911 resultados para Process Management, Maturity Model, CMM, Delphi Study


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The kinetics of growth of Leishmania performed in vitro after internalization of the promastigote form in the cell and the occurrence of the transformation of the parasite into the amastigote form have been described by several authors. They used explants of macrophages in hamster spleen cell culture or in a human macrophage lineage cell, the U937. Using microscopy, the description of morphologic inter-relationship and the analysis of the production of specific molecules, it has been possible to define some of the peculiarities of the biology of the parasite. The present study shows the growth cycle of Leishmania chagasi during the observation of kinetic analysis undertaken with a McCoy cell lineage that lasted for a period of 144 hours. During the process, the morphologic transformation was revealed by indirect immunofluorescence (IF) and the molecules liberated in the extra cellular medium were observed by SDS-PAGE at 24-hour intervals during the whole 144-hour period. It was observed that in the first 72 hours the promastigote form of L. chagasi adhered to the cell membranes and assumed a rounded (amastigote-like) form. At 96 hours the infected cells showed morphologic alterations; at 120 hours the cells had liberated soluble fluorescent antigens into the extra cellular medium. At 144 hours, new elongated forms of the parasites, similar to promastigotes, were observed. In the SDS-PAGE, specific molecular weight proteins were observed at each point of the kinetic analysis showing that the McCoy cell imitates the macrophage and may be considered a useful model for the study of the infection of the Leishmania/cell binomial.

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RESUMO: O envelhecimento demográfico é uma realidade dos nossos dias. A preparação da alta de enfermagem é um elemento da prestação de cuidados que pode ser explorado na fase de envelhecimento para dotar os idosos de conhecimentos, capacidades e responsabilidade na gestão da sua condição de saúde. Deste modo delineou-se um estudo de tipo descritivo, transversal e exploratório com o objectivo de analisar e compreender o processo de preparação da alta hospitalar de enfermagem ao idoso internado por agudização de doença, que se apresente autónomo no momento da alta, de modo a capacitá-lo para a gestão da sua condição de saúde. O estudo decorreu num Serviço de Medicina Interna. Definiu-se como fontes de informação e métodos de colheita de dados 25 entrevistas a idosos, 16 questionários abertos a enfermeiros prestadores de cuidados e análise dos registos do processo de internamento dos idosos. Como principais resultados destacamos que os idosos quando internados apresentam preocupações relacionadas com a sua condição de saúde e o motivo de internamento, os quais são pouco valorizadas na preparação da alta; os cuidados com a saúde que os idosos têm antes do internamento são valorizados nos registos de enfermagem; um terço dos idosos não teve conhecimento do seu diagnóstico médico; os diagnósticos de enfermagem activos no momento da alta não são contemplados na preparação da alta; os idosos com a aproximação do regresso a casa manifestam preocupações sobre os cuidados a ter com a sua saúde e manifestam interesse em ser informados sobre os mesmos; os idosos sentem pouca disponibilidade por parte dos enfermeiros para a preparação da alta; as intervenções de preparação da alta centram-se em intervenções do tipo ensinar, instruir e treinar, tendo-se verificado discrepâncias sobre os cuidados prestados e o seu conteúdo sob as várias fontes de informação; o diálogo é a estratégia de preparação da alta que prevalece; mais informação e informação escrita são aspectos que podem melhorar a preparação da alta segundo os idosos. Podemos assim concluir que não existe uma estrutura de preparação da alta a idosos com capacidade para gerir a sua condição de saúde e que muito pode ser melhorado em termos de preparação da alta a idosos no sentido de tomar o máximo partido deste elemento dos cuidados e assim obter ganhos em saúde. ----------- ABSTRACT: The demographic aging is a reality nowadays. The nursing discharge planning is an element of care that should be studied on aging to provide older people with knowledge, abilities and responsibility in order to deal their health condition. Thus, it was outlined a descriptive study, transversal and exploratory in order to analyze and understand how the process nursing discharge occurs, by planning the elderly hospitalized with acute disease, in order to support patients for better management of health conditions. The study was carried in an Internal Medicine Service of a Central Hospital. As information sources and methods of data collection, we defined 25 interviews with elderly, 16 open-ended questionnaires to nurses and analysis of records from the process of the elderly hospitalized. In the main results we observe the elderly hospitalized have concerns about their health condition and the reason for their hospitalization, which are undervalued in the discharge planning process; the health care reported by elderly related to time before hospitalization were registered in nursing records; one-third of the elderly don’t know the medical diagnosis; the active nursing diagnosis at discharge assets are not included in the discharge planning process; in the discharge, the elderly had concerns over the care of their health and expressed interest in being informed of it; the elderly don’t feel availability from the nurses in the discharge planning; the discharge interventions focus on interventions like teaching, instructing and training, and there have been different views about the care provided and its contents under the various sources of information; the high prevailing strategy to discharge planning is the dialogue; more information and written information are aspects that can improve the discharge planning process. We conclude that there is no structure in discharge planning for the elderly with high ability to manage his health condition. There are several things that can be improved to the discharge planning for the elderly in order to take full advantage of this element of care.

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A Logística, vista como uma perspetiva integradora entre os parceiros de negócio, com objetivos comuns de proporcionar ao cliente mais-valias e aspetos diferenciadores perante os outros concorrentes, contribui em muito na manutenção das empresas na globalização atual, que se torna cada vez mais flexível. Através de uma boa gestão de processos críticos de negócio, boa localização dos materiais, sejam eles quais forem, produtos finais, matérias-primas ou produtos em vias de fabrico e através do transporte a logística cria utilidade temporal e diferenciadora. De facto, a logística poderá assumir um papel fundamental em proporcionar valor acrescentado ao disponibilizar, a tempo, os serviços que os clientes necessitam ou esperam. Enquadrando-se na temática de gestão dos armazéns, o presente projeto consistiu no estudo de operações de picking com a finalidade de otimização dos processos de picking no armazém do operador logístico AR – Serviços de Logística, localizado em Ribeirão, Vila Nova de Famalicão. O trabalho inicial passou pelo levantamento do funcionamento das operações do processo de picking na empresa e posteriormente confrontá-los com as tecnologias e procedimentos atuais no mercado. Com base nos resultados obtidos, foi possível definir e implementar métricas enquadradas nas finalidades estratégicas e operacionais do operador logístico. As soluções passaram também pela melhoria da aplicação de gestão de armazéns (WMS), reavaliação dos indicadores previamente estabelecidos e na aquisição de equipamentos para automatização das operações picking e localizações. Os registos e informações relacionadas com os módulos fulcrais são armazenados e tratados na base de dados de suporte à aplicação com contributo de melhoria contínua aos procedimentos logístico da empresa e sua relação com os stakeholders na estratégia global de negócio com o operador logístico. Finalmente, foi possível analisar os resultados obtidos em modo real em relação as estimativas calculadas e definidas na fase de implementação e desenvolvimento.

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OBJECTIVE: The objective of the study was to develop a model for estimating patient 28-day in-hospital mortality using 2 different statistical approaches. DESIGN: The study was designed to develop an outcome prediction model for 28-day in-hospital mortality using (a) logistic regression with random effects and (b) a multilevel Cox proportional hazards model. SETTING: The study involved 305 intensive care units (ICUs) from the basic Simplified Acute Physiology Score (SAPS) 3 cohort. PATIENTS AND PARTICIPANTS: Patients (n = 17138) were from the SAPS 3 database with follow-up data pertaining to the first 28 days in hospital after ICU admission. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: The database was divided randomly into 5 roughly equal-sized parts (at the ICU level). It was thus possible to run the model-building procedure 5 times, each time taking four fifths of the sample as a development set and the remaining fifth as the validation set. At 28 days after ICU admission, 19.98% of the patients were still in the hospital. Because of the different sampling space and outcome variables, both models presented a better fit in this sample than did the SAPS 3 admission score calibrated to vital status at hospital discharge, both on the general population and in major subgroups. CONCLUSIONS: Both statistical methods can be used to model the 28-day in-hospital mortality better than the SAPS 3 admission model. However, because the logistic regression approach is specifically designed to forecast 28-day mortality, and given the high uncertainty associated with the assumption of the proportionality of risks in the Cox model, the logistic regression approach proved to be superior.

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A presente investigação tem como objetivo estudar a expatriação, especificamente a gestão da carreira de repatriados portugueses que já experienciaram uma ou mais missões internacionais. Pretende-se averiguar de que modo a realização de missões internacionais pode influenciar a evolução da carreira profissional após o regresso ao país/organização de origem. Para a concretização desta investigação foi utilizada a metodologia quantitativa. A fase de recolha de dados consistiu na aplicação de um inquérito por questionário a 75 repatriados ligados a organizações localizadas em Portugal. Os dados obtidos neste estudo revelam que os repatriados valorizam a experiência da expatriação, independentemente da existência ou não de progressão na carreira, pelo facto de adquirirem e desenvolverem novas competências, alcançarem um âmbito funcional mais rico e abrangente e assumirem funções com maior responsabilidade e autonomia. O facto de planearem a MI como fazendo parte de um processo de desenvolvimento de carreira confirma as perspetivas teóricas do novo contrato psicológico, carreira proteana, boundaryless career e carreiras inteligentes. Os resultados permitiram-nos confirmar as hipóteses de estudo, nomeadamente que a satisfação dos repatriados com a gestão do processo de expatriação está relacionada com a vontade de permanecer na organização de expatriação durante e após a realização da MI e que a implementação de práticas de GRH no âmbito da gestão da carreira dos expatriados está associada a um menor receio dos mesmos em relação à fase da repatriação. Porém, os resultados obtidos mostram que as MI não têm impacto direto no desenvolvimento da carreira dos repatriados, não comprovando assim outra das hipóteses orientadoras desta dissertação. Na parte final do estudo são apresentados os principais contributos teóricos e práticos desta dissertação bem como identificadas algumas limitações a par de sugestões de pesquisa futura.

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INTRODUCTION: Although many countries have improved vaccination coverage in recent years, some, including Guinea-Bissau, failed to meet expected targets. This paper tries to understand the main barriers to better vaccination coverage in the context of the GAVI-Alliance (The Global Alliance for Vaccines and Immunisation) cash-based support provided to Guinea-Bissau. METHODS: The analysis is based on a document analysis and a three round Delphi study with a final consensus meeting. RESULTS: Consensus attributed about 25% of the failure to perform better to implementation problems; and about 10% to governance and also 10% to scarce resources. The qualitative analysis validates the importance of implementation issues and upgraded the relevance of the human resources crisis as an important drawback. The recommendations were balanced in their upstream-downstream focus but were blind to health information issues and logistical difficulties. CONCLUSIONS: It is commendable that such a fragile state, with all sorts of barriers, manages to sustain a slow steady growth of its vaccination coverage. Not reaching the targets set reflects the inappropriateness of those targets rather than a lack of commitment of the health workforce. In the unstable context of countries such as Guinea-Bissau, the predictability of the funds from global health initiatives like the GAVI-Alliance seem to make all the difference in achieving small consistent health gains even in the presence of other major bottlenecks.

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This work project addresses the importance of succession planning in family-owned Small and Medium Enterprises (SMEs). This is directly related with Human Resources Management (HRM) given that there is an HRM long term vision in order for the succession to be planned on time and benefit the companies. This study focused on SMEs since these are the entities that have a minor focus on HRM practices. A total of 22 in-depth interviews were conducted and analyzed. Selected SMEs owners/managers and successors/antecessors were interviewed with the purpose of acquiring more insight on the level of succession planning, using a qualitative methodology from which the process of succession was derived. This study unveils that the first step in this process is related to the definition of criteria to be a good successor, followed by the choice of possible successors, being the children the natural successors, but also considering other potential ones, and finally some considerations on the future of these companies.

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The European Union has taken in recent years an increasingly important role in ensuring peace and stability in the international community, and the security and defence policy of the Union has become synonymous with crisis management. The Union has addressed the issue of crisis management through two sources: the military side and the civilian side, which consists in carrying out numerous crisis management operations and missions. This study discusses the role of the European Union in conducting crisis management operations and missions and how the gendarmerie forces contribute to the success of the same. It will discuss the evolution of the European Union's security policy and the concept of crisis management, and seek to demonstrate the added value of the commitment of gendarmerie forces in operations and missions of crisis management, particularly with regard to employment of the European Gendarmerie Force. On the other hand, it will study the planning process for crisis management of the European Union, featuring the entities and agencies involved in it, and presenting the products that result from this same process. The use of Gendarmerie forces in crisis management operations and missions has significant advantages. Its use is recommended to post - conflict scenarios, in complementarity with the armed forces, in order to overcome the "security gap" that mediates the transition from the state of conflict for the period of peace and reconstruction. Gendarmerie forces can also be engaged both in military crisis management operations and civilian crisis management missions.

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Grasslands in semi-arid regions, like Mongolian steppes, are facing desertification and degradation processes, due to climate change. Mongolia’s main economic activity consists on an extensive livestock production and, therefore, it is a concerning matter for the decision makers. Remote sensing and Geographic Information Systems provide the tools for advanced ecosystem management and have been widely used for monitoring and management of pasture resources. This study investigates which is the higher thematic detail that is possible to achieve through remote sensing, to map the steppe vegetation, using medium resolution earth observation imagery in three districts (soums) of Mongolia: Dzag, Buutsagaan and Khureemaral. After considering different thematic levels of detail for classifying the steppe vegetation, the existent pasture types within the steppe were chosen to be mapped. In order to investigate which combination of data sets yields the best results and which classification algorithm is more suitable for incorporating these data sets, a comparison between different classification methods were tested for the study area. Sixteen classifications were performed using different combinations of estimators, Landsat-8 (spectral bands and Landsat-8 NDVI-derived) and geophysical data (elevation, mean annual precipitation and mean annual temperature) using two classification algorithms, maximum likelihood and decision tree. Results showed that the best performing model was the one that incorporated Landsat-8 bands with mean annual precipitation and mean annual temperature (Model 13), using the decision tree. For maximum likelihood, the model that incorporated Landsat-8 bands with mean annual precipitation (Model 5) and the one that incorporated Landsat-8 bands with mean annual precipitation and mean annual temperature (Model 13), achieved the higher accuracies for this algorithm. The decision tree models consistently outperformed the maximum likelihood ones.

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The selective collection of municipal solid waste for recycling is a very complex and expensive process, where a major issue is to perform cost-efficient waste collection routes. Despite the abundance of commercially available software for fleet management, they often lack the capability to deal properly with sequencing problems and dynamic revision of plans and schedules during process execution. Our approach to achieve better solutions for the waste collection process is to model it as a vehicle routing problem, more specifically as a team orienteering problem where capacity constraints on the vehicles are considered, as well as time windows for the waste collection points and for the vehicles. The final model is called capacitated team orienteering problem with double time windows (CTOPdTW).We developed a genetic algorithm to solve routing problems in waste collection modelled as a CTOPdTW. The results achieved suggest possible reductions of logistic costs in selective waste collection.

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Dissertação de mestrado integrado em Engenharia e Gestão Industrial

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Dissertação de mestrado integrado em Engenharia e Gestão de Sistemas de Informação

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Dissertação de mestrado integrado em Engenharia Civil

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Dissertação de mestrado em Sociologia Organizações e Trabalho