Performance evaluation of hospitals that provide care in the public health system, Brazil

OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System.METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction.RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed.CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

Real time fault injection using enhanced OCD -- a performance analysis

Fault injection is frequently used for the verification and validation of dependable systems. When targeting real time microprocessor based systems the process becomes significantly more complex. This paper proposes two complementary solutions to improve real time fault injection campaign execution, both in terms of performance and capabilities. The methodology is based on the use of the on-chip debug mechanisms present in modern electronic devices. The main objective is the injection of faults in microprocessor memory elements with minimum delay and intrusiveness. Different configurations were implemented and compared in terms of performance gain and logic overhead.

The effect of superplasticizers on the mechanical performance of concrete made with fine recycled concrete aggregates

It is considered that using crushed recycled concrete as aggregate for concrete production is a viable alternative to dumping and would help to conserve abiotic resources. This use has fundamentally been based on the coarse fraction because the fine fraction is likely to degrade the performance of the resulting concrete. This paper presents results from a research work undertaken at Institut Superior Tecnico (IST), Lisbon, Portugal, in which the effects of incorporating two types of superplasticizer on the mechanical performance of concrete containing fine recycled aggregate were evaluated. The purpose was to see if the addition of superplasticizer would offset the detrimental effects associated with the use of fine recycled concrete aggregate. The experimental programme is described and the results of tests for splitting tensile strength, modulus of elasticity and abrasion resistance are presented. The relative performance of concrete made with recycled aggregate was found to decrease. However, the same concrete with admixtures in general exhibited a better mechanical performance than the reference mixes without admixtures or with a less active superplasticizer. Therefore, it is argued that the mechanical performance of concrete made with fine recycled concrete aggregates can be as good as that of conventional concrete, if superplasticizers are used to reduce the water-cement ratio of the former concrete.

Anti-Corrosion performance of a new silane coating for corrosion protection of AZ31 Magnesium alloy in Hank’s solution

Mg alloys can be used as bioresorsable metallic implants. However, the high corrosion rate of magnesium alloys has limited their biomedical applications. Although Mg ions are essential to the human body, an excess may cause undesirable health effects. Therefore, surface treatments are required to enhance the corrosion resistance of magnesium parts, decreasing its rate to biocompatible levels and allowing its safe application as bioresorbable metallic implants. The application of biocompatible silane coatings is envisaged as a suitable strategy for retarding the corrosion process of magnesium alloys. In the current work, a new glycidoxypropyltrimethoxysilane (GPTMS) based coating was tested on AZ31 magnesium substrates subjected to different surface conditioning procedures before coating deposition. The surface conditioning included a short etching with hydrofluoric acid (HF) or a dc polarisation in alkaline electrolyte. The silane coated samples were immersed in Hank's solution and the protective performance of the coating was studied through electrochemical impedance spectroscopy (EIS). The EIS data was treated by new equivalent circuit models and the results revealed that the surface conditioning process plays a key role in the effectiveness of the silane coating. The HF treated samples led to the highest impedance values and delayed the coating degradation, compared to the mechanically polished samples or to those submitted to dc polarisation.

Characterization and performance analysis of a VDFLL GNSS receiver architecture

A non-coherent vector delay/frequency-locked loop architecture for GNSS receivers is proposed. Two dynamics models are considered: PV (position and velocity) and PVA (position, velocity, and acceleration). In contrast with other vector architectures, the proposed approach does not require the estimation of signals amplitudes. Only coarse estimates of the carrier-to-noise ratios are necessary.

Impact of different moodle course designs on students? Performance

This work describes the impact of different teachers’ approaches in using Moodle, for supporting their courses, at the Polytechnic of Porto - School of Engineering. The study covers five different courses, from different degrees and different years, and includes a number of Moodle resources especially supporting laboratory classes. These and other active resources are particularly analyzed in order to evaluate students’ adherence to them. One particular course includes a number of remote experiments, made available through VISIR (Virtual Instrument Systems in Reality) and directly accessible through links included in the Moodle course page. The collected data have been correlated with students’ classifications in the lab component and in the exam, each one weighting 50% of their final marks. This analysis benefited from the existence of different teachers’ approaches, which resulted in a diversity of Moodle-supported environments. Conclusions point to the existence of a positive correlation factor between the number of Moodle accesses and the final exam grade, although the quality of the resources made available by the teachers seems to be preponderant over its quantity. In addition, different students perspectives were found regarding active resources: while some seem to encourage students to participate (for instance online quiz or online reports), others, more demanding, are unable to stimulate the majority of them.

Student performance analysis under different moodle course designs

This work extends a recent comparative study covering four different courses lectured at the Polytechnic of Porto - School of Engineering, in respect to the usage of a particular Learning Management System, i.e. Moodle, and its impact on students' results. A fifth course, which includes a number of resources especially supporting laboratory classes, is now added to the analysis. This particular course includes a number of remote experiments, made available through VISIR (Virtual Instrument Systems in Reality) and directly accessible through links included in the Moodle course page. We have analyzed the students' behavior in following these links and in effectively running experiments in VISIR (and also using other lab related resources, in Moodle). This data have been correlated with students' classifications in the lab component and in the exam, each one weighting 50% of their final marks. We aimed to compare students' performance in a richly Moodle-supported environment (with lab component) and in a poorly Moodle-supported environment (with only theoretical component). This question followed from conclusions drawn in the above referred comparative study, where it was shown that even though a positive correlation factor existed between the number of Moodle accesses and the final exam grade obtained by each student, its explanation behind was not straightforward, as the quality of the resources was preponderant over its quantity.

A sustentabilidade e o ciclo de vida dos edifícios

A crescente preocupação que envolve as questões ambientais a nível mundial, cada vez mais agravadas pelo comportamento irresponsável do Homem, conduziu à criação de métodos de avaliação dos impactes ambientais provocados por produtos e sistemas. Sendo o sector da construção responsável por grande parte desses impactes, é evidente a necessidade de aplicação de medidas que visem mitigar ou, no mínimo, reduzir até valores aceitáveis, essas agressões ao meio ambiente. Nesse âmbito, é natural que tenha surgido a ideia de aplicar uma metodologia tão precisa e rigorosa como a LCA ao sector da construção. No entanto, nos dias de hoje, as preocupações alargaram-se às vertentes social e económica que, juntamente com a vertente ambiental, formam o triângulo de equilíbrio do desenvolvimento sustentável. É precisamente essa avaliação tripartida que esta Dissertação pretende abordar, tentando aprofundar conhecimentos e fornecer alternativas, através da análise crítica, que possam contribuir para a melhoria contínua desta metodologia.

Marx-Type solid-state bipolar modulator topologies: Performance comparison

The operation of generalized Marx-type solid-state bipolar modulators is discussed and compared with simplified Marx-derived circuits, to evaluate their capability to deal with various load conditions. A comparative analysis on the number of switches per cell, fiber optic trigger count, losses, and switch hold-off voltages has been made. A circuit topology is obtained as a compromise in terms of operating performance, trigger simplicity, and switching losses. A five-stage laboratory prototype of this circuit has been assembled using 1200 V insulated gate bipolar transistors (IGBTs) and diodes, operating with 1000 V dc input voltage and 1 kHz frequency, giving 5 kV bipolar pulses, with 2.5 mu s pulse width and 5 mu s relaxation time into resistive, capacitive, and inductive loads.

High-performance flexible hybrid field-effect transistors based on cellulose fiber paper

IEEE Electron Device Letters, VOL. 29, NO. 9,

Performance of fractional PID algorithms controlling nonlinear systems with saturation and backlash phenomena

The development of fractional-order controllers is currently one of the most promising fields of research. However, most of the work in this area addresses the case of linear systems. This paper reports on the analysis of fractional-order control of nonlinear systems. The performance of discrete fractional-order PID controllers in the presence of several nonlinearities is discussed. Some results are provided that indicate the superior robustness of such algorithms.

The impact of national cultures on international marketing strategy and subsidiary performance of portuguese SME’s

The dynamic of the international business and its multidimensional nature requires the understanding of the complexities of different contexts dictated by cultural differences between countries. The purpose of this paper is to study, in depth howsmall and medium-sized companies develop their international marketing mix strategy in their overseas subsidiaries. We use the theoretical construct of Hofstede (1980, 1991) in the dimensions of Power Distance (PD), Uncertainty Avoidance (UA), Individualism (IND), Masculinity (MASC) and Long-Term Orientation (LTO) to assess the cross cultural differences between countries and the business practices to analyze the adaptation or standardization of the international marketing mix strategy of foreign Portuguese subsidiaries. Ourstudy uses an exploratoryand qualitative methodology. We conducted semi-structured interviews in order to achieve a good understanding ofinternational marketing mix strategy of four companies from different sectors. Our results show that the national cultural differences have great influence in the marketing strategy of the subsidiary. The business practices adjustments in the subsidiary company that proved to be necessary conditions for their performance are conducted by the products augmented offerings concerning the characteristics of the product, design and brand name in order to meet the requirements and specificities of the host country of the subsidiary.

Sistemas de prevenção de cuidados de saúde

A tomada de decisão na saúde pode-se tornar um processo complexo e moroso. A complexidade associada ao processo de decisão na saúde advém da diversidade de opções clinicamente razoáveis, ou seja, nenhuma opção se sobrepõem _a outra, visto que cada uma possui os seus riscos e benefícios, que são normalmente interpretados de modo diferente entre os indivíduos. Desta forma, cabe ao paciente e _a sua equipa médica optarem pela opção que melhor se enquadra na situação clínica do paciente Para tornar este processo menos complexo, cada vez mais se utiliza as chamadas "ferramentas de decisão", que se caraterizam por fornecer informação sobre as diferentes opções clínicas, traduzindo-se numa diminuição da dificuldade da tomada de decisão. De uma forma geral, as ferramentas de decisão são desenvolvidas com o intuito de facilitar a tomada de decisão, através do aumento do conhecimento científico sobre um determinado problema (tomada de decisão informada) e uma mudança de atitude do paciente face aos seus cuidados de saúde. Na realização da presente dissertação foi desenvolvido um sistema de informação na web, que engloba informação relativa ao rastreio do cancro da próstata. Este sistema também surge acoplado a um conjunto de componentes de decisão, que têm como objetivo auxiliar os indivíduos no processo de decisão para a realização do rastreio do cancro da próstata, assim como a prevenção de doenças relacionadas com a próstata. A implementação desta aplicação web teve como base as necessidades do indivíduo, ou seja informações clínicas sobre possíveis riscos e benefícios associados ao rastreio, assim como fornecer uma maior interatividade com o utilizador. A primeira versão da aplicação já foi testada e avaliada através da participação de um conjunto de indivíduos que compõem o público-alvo para este tipo de aplicações. Os resultados obtidos permitiram concluir que os requisitos definidos para esta aplicação, permitem o aumento do conhecimento do indivíduo e o auxílio na tomada de decisão para a realização do rastreio do cancro da próstata.

Catálise de hydrocraking baseado em zeólitos

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Química

Levantamento de práticas ambientais e energéticas de PMEs em Portugal

Para qualquer empresa o seu maior objetivo passa pela produção de lucro e, atualmente, esse aspeto está diretamente relacionado com a sua capacidade de manter uma gestão que incorpore a responsabilidade social, ambiental e económica, em prol de um desenvolvimento global mais sustentável. As grandes empresas já iniciaram e continuam este processo de mudança, desenvolvendo medidas e estratégias neste sentido. Porém, apesar de representarem o grosso do tecido empresarial, as Pequenas e Médias Empresas só agora começam a dar os primeiros passos em direção a uma gestão mais ponderada ambiental e energeticamente. Com este trabalho pretende-se reunir informação relativa às Pequenas e Médias Empresas portuguesas de forma a compreender quais as principais áreas de atuação, as medidas que poderão ser implementadas e, consolidar o ponto de situação deste sector acerca dos vários temas ao nível do meio ambiente e da energia. Para tal, foram realizados levantamentos energéticos e aplicado um questionário acerca dos comportamentos e práticas ambientais. Verificou-se que apesar da grande maioria das empresas analisadas já terem ponderado a importância e as vantagens da eficiência energética, ainda são poucas as organizações que têm implementados planos, estratégias ou instrumentos para melhoria do seu desempenho ambiental e energético.