Caracterización de la gestión del mantenimiento de equipo biomédico en servicios de urgencia de clínicas y hospitales de Medellín en el período 2008-2009

La gestión de mantenimiento es una herramienta de gran impacto que apoya al personal de Ingeniería en el desarrollo, control y dirección de programas de mantenimiento para el equipo médico. Objetivo: caracterizar la gestión de mantenimiento en servicios de urgencia de clínicas y hospitales del área metropolitana de Medellín en el período 2008-2009. Materiales y métodos: se realizó una encuesta a jefes y técnicos de mantenimiento en once entidades prestadoras de servicios de salud, clasificadas en tercer nivel y pertenecientes a la red de salud del municipio de Medellín. Resultados: entre las instituciones encuestadas se encontró que la causa de falla más común en los equipos del servicio de urgencia es el mal manejo de los equipos (75%) por partede los operarios y que 70% del mantenimiento es realizado por personal con experiencia en el área (tecnólogos en mantenimiento de equipo biomédico e ingenieros biomédicos). En las once instituciones públicas y privadas encuestadas se halló que solo se contaban con cronogramas de mantenimiento y/o con información desactualizada concerniente a las hojas de vida de los equipos, planes de mantenimiento o adquisición y baja de equipos. Conclusión: el estudio muestra la existencia de debilidades en ciertos puntos de la gestión, incluyendo mala organización, poca disponibilidad de repuestos originales y falta de capacitación en el personal que maneja los equipos.

A perceção de Educadores de Infância, Professores do 1º ciclo e Educação Especial em relação às dificuldades no Ensino de crianças portadoras de Trissomia 21

A Trissomia 21 é uma problemática com alta incidência na nossa sociedade e possuí características muito específicas que variam de indivíduo para indivíduo. A educação de uma criança com Trissomia 21 deve ter a mesma finalidade da educação de qualquer outra, ou seja, é necessário dar-lhe todas as oportunidades e todo o apoio necessário para que possa desenvolver as suas faculdades cognitivas e sociais até ao máximo que lhe for possível. Proponho, neste trabalho, a apresentação ao leitor de um conhecimento mais profundo sobre a perceção dos Educadores de Infância, Professores do 1º Ciclo e Educação especial e em qualquer situação profissional em relação às dificuldades no ensino de crianças portadoras de Trissomia 21. Considero que este conhecimento é de extrema importância para professores e educadores, pois assim, poderão ter uma perceção das dificuldades que sentem no ensino destas crianças, quais os obstáculos existentes, os aspetos considerados facilitadores no ensino destas crianças, refletir sobre a necessidade de formação adequada para trabalhar com estas crianças e que estratégias são utilizadas com maior frequência no ensino destas crianças de forma a estimular adequadamente a criança e proporcionar um desenvolvimento adequado. O trabalho está estruturado em duas partes. Na primeira, através de uma revisão de literatura, são abordados assuntos relacionados com a Educação Especial, a Escola e a Educação Inclusiva, a Diferenciação Pedagógica, a Trissomia 21 e a intervenção educativa. A segunda parte cinge-se ao estudo empírico, o qual se desenvolve no âmbito de um modelo quantitativo de investigação, seguindo um plano não-experimental e descritivo. Conta com a amostra de 51 docentes. Alguns já trabalharam e trabalham com crianças portadoras de Trissomia 21, outros nunca trabalharam. A metodologia utilizada privilegiou a aplicação de um questionário para a recolha de dados. Perante a análise da informação recolhida constatou-se que, os docentes inquiridos têm a noção que o ensino deve ser adaptado a estas crianças e das estratégias que devem utilizar na intervenção em contexto escolar. A falta de apoio aos docentes, a falta de formação docente, a falta de equipamento/materialadequado ao desenvolvimento e ao ensino de qualidade destas crianças e a pouca colaboração de alguns encarregados de educação contribuem para o sentimento de insegurança no ensino das crianças portadoras de Trissomia 21.

Estudo tipológico e conceptual de uma creche e jardim de infância para o Bairro da Cova da Moura

Esta Tese tem como objectivo, contribuir para a construção de uma Creche e Jardim de Infância num bairro social de modo a minimizar a realidade actual, bem como a problemática nos "Bairros Sociais". Este estudo incidiu sobre o Bairro da Cova da Moura, situado no concelho da Amadora, sendo considerado um dos mais perigosos da cidade de Lisboa. O Trabalho iniciou-se com uma análise á origem do Bairro da Cova da Moura, ao seu desenvolvimento e, posteriormente aos seus habitantes a fim de, compreender as suas características e vivências. Na sequência deste trabalho, verificou-se a existência de inúmeras carências afectas ao bairro e à sua população, constatando-se que são nas camadas mais jovens, nomeadamente da infância à adolescência que incidem a maioria destas adversidades. Neste contexto, a proposta de trabalho será a concepção do Projecto de uma Creche e Jardim de Infância, apelando a uma educação mais eficaz e proveitosa, proporcionada em condições de conforto arquitectónico, tendo em conta a zona onde se insere e a população que servirá, tentando interligar o bairro e a convivência dos seus habitantes com as populações periféricas. Mediante a análise destes espaços serão mostradas algumas apreciações feitas para a concepção deste tipo de Equipamento, bem como de alguns conceitos e renovações nos mesmos referentes a questões antropológicas, ergonómicas, tipológicas, funcionais e de alguns problemas e dificuldades associados.

Predicting microbial pollution concentrations in UK rivers in response to land use change

The Water Framework Directive has caused a paradigm shift towards the integrated management of recreational water quality through the development of drainage basin-wide programmes of measures. This has increased the need for a cost-effective diagnostic tool capable of accurately predicting riverine faecal indicator organism (FIO) concentrations. This paper outlines the application of models developed to fulfil this need, which represent the first transferrable generic FIO models to be developed for the UK to incorporate direct measures of key FIO sources (namely human and livestock population data) as predictor variables. We apply a recently developed transfer methodology, which enables the quantification of geometric mean presumptive faecal coliforms and presumptive intestinal enterococci concentrations for base- and high-flow during the summer bathing season in unmonitored UK watercourses, to predict FIO concentrations in the Humber river basin district. Because the FIO models incorporate explanatory variables which allow the effects of policy measures which influence livestock stocking rates to be assessed, we carry out empirical analysis of the differential effects of seven land use management and policy instruments (fiscal constraint, production constraint, cost intervention, area intervention, demand-side constraint, input constraint, and micro-level land use management) all of which can be used to reduce riverine FIO concentrations. This research provides insights into FIO source apportionment, explores a selection of pollution remediation strategies and the spatial differentiation of land use policies which could be implemented to deliver river quality improvements. All of the policy tools we model reduce FIO concentrations in rivers but our research suggests that the installation of streamside fencing in intensive milk producing areas may be the single most effective land management strategy to reduce riverine microbial pollution.

Ballet

This solo exhibition featured Ballet, a filmed performance and video installation by Szuper Gallery and an installation of original archive films. Ballet engages with recent histories of rural filmmaking, with movement and dance, linking everyday farming movements with the aesthetics of dance. The starting point for this new work was a series of archival films from the MERL collection, which were made for British farmers as a means both for information and for propaganda, to provide warnings of contagion and nuclear catastrophe, describing procedure and instruction in the case of emergency. Gestural performances and movements of background actors observed in those films were re-scripted into a new choreography of movement for camera to form a playful assemblage.

Low cost brain-computer interface: first results

Brain-Computer Interfacing (BCI) has been previously demonstrated to restore patient communication, meeting with varying degrees of success. Due to the nature of the equipment traditionally used in BCI experimentation (the electroencephalograph) it is mostly conned to clinical and research environments. The required medical safety standards, subsequent cost of equipment and its application/training times are all issues that need to be resolved if BCIs are to be taken out of the lab/clinic and delivered to the home market. The results in this paper demonstrate a system developed with a low cost medical grade EEG amplier unit in conjunction with the open source BCI2000 software suite thus constructing the cheapest per electrode system available, meeting rigorous clinical safety standards. Discussion of the future of this technology and future work concerning this platform are also introduced.

Bridging the Faraoni and Selli oceanic anoxic events: late Hauterivian to early Aptian dysaerobic to anaerobic phases in the Tethys.

A detailed geochemical analysis was performed on the upper part of the Maiolica Formation in the Breggia (southern Switzerland) and Capriolo sections (northern Italy). The analysed sediments consist of well-bedded, partly siliceous, pelagic carbonate, which lodges numerous thin, dark and organic-rich layers. Stable-isotope, phosphorus, organic-carbon and a suite of redox-sensitive trace-element contents (RSTE: Mo, U, Co, V and As) were measured. The RSTE pattern and Corg:Ptot ratios indicate that most organic-rich layers were deposited under dysaerobic rather than anaerobic conditions and that latter conditions were likely restricted to short intervals in the latest Hauterivian, the early Barremian and the pre-Selli early Aptian. Correlations are both possible with organic-rich intervals in central Italy (the Gorgo a Cerbara section) and the Boreal Lower Saxony Basin, as well as with the facies and drowning pattern in the Helvetic segment of the northern Tethyan carbonate platform. Our data and correlations suggest that the latest Hauterivian witnessed the progressive installation of dysaerobic conditions in the Tethys, which went along with the onset in sediment condensation, phosphogenesis and platform drowning on the northern Tethyan margin, and which culminated in the Faraoni anoxic episode. This episode is followed by further episodes of dysaerobic conditions in the Tethys and the Lower Saxony Basin, which became more frequent and progressively stronger in the late early Barremian. Platform drowning persisted and did not halt before the latest early Barremian. The late Barremian witnessed diminishing frequencies and intensities in dysaerobic conditions, which went along with the progressive installation of the Urgonian carbonate platform. Near the Barremian-Aptian boundary, the increasing density in dysaerobic episodes in the Tethyan and Lower Saxony Basins is paralleled by a change towards heterozoan carbonate production on the northern Tethyan shelf. The following return to more oxygenated conditions is correlated with the second phase of Urgonian platform growth and the period immediately preceding and corresponding to the Selli anoxic episode is characterised by renewed platform drowning and the change to heterozoan carbonate production. Changes towards more humid climate conditions were the likely cause for the repetitive installation of dys- to anaerobic conditions in the Tethyan and Boreal basins and the accompanying changes in the evolution of the carbonate platform towards heterozoan carbonate-producing ecosystems and platform drowning.

File Transfer Protocol

The discourse surrounding the virtual has moved away from the utopian thinking accompanying the rise of the Internet in the 1990s. The Cyber-gurus of the last decades promised a technotopia removed from materiality and the confines of the flesh and the built environment, a liberation from old institutions and power structures. But since then, the virtual has grown into a distinct yet related sphere of cultural and political production that both parallels and occasionally flows over into the old world of material objects. The strict dichotomy of matter and digital purity has been replaced more recently with a more complex model where both the world of stuff and the world of knowledge support, resist and at the same time contain each other. Online social networks amplify and extend existing ones; other cultural interfaces like youtube have not replaced the communal experience of watching moving images in a semi-public space (the cinema) or the semi-private space (the family living room). Rather the experience of viewing is very much about sharing and communicating, offering interpretations and comments. Many of the web’s strongest entities (Amazon, eBay, Gumtree etc.) sit exactly at this juncture of applying tools taken from the knowledge management industry to organize the chaos of the material world along (post-)Fordist rationality. Since the early 1990s there have been many artistic and curatorial attempts to use the Internet as a platform of producing and exhibiting art, but a lot of these were reluctant to let go of the fantasy of digital freedom. Storage Room collapses the binary opposition of real and virtual space by using online data storage as a conduit for IRL art production. The artworks here will not be available for viewing online in a 'screen' environment but only as part of a downloadable package with the intention that the exhibition could be displayed (in a physical space) by any interested party and realised as ambitiously or minimally as the downloader wishes, based on their means. The artists will therefore also supply a set of instructions for the physical installation of the work alongside the digital files. In response to this curatorial initiative, File Transfer Protocol invites seven UK based artists to produce digital art for a physical environment, addressing the intersection between the virtual and the material. The files range from sound, video, digital prints and net art, blueprints for an action to take place, something to be made, a conceptual text piece, etc. About the works and artists: Polly Fibre is the pseudonym of London-based artist Christine Ellison. Ellison creates live music using domestic devices such as sewing machines, irons and slide projectors. Her costumes and stage sets propose a physical manifestation of the virtual space that is created inside software like Photoshop. For this exhibition, Polly Fibre invites the audience to create a musical composition using a pair of amplified scissors and a turntable. http://www.pollyfibre.com John Russell, a founding member of 1990s art group Bank, is an artist, curator and writer who explores in his work the contemporary political conditions of the work of art. In his digital print, Russell collages together visual representations of abstract philosophical ideas and transforms them into a post apocalyptic landscape that is complex and banal at the same time. www.john-russell.org The work of Bristol based artist Jem Nobel opens up a dialogue between the contemporary and the legacy of 20th century conceptual art around questions of collectivism and participation, authorship and individualism. His print SPACE concretizes the representation of the most common piece of Unicode: the vacant space between words. In this way, the gap itself turns from invisible cipher to sign. www.jemnoble.com Annabel Frearson is rewriting Mary Shelley's Frankenstein using all and only the words from the original text. Frankenstein 2, or the Monster of Main Stream, is read in parts by different performers, embodying the psychotic character of the protagonist, a mongrel hybrid of used language. www.annabelfrearson.com Darren Banks uses fragments of effect laden Holywood films to create an impossible space. The fictitious parts don't add up to a convincing material reality, leaving the viewer with a failed amalgamation of simulations of sophisticated technologies. www.darrenbanks.co.uk FIELDCLUB is collaboration between artist Paul Chaney and researcher Kenna Hernly. Chaney and Hernly developed together a project that critically examines various proposals for the management of sustainable ecological systems. Their FIELDMACHINE invites the public to design an ideal agricultural field. By playing with different types of crops that are found in the south west of England, it is possible for the user, for example, to create a balanced, but protein poor, diet or to simply decide to 'get rid' of half the population. The meeting point of the Platonic field and it physical consequences, generates a geometric abstraction that investigates the relationship between modernist utopianism and contemporary actuality. www.fieldclub.co.uk Pil and Galia Kollectiv, who have also curated the exhibition are London-based artists and run the xero, kline & coma gallery. Here they present a dialogue between two computers. The conversation opens with a simple text book problem in business studies. But gradually the language, mimicking the application of game theory in the business sector, becomes more abstract. The two interlocutors become adversaries trapped forever in a competition without winners. www.kollectiv.co.uk

How do green roofs mitigate urban thermal stress under heat waves?

As the climate warms, heat waves (HW) are projected to be more intense and to last longer, with serious implications for public health. Urban residents face higher health risks because urban heat islands (UHIs) exacerbate HW conditions. One strategy to mitigate negative impacts of urban thermal stress is the installation of green roofs (GRs) given their evaporative cooling effect. However, the effectiveness of GRs and the mechanisms by which they have an effect at the scale of entire cities are still largely unknown. The Greater Beijing Region (GBR) is modeled for a HW scenario with the Weather Research and Forecasting (WRF) model coupled with a state-of-the-art urban canopy model (PUCM) to examine the effectiveness of GRs. The results suggest GR would decrease near-surface air temperature (ΔT2max = 2.5 K) and wind speed (ΔUV10max = 1.0 m s-1) but increase atmospheric humidity (ΔQ2max = 1.3 g kg-1). GRs are simulated to lessen the overall thermal stress as indicated by apparent temperature (ΔAT2max = 1.7 °C). The modifications by GRs scale almost linearly with the fraction of the surface they cover. Investigation of the surface-atmosphere interactions indicate that GRs with plentiful soil moisture dissipate more of the surface energy as latent heat flux and subsequently inhibit the development of the daytime planetary boundary layer (PBL). This causes the atmospheric heating through entrainment at the PBL top to be decreased. Additionally, urban GRs modify regional circulation regimes leading to decreased advective heating under HW.

Diagnostic reference levels for the most frequent radiological examinations carried out in Brazil

Objectives. A large-scale survey of doses to patients undergoing the most frequent radiological examinations was carried out in health services in Sao Paulo (347 radiological examinations per 1 000 inhabitants), the most populous Brazilian state. Methods. A postal dosimetric kit with thermoluminescence dosimeters was used to evaluate the entrance surface dose (ESD) to patients. A stratified sampling technique applied to the national health database furnished important data on the distribution of equipment and the annual number of examinations. Chest, head (skull and sinus), and spine (cervical, thoracic, and lumbar) examinations were included in the trial. A total of 83 rooms and 868 patients were included, and 1 415 values of ESD were measured. Results. The data show large coefficients of variation in tube charge, giving rise to large variations in ESD values. Also, a series of high ESD values associated with unnecessary localizing fluoroscopy were detected. Diagnostic reference levels were determined, based on the 75th percentile (third quartile) of the ESD distributions. For adult patients, the diagnostic reference levels achieved are very similar to those obtained in international surveys. However, the situation is different for pediatric patients: the ESD values found in this survey are twice as large as the international recommendations for chest radiographs of children. Conclusions. Despite the reduced number of ESD values and rooms for the pediatric patient group, it is recommended that practices in chest examinations be revised and that specific national reference doses and image quality be established after a broader survey is carried out.

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

New York Trade School Graduates David J. Stevens and Ernest Fitzgerald

David J. Stevens and Ernest Fitzgerald were 1948 graduates of the Plumbing Department at the New York Trade School and are pictured with a truck from their successful D.H. Stevens Company in Washington, DC. Original caption reads, "David J. Stevens - Plumbing 1948, is shown here with Ernest Fitzgerald - Plumbing 1948, with two of their thirteen pieces of equipment necessary to satisfy 650 calls per month. David Stevens is the third generation to have graduated from Plumbing." Black and white photograph with caption adhered to reverse.

Flood Risk Management In Small Urban River Using A Sustainable Urban Drainage System: Wortley Beck, Leeds, Uk

In the UK, urban river basins are particularly vulnerable to flash floods due to short and intense rainfall. This paper presents potential flood resilience approaches for the highly urbanised Wortley Beck river basin, south west of the Leeds city centre. The reach of Wortley Beck is approximately 6km long with contributing catchment area of 30km2 that drain into the River Aire. Lower Wortley has experienced regular flooding over the last few years from a range of sources, including Wortley Beck and surface and ground water, that affects properties both upstream and downstream of Farnley Lake as well as Wortley Ring Road. This has serious implications for society, the environment and economy activity in the City of Leeds. The first stage of the study involves systematically incorporating Wortley Beck’s land scape features on an Arc-GIS platform to identify existing green features in the region. This process also enables the exploration of potential blue green features: green spaces, green roofs, water retention ponds and swales at appropriate locations and connect them with existing green corridors to maximize their productivity. The next stage is involved in developing a detailed 2D urban flood inundation model for the Wortley Beck region using the CityCat model. CityCat is capable to model the effects of permeable/impermeable ground surfaces and buildings/roofs to generate flood depth and velocity maps at 1m caused by design storm events. The final stage of the study is involved in simulation of range of rainfall and flood event scenarios through CityCat model with different blue green features. Installation of other hard engineering individual property protection measures through water butts and flood walls are also incorporated in the CityCat model. This enables an integrated sustainable flood resilience strategy for this region.

Proposta de uma sistemática de avaliação de investimentos utilizando o método ABC (activity-based costing)

As técnicas tradicionais de avaliação de rentabilidade apresentam características que resultam eficazes no que tange aos aspectos econômicos da análise de investimentos. No entanto, a validade das informações fornecidas por estes métodos depende dos dados incluídos na avaliação. Neste sentido, em função da complexidade e do inter-relacionamento existente nos processos produtivos de empresas, as alterações proporcionadas por um investimento podem ter impacto sobre áreas que não estão diretamente envolvidas com o projeto a ser implementado. Este fato dificulta a identificação e conseqüente inclusão da totalidade dos fatores que causam impacto na análise do projeto. Além disso, impactos relacionados a atividades indiretas não possuem uma metodologia que permita sua quantificação. Como forma de abordar o problema, este trabalho apresenta uma sistemática de avaliação de investimentos que, através de uma seqüência estruturada de passos e com a utilização das informações geradas por um sistema de custeio do tipo ABC (Activity-Based Costing), possibilita incluir na análise impactos indiretos gerados pelo projeto. A aplicação desta sistemática em um projeto de substituição de equipamento numa empresa do ramo industrial mostra que as informações geradas complementam aquelas obtidas quando da aplicação das técnicas tradicionais. Desta forma, foi possível avaliar o impacto econômico provocado por possíveis alterações nos setores não diretamente ligados ao projeto.

Uma avaliação ex-ante do impacto sobre a capacidade tecnológica da localidade acolhedora das empresas que aderiram ao regime automotivo brasileiro e os seus desdobramentos estaduais : o caso da instalação da General Motors do Brasil em Gravataí, Rio Grande do Sul

Esta tese discute três temas: políticas públicas, gestão tecnológica, e setor automotivo. Tendo por objetivo abreviar o ciclo de absorção e desenvolvimento de tecnologia, um volume expressivo de recursos tem sido transferido do setor público para o setor privado através do que é denominado de Política Pública Indutora (PPI). Os governos pretendem, assim, atrair aquelas empresas tecnologicamente mais capacitadas, na expectativa de que transfiram para a localidade onde se instalam o conhecimento que detêm. No Brasil, um dos setores-alvo deste tipo de política tem sido o automotivo, circunstância observada em diferentes momentos da história. Efetivamente, o Regime Automotivo Brasileiro pretende não apenas acelerar o desenvolvimento do país, mas também promover uma significativa transferência de tecnologia. A análise das PPI, por ser de extrema importância, é bastante influenciada e dificultada quer por seus defensores, quer por seus destratores, que as veêm sob os aspectos de sucesso ou não; mas, não bastasse essa dificuldade, há também o elevado conteúdo ideológico que sustenta as argumentações, que faz com que a avaliação se perca num quadro inconclusivo. Afinal, estas iniciativas são benéficas ou não para o país e para as economias regionais? Finalmente, a eficácia, e portanto o acerto desta estratégia só pode ser avaliado expost facto, quando já comprometidos, quiçá irremediavelmente, os recursos públicos. Por essa razão, este estudo desenvolve uma análise ex-ante das políticas públicas do tipo indutoras, fazendo uso de um modelo compreensivo que permite uma análise longitudinal, captando assim, as mudanças no ambiente. Entre outras, procurou-se responder à seguinte questão: é possível, hoje, inferir quanto à contrib uição, se positiva ou negativa, que o Regime Automotivo Brasileiro e os seus desdobramentos estaduais trarão à capacidade tecnológica no entorno da empresa atraída? O problema e a questão de pesquisa foram abordados, predominantemente, sob um enfoque qualitativo, e o método escolhido foi o estudo de caso. Com o auxílio do modelo proposto foi analisada e avaliada a potencialidade de aumento na capacidade tecnológica induzida pela instalação da unidade montadora da General Motors do Brasil, em Gravataí, Rio Grande do Sul. Ao final conclui- se que os benefícios previstos pelo Regime Automotivo Brasileiro, no que diz respeito a capacitação tecnológica local, dificilmente serão atingidos pela instalação de novas empresas automotivas ou a modernização das existentes.