioeconomic contextual and health care factors in primary care associated with maternal near misses and their marker conditions. This is an ecological study that used aggregated data of 63 clusters formed by the municipalities of State of Rio Grande do Norte, Brazil, using the Skater method of area regionalization, as the unit of analysis. The ratio of maternal near misses and their marker conditions were obtained from the Hospital Information System of the Brazilian Unified Health System. In multiple linear regression analysis, there was a significant association between maternal near misses and variables of poverty and poor primary health care. Hypertensive disorders were also associated with poverty and poor primary care and the occurrence of hemorrhaging was associated with infant mortality. It was observed that the occurrence of maternal near misses is linked to unfavorable socioeconomic conditions and poor quality health care that are a reflection of public policies that accentuate health inequalities.

Near miss materno e iniquidades em saúde: análise de determinantes contextuais no Rio Grande do Norte, Brasil

The scope of this study was to identify socioeconomic contextual and health care factors in primary care associated with maternal near misses and their marker conditions. This is an ecological study that used aggregated data of 63 clusters formed by the municipalities of State of Rio Grande do Norte, Brazil, using the Skater method of area regionalization, as the unit of analysis. The ratio of maternal near misses and their marker conditions were obtained from the Hospital Information System of the Brazilian Unified Health System. In multiple linear regression analysis, there was a significant association between maternal near misses and variables of poverty and poor primary health care. Hypertensive disorders were also associated with poverty and poor primary care and the occurrence of hemorrhaging was associated with infant mortality. It was observed that the occurrence of maternal near misses is linked to unfavorable socioeconomic conditions and poor quality health care that are a reflection of public policies that accentuate health inequalities.

Prevalência e fatores associados ao Near Miss Materno: inquérito populacional em uma capital do Nordeste Brasileiro

The scope of this study was to determine the prevalence of near misses and complications during pregnancy and the puerperal period, identifying the main clinical and intervention markers and socioeconomic and demographic factors associated with near misses. It involved a cross-sectional, population-based and probabilistic study with multi-stage complex sampling design conducted in Natal, State of Rio Grande do Norte, Brazil. A validated questionnaire was given to 848 women aged 15 to 49 identified in 8,227 households in 60 census sectors. In theanalysis of associations, the Chi-square test applied and calculated the prevalence ratio (PR) with Confidence Interval (CI) of 95% and 5% significance. The prevalence of maternal near misses was 41.1/1000LB, with hospitalization in an Intensive Care Unit (19.1/1000LB) and eclampsia (13.5/1000LB) being the most important markers. The prevalence of complications during pregnancy and the puerperal period was 21.2%. The highest prevalence of near misses was observed in older women, of black/brown race and low socioeconomic status. Conducting population surveys is feasible and may add important information to the study of near misses and the markers highlight the need for enhancing maternal care to reduce health inequality.

Prevalência e fatores associados ao Near Miss Materno: inquérito populacional em uma capital do Nordeste Brasileiro

The scope of this study was to determine the prevalence of near misses and complications during pregnancy and the puerperal period, identifying the main clinical and intervention markers and socioeconomic and demographic factors associated with near misses. It involved a cross-sectional, population-based and probabilistic study with multi-stage complex sampling design conducted in Natal, State of Rio Grande do Norte, Brazil. A validated questionnaire was given to 848 women aged 15 to 49 identified in 8,227 households in 60 census sectors. In theanalysis of associations, the Chi-square test applied and calculated the prevalence ratio (PR) with Confidence Interval (CI) of 95% and 5% significance. The prevalence of maternal near misses was 41.1/1000LB, with hospitalization in an Intensive Care Unit (19.1/1000LB) and eclampsia (13.5/1000LB) being the most important markers. The prevalence of complications during pregnancy and the puerperal period was 21.2%. The highest prevalence of near misses was observed in older women, of black/brown race and low socioeconomic status. Conducting population surveys is feasible and may add important information to the study of near misses and the markers highlight the need for enhancing maternal care to reduce health inequality.

Grabbing Your Attention: The Impact of Finding a First Target in Multiple-Target Search

For over 50 years, the Satisfaction of Search effect, and more recently known as the Subsequent Search Miss (SSM) effect, has plagued the field of radiology. Defined as a decrease in additional target accuracy after detecting a prior target in a visual search, SSM errors are known to underlie both real-world search errors (e.g., a radiologist is more likely to miss a tumor if a different tumor was previously detected) and more simplified, lab-based search errors (e.g., an observer is more likely to miss a target ‘T’ if a different target ‘T’ was previously detected). Unfortunately, little was known about this phenomenon’s cognitive underpinnings and SSM errors have proven difficult to eliminate. However, more recently, experimental research has provided evidence for three different theories of SSM errors: the Satisfaction account, the Perceptual Set account, and the Resource Depletion account. A series of studies examined performance in a multiple-target visual search and aimed to provide support for the Resource Depletion account—a first target consumes cognitive resources leaving less available to process additional targets.

To assess a potential mechanism underlying SSM errors, eye movements were recorded in a multiple-target visual search and were used to explore whether a first target may result in an immediate decrease in second-target accuracy, which is known as an attentional blink. To determine whether other known attentional distractions amplified the effects of finding a first target has on second-target detection, distractors within the immediate vicinity of the targets (i.e., clutter) were measured and compared to accuracy for a second target. To better understand which characteristics of attention were impacted by detecting a first target, individual differences within four characteristics of attention were compared to second-target misses in a multiple-target visual search.

The results demonstrated that an attentional blink underlies SSM errors with a decrease in second-target accuracy from 135ms-405ms after detection or re-fixating a first target. The effects of clutter were exacerbated after finding a first target causing a greater decrease in second-target accuracy as clutter increased around a second-target. The attentional characteristics of modulation and vigilance were correlated with second- target misses and suggest that worse attentional modulation and vigilance are predictive of more second-target misses. Taken together, these result are used as the foundation to support a new theory of SSM errors, the Flux Capacitor theory. The Flux Capacitor theory predicts that once a target is found, it is maintained as an attentional template in working memory, which consumes attentional resources that could otherwise be used to detect additional targets. This theory not only proposes why attentional resources are consumed by a first target, but encompasses the research in support of all three SSM theories in an effort to establish a grand, unified theory of SSM errors.

The Optimality of Decision Making During Motor Learning

In our daily lives, we often must predict how well we are going to perform in the future based on an evaluation of our current performance and an assessment of how much we will improve with practice. Such predictions can be used to decide whether to invest our time and energy in learning and, if we opt to invest, what rewards we may gain. This thesis investigated whether people are capable of tracking their own learning (i.e. current and future motor ability) and exploiting that information to make decisions related to task reward. In experiment one, participants performed a target aiming task under a visuomotor rotation such that they initially missed the target but gradually improved. After briefly practicing the task, they were asked to select rewards for hits and misses applied to subsequent performance in the task, where selecting a higher reward for hits came at a cost of receiving a lower reward for misses. We found that participants made decisions that were in the direction of optimal and therefore demonstrated knowledge of future task performance. In experiment two, participants learned a novel target aiming task in which they were rewarded for target hits. Every five trials, they could choose a target size which varied inversely with reward value. Although participants’ decisions deviated from optimal, a model suggested that they took into account both past performance, and predicted future performance, when making their decisions. Together, these experiments suggest that people are capable of tracking their own learning and using that information to make sensible decisions related to reward maximization.