Health surveys and use of maternal and child health care services in three municipalities within the Sao Paulo metropolitan area

Objectives. To describe the changes in the use of maternal and child health care services by residents of three municipalities-Embu, Itapecerica da Serra, and Taboao da Serra-in the Sao Paulo metropolitan area, 12 years after the implementation of the Unified Health System (SUS) in Brazil, and to analyze the potential of population-based health care surveys as sources of data to evaluate these changes. Methods. Two population-based, cross-sectional surveys were carried out in 1990 and 2002 in municipalities located within the Sao Paulo metropolitan area. For children under 1 year of age, the two periods were compared in terms of outpatient services utilization and hospital admission; for the mothers, the periods were compared in terms of prenatal care and deliveries. In both surveys, stratified and multiple-stage conglomerate sampling was employed, with standardization of interview questions. Results. The most important changes observed were regarding the location of services used for prenatal care, deliveries, and hospitalization of children less than 1 year of age. There was a significant increase in the use of services in the surrounding region or hometown, and decrease in the utilization of services in the city of Sao Paulo (in 1990, 80% of deliveries and almost all admissions for children less than 1 year versus 32% and 46%, respectively, in 2002). The use of primary care units and 24-hour walk-in clinics also increased. All these changes reflect care provided by public resources. In the private sector, there was a decrease in direct payments and payments through company-paid health insurance and an increase in payments through self-paid health insurance. Conclusions. The major changes observed in the second survey occurred simultaneous to the changes that resulted from the implementation of the SUS. Population-based health surveys are adequate for analyzing and comparing the utilization of health care services at different times.

Module property verification : A method to plan and perform quality verifications in modular architectures

Modular product architectures have generated numerous benefits for companies in terms of cost, lead-time and quality. The defined interfaces and the module’s properties decrease the effort to develop new product variants, and provide an opportunity to perform parallel tasks in design, manufacturing and assembly. The background of this thesis is that companies perform verifications (tests, inspections and controls) of products late, when most of the parts have been assembled. This extends the lead-time to delivery and ruins benefits from a modular product architecture; specifically when the verifications are extensive and the frequency of detected defects is high. Due to the number of product variants obtained from the modular product architecture, verifications must handle a wide range of equipment, instructions and goal values to ensure that high quality products can be delivered. As a result, the total benefits from a modular product architecture are difficult to achieve. This thesis describes a method for planning and performing verifications within a modular product architecture. The method supports companies by utilizing the defined modules for verifications already at module level, so called MPV (Module Property Verification). With MPV, defects are detected at an earlier point, compared to verification of a complete product, and the number of verifications is decreased. The MPV method is built up of three phases. In Phase A, candidate modules are evaluated on the basis of costs and lead-time of the verifications and the repair of defects. An MPV-index is obtained which quantifies the module and indicates if the module should be verified at product level or by MPV. In Phase B, the interface interaction between the modules is evaluated, as well as the distribution of properties among the modules. The purpose is to evaluate the extent to which supplementary verifications at product level is needed. Phase C supports a selection of the final verification strategy. The cost and lead-time for the supplementary verifications are considered together with the results from Phase A and B. The MPV method is based on a set of qualitative and quantitative measures and tools which provide an overview and support the achievement of cost and time efficient company specific verifications. A practical application in industry shows how the MPV method can be used, and the subsequent benefits

Bases conceituais para a estruturação de programas de desenvolvimento gerencial para a STU-RJ da CBTU

A presente dissertação enfoca o desenvolvimento gerencial na Superintendência de Trens Urbanos do Rio de Janeiro STU-RJ, da Companhia Brasileira de Trens Urbanos C8TU, propondo as bases conceituais que podem nortear os esforços para a capacitação do corpo gerencial dessa organização. As bases conceituais propostas estão fundamentadas na revisão de diversas teorias do desenvolvimento gerencial e em uma pesquisa que revela as principais características do corpo gerencial da organização. O estudo apresenta um resumo da contribuição de diversos autores sobre o tema, o qual constitui o quadro teórico de referência. Apresenta, também a pesquisa realizada junto aos gerentes.

Lean management and innovation in operational efficiency: the EGR project implemented by Pirelli Tyre Brazil in Santo André plant

O trabalho tem como objetivo avaliar e descrever analiticamente a implementação de práticas de manufatura enxuta pela Pirelli Pneus no seu complexo industrial da América Latina. Além de uma descrição estruturada e ampla dos princípios de produção de Toyota e fundamentos teóricos do Lean thinking, uma ênfase especial será dedicada ao projeto EGR (Especialistas em Gestão da Rotina), como uma ferramenta estratégica para ser usada pela empresa multinacional italiana no futuro próximo, de modo a alcançar um resultado mais eficaz e eficiente na gestão da rotina diária. Este projeto, que representa um componente significativo do Pirelli Manufacturing System (PMS) e, principalmente, voltado para supervisores e gestores de plantas, consiste principalmente em ajudar a empresa a desenvolver a capacidade empresarial para avaliar corretamente o gap potencial existente entre os resultados atuais e os esperados, para tanto entender os desvios, bem como as causas subjacentes, e melhorar continuamente o desempenho da empresa por meio da padronização de processos e redução de desperdicios. Esses objetivos podem ser perseguidos, atuando em dois meios essenciais: habilidades técnicas e comportamentais de liderança para apoiar cada equipe de projeto; uma maior eficácia na gestão de indicadores de desempenho nas diferentes unidades de fábrica, de acordo com KPIs estabelecidos no nível central pelo Head Quarter. Além disso, a investigação será focada na experiência peculiar da planta de Santo André, onde o EGR começou como piloto, com o objetivo de captar as alterações relevantes (no lado organizacional e econômico) que este projeto trouxe para a empresa, através da realização de pesquisa de campo e entrevistas, que são orientados a recolher provas, considerações e opiniões de todos os principais atores envolvidos.

Caminhos que estruturam cidades: redes técnicas de transporte sobre trilhos e a conformação intra-urbana de Natal

The railroad, from 1870 and on, becomes an usual complaining in the press s and politician elite s speeches, especially because of Natal s geographic isolation. The implantation of two railroads in the capital territory Estrada de Ferro de Natal a Nova Cruz, afterwards part of Great Western Railway Company network, and Estrada de Ferro Central do Rio Grande do Norte had serious implications in the urban environment. While railroad s structures were already consolidated, other transportation mechanisms were being implanted in the first decades of the 20th century, such as trams lines, which, by the way, was a transport modal that also used rails as a dislocation meaning. Considering these questions, we may ask: how come railroads and tramways demands, roads and buildings had influenced the internal organization of Natal? We work with the general hypothesis that the influence of technical networks, composed by tramways and railroads, over Natal s urban space happened in a diversified way, sometimes consolidating social aspects in certain areas, sometimes improving the occupation of others. The impact over the city s territory also happens in a diversified way between the buildings/railroad s complexes and the pathways. The different scale of the train in comparison to the trams velocity, size, noise level, flow, among others is also a cause to the different consequences in urban environment. The main objective of this work is to understand the role of circulation technical networks in the construction process of urban space in Natal, as a way to contribute to the urban historiography about the subject. The time frame adopted, between 1881 and 1937, marks the time path of railroads and tramways in Rio Grande do Norte: 1881 is the year of railroad s first section inauguration from Natal to São José do Mipibu as well of the railroad complex in the Republic Square in Natal; the year of 1937 marks the beginning of tramways declination process in the city. At this time railroads and tramways had to face more intensively the competition of motor vehicles. The theory reference adopted is based on concepts and analysis of authors, such as Flávio Villaça and Roberto Lobato Corrêa references to the concepts of urban structure , localization and accessibility and Gabriel Dupuy to explain the concept of urban technical networks . These references reveal the conflict of different realities in the urban universe interests and values which is an important factor about the construction of urban space. The information sources used were from two distinctive natures: primary, journals of the time studied and official government reports, and secondary, based on other works about the subject. It was also used by this study iconographic source, especially images from the data base of the research group História da Cidade, do Território e do Urbanismo .

Health surveys and use of maternal and child health care services in three municipalities within the São Paulo metropolitan area

Objectives. To describe the changes in the use of maternal and child health care services by residents of three municipalities-Embu, Itapecerica da Serra, and Taboao da Serra-in the São Paulo metropolitan area, 12 years after the implementation of the Unified Health System (SUS) in Brazil, and to analyze the potential of population-based health care surveys as sources of data to evaluate these changes.Methods. Two population-based, cross-sectional surveys were carried out in 1990 and 2002 in municipalities located within the São Paulo metropolitan area. For children under 1 year of age, the two periods were compared in terms of outpatient services utilization and hospital admission; for the mothers, the periods were compared in terms of prenatal care and deliveries. In both surveys, stratified and multiple-stage conglomerate sampling was employed, with standardization of interview questions.Results. The most important changes observed were regarding the location of services used for prenatal care, deliveries, and hospitalization of children less than 1 year of age. There was a significant increase in the use of services in the surrounding region or hometown, and decrease in the utilization of services in the city of São Paulo (in 1990, 80% of deliveries and almost all admissions for children less than 1 year versus 32% and 46%, respectively, in 2002). The use of primary care units and 24-hour walk-in clinics also increased. All these changes reflect care provided by public resources. In the private sector, there was a decrease in direct payments and payments through company-paid health insurance and an increase in payments through self-paid health insurance.Conclusions. The major changes observed in the second survey occurred simultaneous to the changes that resulted from the implementation of the SUS. Population-based health surveys are adequate for analyzing and comparing the utilization of health care services at different times.

Location and contract pricing of distributed generation using a genetic algorithm

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Promoting corporate social responsibility in small and medium enterprises in the Caribbean: survey results

Includes bibliography

Hydrodynamic modeling and morphological analysis of Lake Água Preta: one of the water sources of Belém-PA-Brazil

The main contribution from this paper includes the hydrodynamic modeling and morphological analysis of Lake Água Preta in Belém city, Pará State, Brazil. The lake bathymetry was taken through the data provided by COSANPA (the local sanitation and water supply company) dating back to 1975, and from a 2009 field study. Both bathymetries produced two terrain elevation models, which were used for morphological analysis and hydrodynamic simulations. The morphological analysis has revealed that, from 1975 to 2009, the annual mean rate of sedimentation varies between 23,065 and 29,081 m3/year. Through this result, the sedimentation time of Lake Água Preta, from 2009, has been calculated, which varies between 295 and 381 years, maintaining the same rate of sedimentation, water consumption and pumping. The hydrodynamic model simulated the depths and velocities, showing a slight flow with velocities ranging from 0 to 33 cm/s. This flow is established between water input and output of the lake, which is used as reservoir of Belém city.

O centenário da ferrovia brasileira (1954): ensaio sobre a elabo-ração da memória ferroviária no Brasil

In 1954, it was celebrated the centenary of railways in Brazil. The date refers to the first section of 14.5 km of railway in Brazil (30/04/1854), in Rio de Janeiro, between Mauá and Fragoso, of the Petropolis Railway Company (Estrada de Ferro Petrópolis). Some of the texts and commemorative events indicated the symbolic values that the railroad took in the Brazilian history. Firstly, on 30.04.1954, the railway section Mauá-Fragoso and steam locomotive “Baroness” (the first used on the track) were declared national monuments(Decree No. 35,447-A, April 30, 1954). Secondly, some entities (Clube de Engenharia, Conselho Nacional de Geografia, Ministério da Viação e Obras Públicas) highlighted the importance of celebrating the Brazilian railway history and its historical significance, economic and geographical. For this, some events was occurred (the commemoration of one hundred years in Rio de Janeiro and Recife on 30.04.1954). Among the texts wrought produced, we highlight the text I Centenary of Brazilian Railroad (1954), released by the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística), and the National Council of Geography (Conselho Nacional de Geografia). The emphasis given to the railway refersto the geographical perspective (territorial expansion), but also makes mention of the Barãode Mauá, the founder of Petropolis Railway Company. We aim to understand the celebration from evocations about the Brazilian railroad history and some ideas that is assigned to the railway (and the Barãode Mauá), and railway heritage (the track and the locomotive “Baroneza”). On basis of this review will seek to understand how it was reconceived the railroad memory in view of these values and material elements.

Botucatu: modernização e infraestrutura urbana no interior paulista (1928-1934)

Pós-graduação em História - FCLAS

O transporte ferroviário no nordeste brasileiro e o potencial de desenvolvimento do sudoeste do Estado do Piauí

Pós-graduação em Geografia - IGCE

Mapping the lignin distribution in pretreated sugarcane bagasse by confocal and fluorescence lifetime imaging microscopy

Abstract Background Delignification pretreatments of biomass and methods to assess their efficacy are crucial for biomass-to-biofuels research and technology. Here, we applied confocal and fluorescence lifetime imaging microscopy (FLIM) using one- and two-photon excitation to map the lignin distribution within bagasse fibers pretreated with acid and alkali. The evaluated spectra and decay times are correlated with previously calculated lignin fractions. We have also investigated the influence of the pretreatment on the lignin distribution in the cell wall by analyzing the changes in the fluorescence characteristics using two-photon excitation. Eucalyptus fibers were also analyzed for comparison. Results Fluorescence spectra and variations of the decay time correlate well with the delignification yield and the lignin distribution. The decay dependences are considered two-exponential, one with a rapid (τ1) and the other with a slow (τ2) decay time. The fastest decay is associated to concentrated lignin in the bagasse and has a low sensitivity to the treatment. The fluorescence decay time became longer with the increase of the alkali concentration used in the treatment, which corresponds to lignin emission in a less concentrated environment. In addition, the two-photon fluorescence spectrum is very sensitive to lignin content and accumulation in the cell wall, broadening with the acid pretreatment and narrowing with the alkali one. Heterogeneity of the pretreated cell wall was observed. Conclusions Our results reveal lignin domains with different concentration levels. The acid pretreatment caused a disorder in the arrangement of lignin and its accumulation in the external border of the cell wall. The alkali pretreatment efficiently removed lignin from the middle of the bagasse fibers, but was less effective in its removal from their surfaces. Our results evidenced a strong correlation between the decay times of the lignin fluorescence and its distribution within the cell wall. A new variety of lignin fluorescence states were accessed by two-photon excitation, which allowed an even broader, but complementary, optical characterization of lignocellulosic materials. These results suggest that the lignin arrangement in untreated bagasse fiber is based on a well-organized nanoenvironment that favors a very low level of interaction between the molecules.

Authoring tools and management information systems: study of a generalizable architecture

The need to effectively manage the documentation covering the entire production process, from the concept phase right through to market realise, constitutes a key issue in the creation of a successful and highly competitive product. For almost forty years the most commonly used strategies to achieve this have followed Product Lifecycle Management (PLM) guidelines. Translated into information management systems at the end of the '90s, this methodology is now widely used by companies operating all over the world in many different sectors. PLM systems and editor programs are the two principal types of software applications used by companies for their process aotomation. Editor programs allow to store in documents the information related to the production chain, while the PLM system stores and shares this information so that it can be used within the company and made it available to partners. Different software tools, which capture and store documents and information automatically in the PLM system, have been developed in recent years. One of them is the ''DirectPLM'' application, which has been developed by the Italian company ''Focus PLM''. It is designed to ensure interoperability between many editors and the Aras Innovator PLM system. In this dissertation we present ''DirectPLM2'', a new version of the previous software application DirectPLM. It has been designed and developed as prototype during the internship by Focus PLM. Its new implementation separates the abstract logic of business from the real commands implementation, previously strongly dependent on Aras Innovator. Thanks to its new design, Focus PLM can easily develop different versions of DirectPLM2, each one devised for a specific PLM system. In fact, the company can focus the development effort only on a specific set of software components which provides specialized functions interacting with that particular PLM system. This allows shorter Time-To-Market and gives the company a significant competitive advantage.

INTERNAL AUDIT AND GROWTH OF PUBLIC INSTITUTIONS

The ONATRACOM was established by the law number 08/2007 of 03/02/2007 determining the responsibilities, organization and functioning of Rwanda Public Transport Authority with function of promoting public transportation between Rwanda and other countries; participating in the implementation of the public transportation policy of Ministry in charge of transportation; perform any other activity that is directly or indirectly related to its objectives; and establish relations and collaborate with other regional and international agencies with similar attributions. In the recent days many public institutions have been listed by general auditor for being mismanaged and are on the course of deficit. This study aimed at examining internal audit growth of public institutions, case study of ONATRACOM – Rwanda. This research was conducted as a case study using ONATRACOM in NYARUGENGE District. The study was built at four specific objectives which are to determine if internal audit lead to the business growth of ONATRACOM, to find out if achieving internal audit increases the net profit and sales of ONATRACOM, to explore if there is internal sources of funds for pursuing growth opportunities in ONATRACOM, to assess whether ONATRACOM is able to obtain external sources of funds for pursuing growth opportunities as a result of internal audit impact or not. The findings were got from 27 respondents as the sample from the total target population of 96. Questionnaire was used as the technique to obtain primary data, while secondary data were obtained through examining the existing literature about the study. Chapter four presents the finding in form of descriptive statistical tables starting with the profile of the respondent and findings in line with the research objectives, It was found out that ONATRACOM was failure in its services because it was not achieve its targeted objectives and in this company, the internal audit was not effective in order to make performance of that company.