Meta-heuristic Solution Methods for Rich Vehicle Routing Problems

Le problème de tournées de véhicules (VRP), introduit par Dantzig and Ramser en 1959, est devenu l'un des problèmes les plus étudiés en recherche opérationnelle, et ce, en raison de son intérêt méthodologique et de ses retombées pratiques dans de nombreux domaines tels que le transport, la logistique, les télécommunications et la production. L'objectif général du VRP est d'optimiser l'utilisation des ressources de transport afin de répondre aux besoins des clients tout en respectant les contraintes découlant des exigences du contexte d’application. Les applications réelles du VRP doivent tenir compte d’une grande variété de contraintes et plus ces contraintes sont nombreuse, plus le problème est difficile à résoudre. Les VRPs qui tiennent compte de l’ensemble de ces contraintes rencontrées en pratique et qui se rapprochent des applications réelles forment la classe des problèmes ‘riches’ de tournées de véhicules. Résoudre ces problèmes de manière efficiente pose des défis considérables pour la communauté de chercheurs qui se penchent sur les VRPs. Cette thèse, composée de deux parties, explore certaines extensions du VRP vers ces problèmes. La première partie de cette thèse porte sur le VRP périodique avec des contraintes de fenêtres de temps (PVRPTW). Celui-ci est une extension du VRP classique avec fenêtres de temps (VRPTW) puisqu’il considère un horizon de planification de plusieurs jours pendant lesquels les clients n'ont généralement pas besoin d’être desservi à tous les jours, mais plutôt peuvent être visités selon un certain nombre de combinaisons possibles de jours de livraison. Cette généralisation étend l'éventail d'applications de ce problème à diverses activités de distributions commerciales, telle la collecte des déchets, le balayage des rues, la distribution de produits alimentaires, la livraison du courrier, etc. La principale contribution scientifique de la première partie de cette thèse est le développement d'une méta-heuristique hybride dans la quelle un ensemble de procédures de recherche locales et de méta-heuristiques basées sur les principes de voisinages coopèrent avec un algorithme génétique afin d’améliorer la qualité des solutions et de promouvoir la diversité de la population. Les résultats obtenus montrent que la méthode proposée est très performante et donne de nouvelles meilleures solutions pour certains grands exemplaires du problème. La deuxième partie de cette étude a pour but de présenter, modéliser et résoudre deux problèmes riches de tournées de véhicules, qui sont des extensions du VRPTW en ce sens qu'ils incluent des demandes dépendantes du temps de ramassage et de livraison avec des restrictions au niveau de la synchronization temporelle. Ces problèmes sont connus respectivement sous le nom de Time-dependent Multi-zone Multi-Trip Vehicle Routing Problem with Time Windows (TMZT-VRPTW) et de Multi-zone Mult-Trip Pickup and Delivery Problem with Time Windows and Synchronization (MZT-PDTWS). Ces deux problèmes proviennent de la planification des opérations de systèmes logistiques urbains à deux niveaux. La difficulté de ces problèmes réside dans la manipulation de deux ensembles entrelacés de décisions: la composante des tournées de véhicules qui vise à déterminer les séquences de clients visités par chaque véhicule, et la composante de planification qui vise à faciliter l'arrivée des véhicules selon des restrictions au niveau de la synchronisation temporelle. Auparavant, ces questions ont été abordées séparément. La combinaison de ces types de décisions dans une seule formulation mathématique et dans une même méthode de résolution devrait donc donner de meilleurs résultats que de considérer ces décisions séparément. Dans cette étude, nous proposons des solutions heuristiques qui tiennent compte de ces deux types de décisions simultanément, et ce, d'une manière complète et efficace. Les résultats de tests expérimentaux confirment la performance de la méthode proposée lorsqu’on la compare aux autres méthodes présentées dans la littérature. En effet, la méthode développée propose des solutions nécessitant moins de véhicules et engendrant de moindres frais de déplacement pour effectuer efficacement la même quantité de travail. Dans le contexte des systèmes logistiques urbains, nos résultats impliquent une réduction de la présence de véhicules dans les rues de la ville et, par conséquent, de leur impact négatif sur la congestion et sur l’environnement.

Impacto del proceso de eliminación del doble conteo del material importado por Carbones del Cerrejón Limited en términos de eficiencia y efectividad en el proceso de nacionalización y liberación del material

La operación de mega minería que abarca CERREJON se desarrolla bajo lo más altos estándares de seguridad y calidad, con el compromiso de entregar al mercado un excelente producto y evitando el deterioro del entorno. Uno de los puntos más fuertes de la compañía se haya en la integración de los procesos productivos entre la mina de carbón, el ferrocarril y el puerto, logrando que la operación sea eficiente y que garantice niveles altos de óptimos resultados y que los porcentajes de falla no existan o cada vez sean menores en el proceso de explotación y transporte del carbón de Colombia hacia el mundo. El departamento de MATERIALES es el punto de origen para garantizar que se desarrolle la operación, dado que el departamento tiene la gran labor de adquirir y entregar los bienes y servicios requeridos por la Compañía al más bajo costo total evaluado, en el menor tiempo posible y bajo el marco de la legislación Colombiana en el proceso de nacionalización, con un alto énfasis en el desarrollo de relaciones fuertes y sinérgicas entre todos los eslabones de la cadena. Todo el proceso del departamento se enmarca dentro de un ciclo que debe encaminarse a ser cada vez más efectivo y eficiente; de allí que se busquen opciones de mejoramiento para afinar los procesos. Para que sea posible y factible manejar una mega operación como esta se requiere afinar al máximo la red que se establece en su cadena de abastecimiento, buscando lograr un flujo de producto, información y fondos que garanticen disponibilidad del producto, para así generar una rentabilidad alta a la compañía, y controlar los costos por la operación. Dado que la cadena de suministro es susceptible a mejoras, gracias a la interacción con los proveedores, colaboradores y clientes; se pretende sacar el mejor provecho de esto, a través del análisis de la cadena actual de CERREJON; presentando una opción de mejora en uno de los eslabones del proceso productivo, esta opción ha sido contemplada desde años anteriores, pero en esta ocasión gracias a la integración de afinamientos en los sistemas de información, y la participación activa de los proveedores, se encuentra una opción viable de la eliminación de un reproceso, que garantiza eficiencia y efectividad en la agilización del ciclo de producción en CERREJON. A través de la ejecución del proyecto de reforma del conteo, se presenta la oportunidad de mejoramiento en la cadena del departamento; el proceso de reconteo en la mina, realizado posteriormente al conteo inicial en Puerto Bolívar, de los materiales que llegan importados vía marítima. El proceso de afinamiento del recibo documental en el consolidador de carga y los mayores proveedores de entrega directa (HITACHI y MCA) al transportador, genera la opción del uso de terminales portátiles, que de la mano con los ajustes documentales, permitirán que la carga sea contada y separada por localización, para enviarla vía tren a LMN, reduciendo tiempo de entrega al cliente final, los costos de remanejo al volver a contar, y los costos asociados a las entregas no oportunas de devolución de contenedores.

Collaborative business networks evaluation of technological tools for decision support making

Nowadays, companies are living great difficulties on managing their business due to constant and unpredictable economic market fluctuations. Recent changes in market trends (such as the constant demand for new products and services, mass customization and the drastic reduction of delivery time) lead companies to adopt strategies of creating partnerships with other companies as a way to respond effectively to such difficult economical times. Collaborative Networks’ concept born by the consequence of companies could no longer consider their internal business processes’ management as sufficient and tend to seek for a collaborative approach with other partners for their critical processes. Information technologies (ICT) assumed a major role acting as “enablers” of these kinds of networks, enhancing information sharing and business process integration. Several new trends concerning ICT architectures have been created to support collaborative networks requirements, but still doesn’t exist a common platform to reduce the needed integration effort on virtual organizations. This study aims to investigate the current technological solutions available in the market which enhances the management of companies’ business processes (specially, Collaborative Planning). Finally, the research work ends with the presentation of a conceptual model to answer to the constraints evaluated.

A novel alternative to cryopreservation for the short-term storage of stem cells for use in cell therapy using alginate encapsulation

Efficient transport of stem/progenitor cells without affecting their survival and function is a key factor in any practical cell-based therapy. However, the current approach using liquid nitrogen for the transfer of stem cells requires a short delivery time window is technically challenging and financially expensive. The present study aims to use semipermeable alginate hydrogels (crosslinked by strontium) to encapsulate, store, and release stem cells, to replace the conventional cryopreservation method for the transport of therapeutic cells within world-wide distribution time frame. Human mesenchymal stem cell (hMSC) and mouse embryonic stem cells (mESCs) were successfully stored inside alginate hydrogels for 5 days under ambient conditions in an air-tight environment (sealed cryovial). Cell viability, of the cells extracted from alginate gel, gave 74% (mESC) and 80% (hMSC) survival rates, which compared favorably to cryopreservation. More importantly, the subsequent proliferation rate and detection of common stem cell markers (both in mRNA and protein level) from hMSCs and mESCs retrieved from alginate hydrogels were also comparable to (if not better than) results gained following cryopreservation. In conclusion, this new and simple application of alginate hydrogel encapsulation may offer a cheap and robust alternative to cryopreservation for the transport and storage of stem cells for both clinical and research purposes.

Escolha de canais de venda em comércio eletrônico

The electronic commerce has become a channel of advertising, commercialization and distribution of products and services, continuously increasing it¿s importance in terms of both physical and financial volumes, but still exist many gaps in the knowledge about the choice process of sales channels in the electronic commerce. The objective of this work is to raise and quantify the relevant factors in the choice of these channels in Brazil. The identification of the relevant factors was made through depth interviews with consumers, users of electronic commerce, as well as through the existing theoretical referential on the subject. The quantification of these factors was carried out with book purchasers by electronic commerce, through quantitative research, using the methodology of conjoint analysis, where the price was the most important factor, followed by delivery time, positive experience on previous purchase, usability of the site, positive recommendation of friends and the site brand. These results indicate as important attributes: price, confidence, usability and brand.

Politicas publicas e telecomunicações no Brasil (1985-1992) : analise dos impactos sociais

Após 1985, o objetivo de privatização e desregulamentação substituiu a doutrina de desenvolvimento e segurança que orientava a formulação da política de telecomunicações no Brasil desde 1962. Utilizando referências da Escola de Análise de Políticas Públicas, Escolha Coletiva e da Teoria da Regulação, a pesquisa analisa os reflexos dessa mudança nas áreas sociais: Educação, Saúde e Previdência. O monitoramento da política de telecomunicações identificou programas visando a popularização do telefone, mas que não atingiram plenamente seus objetivos. Novas tecnologias foram introduzidas, como o satélite BRASILSAT, a telefonia celular e a TV a cabo, mas os benefícios principais de sua disseminação continuaram em favor de grupos preferenciais. A recente reformulação dos programas de TV educativos e a iniciativa de prover o acesso das escolas à rede INTERNET permitem prognosticar impactos positivos na Educação, entretanto, até 1992, a população continuava a ser mantida ausente da agenda da política pública e a tecnologia da informação ainda não tinha chegado nas escolas. Os impactos na Previdência decorreram da implantação de uma moderna rede de comunicações pela DATAPREV, reduzindo os prazos de atendimento aos segurados do INSS, e melhorando o controle fmanceiro sobre a arrecadação de contribuições e o pagamento dos benefícios. Os impactos na Saúde ainda não foram sentidos no atendimento ao cidadão, mas a disseminação de informações coletadas e processadas pelos sistemas do DATASUS provocaram efeitos positivos no planejamento e controle dos gastos com consultas médicas e internações hospitalares.

Resultados Perinatais de Gêmeos com Pesos Discordantes ao Nascer

Objetivo: estudar as influências da diferença de pesos entre gêmeos, no nascimento, sobre o resultado perinatal. Métodos: analisaram-se, retrospectivamente, as informações referentes aos partos gemelares ocorridos na Maternidade do Hospital Regional de Clínicas de Sorocaba, SP, de julho de 1997 a junho de 1998. A amostragem foi composta de 89 mães e seus gêmeos, divididos em três classes de diferença de pesos ao nascer: com concordância (diferença <15%), discordância leve (de 15 a 25%) e discordância grave (>25%). As variáveis independentes analisadas foram essas três classes e as dependentes foram: baixo peso ao nascer, índice de Apgar menor que 7 no primeiro e quinto minuto, nascimentos pré-termo, tempo médio de internação do recém-nascido no berçário e coeficiente de mortalidade perinatal I. Para análise estatística utilizaram-se o teste de Kruskal-Wallis, complementado pelo teste de Hollander, e o teste de Blackwell. Resultados: a incidência de discordância de pesos entre pares de gêmeos foi de 30,3%, sendo 19,1% de discordância leve e 11,2% de discordância grave. Observamos nas classes, respectivamente, os números de gestações (62, 17 e 10) e de nascimentos pré-termo (32, 9 e 7). Para o primeiro e o segundo gêmeo, observamos: baixo peso ao nascer (39/41, 13/12 e 8/9), Apgar <7 no primeiro minuto (16/13, 3/7 e 2/3), Apgar menor que 7 no quinto minuto (4/4, 0/2 e 1/2), tempo médio (dias) de internação no berçário (3,7/3,7, 4,6/6,0 e 7,3/8,7) e coeficiente de mortalidade perinatal I (22,4/16,8, 0/16,8 e 5,6/5,6). Conclusões: o baixo peso ao nascer e nascimentos pré-termo foram mais freqüentes nos gêmeos da classe com discordância grave. Houve tendência ao agravamento progressivo do resultado perinatal, respectivamente, nas classes com concordância, discordância leve e discordância grave.

Lean Six sigma aplicado a uma empresa do setor de embalagens

With the advent of a global economy, Lean Six Sigma meets the demand of new production process that creates products within the customer’s specification without any wastage. The objectives of this work is to use the concepts Lean Manufacturing and Six Sigma parallel to minimize costs, increase the customer base, reduce the delivery time which implies an increase in the turnover of products on the shelves in a packaging company. We used the DMAIC method to continue working. The method DMAIC indicated the main failure modes that were fixed in the step improve. At this stage the tools of Lean Manufacturing gain tremendous value by optimizing processes with defects. The conclusion involves an increase in monthly billing, a corporate restructuring and, finally, a renewal in how to conduct the work of management

Aplicação da teoria das restrições na manufatura de uma empresa siderúrgica

The competition among companies nowadays, caused by globalization and with customers more and more demanding, makes the companies rethink their strategies for survival. To improve their competition the companies are adopting management tool to improve the manufacturing management, which is considered a key to success. The present study aimed to develop a method, based on techniques of theory of constraints and operational research, to ensure the best use of resources and best decision of a production line on a steel company, with focus in the customers’ delivery time, which is a requirement of the current market. The conclusion of this study is that the correct use of the management tools, such as theory of constraints and operational research, can ensure a long survival for the companies that duel for the market share, especially in regard to customers’ delivery time, that generates their satisfaction

Estudo sobre uma turbina a gás instalada em uma refinaria de petróleo

The gas turbine (GT) is known to have: low cost of capital over the amount of energy, high flexibility, high reliability, short delivery time, commissioning and commercial operation at the beginning and quick departure. The gas turbine is also recognized for its superior environmental performance, manifested in air pollution containment and reducing greenhouse gases (Mahi, 1994). Gas turbines in simple cycle mode (SC) have long been used by utilities to limited power generation peak. In addition, manufacturing facilities use gas turbines for power generation units on site, often in combination with the process of heat production, such as hot water and steam process. In recent years, the performance of industrial gas turbines has been improved due to significant investments in research and development, in terms of fuel to electricity conversion efficiency, plant capacity, availability and reliability. The greater availability of energy resources such as natural gas (NG), the significant reduction of capital costs and the introduction of advanced cycles, have also been a success factor for the increased use of gas turbines to load applications base (Poulikas, 2004). Open Cycle Gas Turbine with a greater degree of heat to the atmosphere may alternatively be used to produce additional electricity using a steam cycle, or to compose a cogeneration process. The combined cycle (CC) uses the heat from the gas turbine exhaust gas to increase the power output and increase the overall efficiency of more than 50% second (Najjar, 2001). The initial discovery of these cycles in the commercial power generation market was possible due to the development of the gas turbine. Only from the 1970s that gas turbine inlet temperature and therefore the exhaust gas temperature was sufficiently high to allow a better efficiency in the combined cycle ... (Complete Abstract click electronic access below)

Isolamento, cultivo, caracterização e criopreservação de células tronco mesenquimais derivadas de membrana amniótica, geléia de Wharton e sangue do cordão umbilical de fetos bovinos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O emprego de técnicas de qualidade de serviço em redes sem fio aplicado à automação predial

Pós-graduação em Engenharia Elétrica - FEIS

Trauma care capacity and performance in Texas: Regional comparisons

Objective. The study reviewed one year of Texas hospital discharge data and Trauma Registry data for the 22 trauma services regions in Texas to identify regional variations in capacity, process of care and clinical outcomes for trauma patients, and analyze the statistical associations among capacity, process of care, and outcomes. ^ Methods. Cross sectional study design covering one year of state-wide Texas data. Indicators of trauma capacity, trauma care processes, and clinical outcomes were defined and data were collected on each indicator. Descriptive analyses were conducted of regional variations in trauma capacity, process of care, and clinical outcomes at all trauma centers, at Level I and II trauma centers and at Level III and IV trauma centers. Multilevel regression models were performed to test the relations among trauma capacity, process of care, and outcome measures at all trauma centers, at Level I and II trauma centers and at Level III and IV trauma centers while controlling for confounders such as age, gender, race/ethnicity, injury severity, level of trauma centers and urbanization. ^ Results. Significant regional variation was found among the 22 trauma services regions across Texas in trauma capacity, process of care, and clinical outcomes. The regional trauma bed rate, the average staffed bed per 100,000 varied significantly by trauma service region. Pre-hospital trauma care processes were significantly variable by region---EMS time, transfer time, and triage. Clinical outcomes including mortality, hospital and intensive care unit length of stay, and hospital charges also varied significantly by region. In multilevel regression analysis, the average trauma bed rate was significantly related to trauma care processes including ambulance delivery time, transfer time, and triage after controlling for age, gender, race/ethnicity, injury severity, level of trauma centers, and urbanization at all trauma centers. Transfer time only among processes of care was significant with the average trauma bed rate by region at Level III and IV. Also trauma mortality only among outcomes measures was significantly associated with the average trauma bed rate by region at all trauma centers. Hospital charges only among outcomes measures were statistically related to trauma bed rate at Level I and II trauma centers. The effect of confounders on processes and outcomes such as age, gender, race/ethnicity, injury severity, and urbanization was found significantly variable by level of trauma centers. ^ Conclusions. Regional variation in trauma capacity, process, and outcomes in Texas was extensive. Trauma capacity, age, gender, race/ethnicity, injury severity, level of trauma centers and urbanization were significantly associated with trauma process and clinical outcomes depending on level of trauma centers. ^ Key words: regionalized trauma systems, trauma capacity, pre-hospital trauma care, process, trauma outcomes, trauma performance, evaluation measures, regional variations ^

Metamodelo para la definición, implantación y mejora de los procesos de gestión de proyectos

En los últimos años hemos sido testigos de la creciente demanda de software para resolver problemas cada vez más complejos y de mayor valor agregado. Bajo estas circunstancias, nos podemos hacer la siguiente pregunta: ¿Está preparada la industria de software para entregar el software que se necesita en los próximos años, de acuerdo con las demandas del cliente? Hoy en día, muchos expertos creen que el éxito de esta industria dependerá de su capacidad para gestionar los proyectos, las personas y los recursos. En este sentido, la gestión de proyectos es un factor clave para el éxito de los proyectos software en todo el mundo. Además, considerando que las Pequeñas y Medianas Empresas de software (PYMEs) representan el 99,87% de las empresas españolas, es vital para este tipo de empresas la implementación de los procesos involucrados con la gestión de proyectos. Es cierto que existen muchos modelos que mejoran la eficacia de la gestión de proyectos, pero la mayoría de ellos se centra únicamente en dos procesos: la planificación del proyecto y la monitorización y control del proyecto, ninguno de los cuales a menudo es asequible para las PYMEs. Estos modelos se basan en el consenso de un grupo de trabajo designado para establecer cómo debe ser gestionado el proceso software. Los modelos son bastante útiles ya que proporcionan lineamientos generales sobre dónde empezar a mejorar la gestión de los proyectos, y en qué orden, a personas que no saben cómo hacerlo. Sin embargo, como se ha dicho anteriormente, la mayoría de estos modelos solamente funcionan en escenarios dentro de las grandes empresas. Por lo tanto, es necesario adaptar los modelos y herramientas para el contexto de PYMEs. Esta tesis doctoral presenta una solución complementaria basada en la aplicación de un metamodelo. Este metamodelo es creado para mejorar la calidad de los procesos de la gestión de proyectos a través de la incorporación de prácticas eficaces identificadas a través del análisis y estudio de los modelos y normas existentes relacionadas con la gestión de proyectos. viii ProMEP – Metamodelo para la gestión de proyectos Por lo tanto, el metamodelo PROMEP (Gestión de Proyectos basada en Prácticas Efectivas) permitirá establecer un proceso estándar de gestión de proyectos que puede adaptarse a los proyectos de cada empresa a través de dos pasos: En primer lugar, para obtener una fotografía instantánea (o base) de los procesos de gestión de proyectos de las PYMEs se creó un cuestionario de dos fases para identificar tanto las prácticas realizadas y como las no realizadas. El cuestionario propuesto se basa en el Modelo de Madurez y Capacidad Integrado para el Desarrollo v1.2 (CMMI-DEV v1.2). Como resultado adicional, se espera que la aplicación de este cuestionario ayude a las PYMEs a identificar aquellas prácticas que se llevan a cabo, pero no son documentadas, aquellas que necesitan más atención, y aquellas que no se realizan debido a la mala gestión o al desconocimiento. En segundo lugar, para apoyar fácilmente y eficazmente las tareas de gestión de proyectos software del metamodelo PROMEP, se diseñó una biblioteca de activos de proceso (PAL) para apoyar la definición de los procesos de gestión de proyectos y realizar una gestión cuantitativa de cada proyecto de las PYMEs. Ambos pasos se han implementado como una herramienta computacional que apoya nuestro enfoque de metamodelo. En concreto, la presente investigación propone la construcción del metamodelo PROMEP para aquellas PYMEs que desarrollan productos software de tal forma que les permita planificar, monitorizar y controlar sus proyectos software, identificar los riesgos y tomar las medidas correctivas necesarias, establecer y mantener un conjunto de activos de proceso, definir un mecanismo cuantitativo para predecir el rendimiento de los procesos, y obtener información de mejora. Por lo tanto, nuestro estudio sugiere un metamodelo alternativo para lograr mayores niveles de rendimiento en los entornos de PYMEs. Así, el objetivo principal de esta tesis es ayudar a reducir los excesos de trabajo y el tiempo de entrega, y aumentar así la calidad del software producido en este tipo de organizaciones. Abstract In recent years we have been witnessing the increasing demand for software to solve more and more complex tasks and greater added value. Under these circumstances, we can ourselves the following question: Is the software industry prepared to deliver the software that is needed in the coming years, according to client demands? Nowadays, many experts believe that the industry’ success will depend on its capacity to manage the projects, people and resources. In this sense, project management is a key factor for software project success around the world. Moreover, taking into account that small and medium-sized software enterprises (SMSe) are the 99.87% of the Spanish enterprises, it is vital for this type of enterprises to implement the processes involved in project management. It is true that there are many models that improve the project management effectiveness, but most of them are focused only on two processes: project planning and project monitoring and control, neither of which is affordable for SMSe. Such models are based on the consensus of a designated working group on how software process should be managed. They are very useful in that they provide general guidelines on where to start improving the project management, and in which order, to people who do not know how to do it. However, as we said, the majority of these models have only worked in scenarios within large companies. So, it is necessary to adapt these models and tools to the context of SMSe. A complementary solution based on the implementation of a metamodel is presented in this thesis. This metamodel is created to improve the quality of project management processes through the incorporation of effective practices identified through the analysis and study of relevant models and standards related to project management. Thus, the PROMEP (PROject Management based on Effective Practices) metamodel will allow establishing a project management standard process to be tailored to each enterprise’s project through two steps: Firstly, to obtain a baseline snapshot of project management processes in SMSe a two-phase questionnaire was created to identify both performed and nonperformed practices. The x ProMEP – Metamodelo para la gestión de proyectos proposed questionnaire is based on Capability Maturity Model Integration for Development v1.2. As additional result, it is expected that the application of the questionnaire to the processes will help SMSe to identify those practices which are performed but not documented, which practices need more attention, and which are not implemented due to bad management or unawareness. Secondly, to easily an effectively support the software project management tasks in the PROMEP metamodel, a Process Asset Library (PAL) is designed to support the definition of project management processes and to achieve quantitative project management in SMSe. Both steps have been implemented as a computational tool that supports our metamodel approach. Concretely, the present research proposes the accomplishment of the PROMEP metamodel for those SMSe which develop software products and enable them to plan, supervise and control their software projects, identify risks and take corrective actions, establish and maintain a set of process assets, define quantitative models that predict the process performance, and provide improvement information. So, our study suggests an alternative metamodel to achieve higher performance levels in the SMSe environments. The main objective of this thesis is help to reduce software overruns and delivery time, and increase software quality in these types of organizations.

Estudo da viabilidade para introduzir na rotina testes de diagnóstico para infecção respiratória aguda

Para avaliar os benefícios da comunicação rápida ao clínico do diagnóstico de vírus respiratórios, foi analisado a viabilidade econômica de 2 testes, com o tempo de entrega de resultado em 2 horas para teste rápido e 48 horas para Biologia Molecular. As amostras coletadas foram processadas utilizando técnicas convencionais e os testes disponíveis no mercado local. Foram escolhidos dois testes rápidos pelo método de imunocromatografia para quatro parâmetros analíticos: Influenza A, Influenza H1N1, Influenza B e Vírus Sincicial Respiratório (RSV) e em Biologia Molecular um teste de RT-PCR multiplex com 25 patógenos entre vírus e bactérias. O tipo de amostra utilizada foi swab e lavado de nasofaringe. A população escolhida para o estudo foi paciente adulto, em tratamento de câncer, que necessita de uma resposta rápida já que a maioria se encontra com comprometimento do sistema imune por doença ou por tratamento. O estudo foi transversal, realizado entre os anos de 2012 e 2013, para avaliar a viabilidade econômica da introdução de testes de diagnóstico da infecção respiratória aguda de etiologia viral a partir de amostras de nasofaringe em pacientes com câncer atendidos no Centro de Atendimento de Oncologia Intercorrência (CAIO ), do Instituto do Câncer do Estado de São Paulo (ICESP), hospital público que atende exclusivamente Sistema Único de Saúde (SUS) e Hospital A.C. Camargo, que atende tanto a pacientes do SUS como da rede privada. O estudo incluiu 152 pacientes em tratamento para qualquer tipo de câncer, predominantemente do sexo feminino (81 mulheres e 70 homens) com idades entre 18-86 anos. Para participar do estudo o paciente era consultado e o critério para escolha do paciente foi ser portador de câncer, com história de febre (ainda que referida) acompanhada de tosse ou dor de garganta, tosse e sintomas respiratórios agudos, atendidos por protocolo padronizado que inclui avaliação na admissão, seguimento e manejo antimicrobiano. Para a avaliação econômica os pacientes foram classificados de acordo com o estado geral de saúde, se apresentavam bom estado de estado de saúde poderiam receber alta e faziam uso da medicação em casa evitando 5 dias de internação se recebessem algum resultado para Influenza ou RSV, no entanto os pacientes que apresentavam outro vírus, resultado negativo ou o estado geral era ruim permaneciam internados por 7 dias em observação e cuidados com medicação adequada. Foram realizadas análises econômicas em dois âmbitos: o sistema de saúde publico e o privado considerando o fator diminuição de dias de internação. A analise de Custo-benefício foi eficiente no Sistema privado mas inadequada para o SUS assim como, qualquer outra medida monetária já que os valores de reembolso do SUS estão defasados do custo de qualquer internação. A análise de Custo-efetividade que olha para outros fatores além do monetário foi efetiva nos dois sistemas que enfrentam falta de leitos além da condição de saúde do paciente de evitar a ingestão desnecessária de antibióticos, evitar os gastos do acompanhante, perda de dias de trabalho e estudo. Não houve correspondência de resultados dos testes rápidos com o multiplex de Biologia Molecular